Consistencies of 3D TTE global longitudinal strain of both ventricles between assessors were worse for 2D, but better for 3D ventricular EF

• Consistencies of independent TTE estimates between 2 assessors of 3D LV GLS were good as well as 2D LV GLS and 3D LV volume.
• Those of 3D RV GLS were worse than those of 2D RV GLS, 3D RV EDV and 3D RV ESV in a population containing 74% HCM patients.
• The consistencies of independent TTE estimates between the two assessors of 3D LV EF and 3D RV EF were both very poor.
• It may be difficult to evaluate cardiac function accurately from 3D measurements on 3D TTE because of operator dependence.
• Thus, 2D and 3D GLS for LV and 2D GLS for RV, especially whole RV, may be preferable.

PurposeWe evaluated the consistency of different-assessors in estimating three-dimensional (3D) global-longitudinal-strain (GLS) of left (LV) and right ventricle (RV) using transthoracic-echocardiography (TTE) for LV and RV systolic-function. We compared results from two-independent-specialists using this-approach for 3D LV and RV parameters in a population with 74% hypertrophic-cardiomyopathy (HCM) patients.Methods58 patients (43 HCM (32 male; 62 ± 15 years) and 15 controls (5 male; 53 ± 22 years)) underwent TTE (Vivid-E9) to measure 2D and 3D GLS of the LV and RV by two-independent-specialists.ResultsConsistencies of estimates of 3D LV end-diastolic volume (EDV), end-systolic volume (ESV), and ejection-fraction (EF) between the two-assessors were 0.872 (3D LVEDV, P < 0.001), 0.797 (3D LVESV, P < 0.001), and 0.215 (3D LVEF, P = 0.105). Consistencies of 2D and 3D LV GLS between two-assessors were 0.900 (2D LVGLS, P < 0.001) and 0.874 (3D LVGLS, P < 0.001). Consistencies of estimates of 3D RVEDV, RVESV, and RVEF between two assessors were 0.781 (3D RVEDV, P < 0.001), 0.755 (3D RVESV, P < 0.001), and 0.26 (3D RVEF, P = 0.049). Consistencies of 2D and 3D GLS of whole RV and those of RV free wall only between two-assessors were 0.886 (2D GLS of whole RV, P < 0.001), 0.687 (3D GLS of whole RV, P < 0.001), 0.707 (2D GLS of RV free wall, P < 0.001), and 0.630 (3D GLS of RV free wall, P < 0.001).ConclusionsConsistencies of independent-estimates of 3D GLS of the LV and RV using TTE between two-assessors were worse than for 2D GLS of the LV and RV, but better than for 3D LVEF and RVEF in a population with 74% HCM patients.