Moderated Posters session * The emerging role of 2-dimensional strain in clinical practice: 13/12/2013, 14:00-18:00 * Location: Moderated Poster area

Purpose: Intervendor differences of 2D/3D strain measurements are well known issues that significantly limit their adoption in clinical routine. Whether a similar discordance affects also the quantitation of left ventricular (LV) geometry and function and the LV normative ranges for different 3D echo softwares has not been investigated. Methods: Full-volume LV 3D data sets (35±6 vps) have been acquired in 235 healthy volunteers (44±14 years, range 18–76 years, 104 men) using a GE Vivid E9 scanner. Exclusion criteria were athletic training, pregnancy, body mass index > 30 kg/m2, and poor apical acoustic window. An experienced researcher analyzed all LV data sets using a vendor-specific software (EchoPac BT12, GE Healthcare, N). Three months later, the same researcher repeated the analysis with a vendor-independent DICOM-based software (4D LV Analysis 3.1, TomTec, D), being blinded from previous measurements. Results: Despite the differences in LV parameters obtained with the two softwares were statistically significant (Table), Bland-Altman analysis shows a clinically irrelevant bias and reasonable limits of agreement for LV volumes and EF. LV mass measurements by EchoPac were slightly larger than those by TomTec and had relatively wider limits of agreement than LV volumes. Both softwares showed significant and consistent relationships of LV 3D parameters with age, gender and body size in healthy subjects (p<0.0001 for all relationships). Conclusion: Our data shows that converting 3D data sets in DICOM format does not significantly affect the normative values for LV volumes and ejection fraction with respect to those provided by proprietary software. The availability of vendor-independent softwares and respective normative values will encourage the adoption of 3D echocardiography for routine LV quantitation in multi-vendor echo labs.<cross-ref type="tbl" refid="CHAPTERsub51158TB1"></cross-ref> <tbl id="CHAPTERsub51158TB1" loc="float"><tblbdy top-stubs="1"><r><c cspan="1" rspan="1"></c><c cspan="1" rspan="1">Vendor-specific software</c><c cspan="1" rspan="1">Vendor-independent software</c><c cspan="1" rspan="1">p</c><c cspan="1" rspan="1">Bias</c><c cspan="1" rspan="1">Limits of agreement</c></r><r><c cspan="1" rspan="1">End-diastolic volume (ml)</c><c cspan="1" rspan="1">108±26</c><c cspan="1" rspan="1">106±25</c><c cspan="1" rspan="1">0.002</c><c cspan="1" rspan="1">2</c><c cspan="1" rspan="1">-17 to +21</c></r><r><c cspan="1" rspan="1">End-systolic volume (ml)</c><c cspan="1" rspan="1">40±11</c><c cspan="1" rspan="1">39±11</c><c cspan="1" rspan="1">0.516</c><c cspan="1" rspan="1">0.2</c><c cspan="1" rspan="1">-8 to +9</c></r><r><c cspan="1" rspan="1">Stroke-volume (ml)</c><c cspan="1" rspan="1">68±16</c><c cspan="1" rspan="1">66±15</c><c cspan="1" rspan="1"><0.001</c><c cspan="1" rspan="1">2</c><c cspan="1" rspan="1">-13 to +17</c></r><r><c cspan="1" rspan="1">Ejection fraction (%)</c><c cspan="1" rspan="1">64±4</c><c cspan="1" rspan="1">63±4</c><c cspan="1" rspan="1">0.007</c><c cspan="1" rspan="1">1</c><c cspan="1" rspan="1">-6 to +7</c></r><r><c cspan="1" rspan="1">Mass (g)</c><c cspan="1" rspan="1">133±22</c><c cspan="1" rspan="1">124±28</c><c cspan="1" rspan="1"><0.001</c><c cspan="1" rspan="1">9</c><c cspan="1" rspan="1">-24 to +43</c></r></tblbdy></tbl>