Mohamed Elnwagy

Ministry of Health Saudi Arabia

Title: Left Ventricular Ejection Fraction: A Comparative Analysis of Simpson Method and Three-Dimensional Heart Model

---

Biography

Abstract

Assessment of the left ventricular (LV) systolic function is fundamental for the diagnosis and prognosis of most cardiac diseases. Transthoracic echocardiography is the most widely used tool . Current guideline recommends that LV systolic function should be routinely assessed using 2D or 3D Echocardiography (3DE) by calculating ejection fraction (EF%) from end-systolic and end-diastolic volumes. The biplane method of disks (modified Simpson's rule) is the currently recommended 2D method to assess LVEF%. However, this method is time-consuming, and the accuracy is dependent on the quality of LV image acquisition that requires visualization of the endocardial border of the entire LV cavity and avoid foreshortening of the LV. By using artificial intelligence (AI), the automated 3D measurement of LV volume and EF is more feasible, reproducible and rapid. To date, there is no enough data about this subject in our region. Hence our aim is to correlate the efficacy and feasibility of automated 3D ejection fraction to 2D Simpson methods in evaluation of the left ventricular ejection fraction in our cardiac centre.

Methods: A total of 122 consecutive patients referred for routine echocardiography were included in the study. Two-dimensional echocardiography was performed by experienced echocardiographers using a commercially available Philips EPIQ machine equipped with X5-1 Matrix probe for 2DE and DHM 3DE acquisitions, respectively.

Results: 2D modified Simpson methods echocardiography results for estimated LVEF were 52.44 ± 18 %. Using 3D Heart Model, LVEF were 51.30 ± 19 %. 72 out of 122 of LVEF values estimated by modified Simpson methods were correlated with LVEF values estimated by 3D Heart Model (which accounts for 59% of cases). 2DE measurement of LV volumes and EF was completed in 8 ± 2 min. per patient. 3DE Heart Model A.I acquisition and analysis in most patients was completed in 5 min. ± 2 min. Bland Alman plot (see figure A) showed on average the LVEF estimated by modified Simpson methods measures 1.139 units more than the LVEF estimated by 3D Heart Model. This level of agreement well manifested in LVEF higher than 40%.

Conclusion: 3D Heart Model provides fast and accurate LV volumes and LVEF quantitation, as it avoids geometric assumptions and left ventricular foreshortening.