Feasibility of One-Beat Real-Time Full-Volume Three-Dimensional Echocardiography for Assessing Left Ventricular Volumes and Deformation Parameters

Background: Real-time three-dimensional echocardiographic (3DE) imaging usually requires multibeat acquisition to maintain high temporal and spatial resolution for full-volume data sets. However, this procedure generates stitch artifacts in patients with irregular heartbeats; thus, one-beat acquisition might be useful. The aim of this study was to compare the efficacy of using new-generation one-beat full-volume acquisition for measuring left ventricular (LV) mechanical parameters with that of four-beat acquisition.

Methods: In protocol 1, 34 patients who had undergone both cardiac magnetic resonance and 3DE imaging on the same day were prospectively enrolled. In protocol 2, 115 patients in sinus rhythm who had undergone 3DE examinations were retrospectively enrolled. LV volume, ejection faction, and global strain were measured using one-beat and four-beat 3DE data sets. In protocol 3, 26 patients with atrial fibrillation who had acquisition of consecutive one-beat full-volume data sets were retrospectively enrolled, and it was determined whether the LV parameters in the index beat were correlated with corresponding average values obtained from multiple one-beat acquisitions.

Results: In protocol 1, the correlations between LV volumes and LV ejection fraction between cardiac magnetic resonance and 3DE imaging with one-beat acquisition were excellent (r = 0.91-0.93). In protocol 2, correlations were also excellent (r = 0.94-0.99), and there were no significant differences in volume rate, LV volumes, LV ejection fraction, and global strain parameters between one-beat and four-beat acquisition data sets. In protocol 3, correlations were excellent (r = 0.94-0.99) between LV parameters from the index beat and corresponding average values.

Conclusions: Three-dimensional echocardiographic full-volume data sets with one-beat acquisition not only maintained volume rate but also provided LV mechanical parameter values similar to those obtained using multibeat acquisition. Using one-beat acquisition for patients with atrial fibrillation expands its clinical applicability.