Three-dimensional echocardiography should be routinely performed alongside clinically indicated 2D echocardiography, a study suggests

"Three-dimensional echocardiography (3DE) should be routinely performed alongside clinically indicated 2D echocardiography (2DE), a study suggests [1].

Earlier studies have shown that 3DE allows more accurate assessment of left ventricular volumes and ejection fraction.

Now, researchers show that it would be viable to use 3DE alongside 2DE in routine practice, and that this addition could significantly impact on clinical decision-making.

They looked at both 2D and 3D data for 220 patients attending hospital-based echocardiography laboratories in Japan, Australia and Hong Kong. Clinical indications cited included ischemic heart disease, valvular heart disease, congestive heart failure, hypertension, pulmonary hypertension and arrhythmia.

The study group found that the total time taken for the combined 2D and 3D study was only slightly increased compared to 2D alone, by around five minutes.

They reported that the 3D study gave a mean absolute difference in ejection fraction (EF) of six per cent compared to 2DE. Twenty patients in the study group were re-allocated with 3DE according to the EF criterion of <40 per cent, and 14 according to the criterion of <35 per cent - equating to 9.1 and 6.4 per cent of the patient population, respectively.

The researchers noted that the impact on clinical decision-making appeared most substantial in the subgroup of patients with an EF of 25 to 50 per cent.

They concluded: "The addition of 3DE to routine clinically indicated 2D echocardiography is feasible, with limited costs in terms of time, and has the potential to significantly impact upon clinical decision-making.

"The results highlight the likelihood of reclassification of visual EF estimations at the critical EF levels where management decisions are made."


[1] Feasibility and clinical decision-making with 3D echocardiography in routine practice
Heart 2008;94:440-445"