Turk Kardiyol Dern Ars. 2012; 40(5): 419-426 | DOI: 10.5505/tkda.2012.65928

Assessment of left ventricular volume and functions by real-time three-dimensional echocardiography in patients with compensated and decompensated heart failure

Erdal Aktürk¹, Ertuğrul Kurtoğlu², Necip Ermiş³, Jülide Yağmur³, Nusret Açıkgöz³, Yasin Karakuş³, Hasan Pekdemir³, Ramazan Özdemir^3
1Adiyaman University School of Medicine, Department of Cardiology, Adiyaman, Turkey
²Elazığ Education And Research Hospital, Department Of Cardiology, Elazıg, Turkey
³Inonu University, Faculty Of Medicine, Department Of Cardiology, Malatya, Turkey.

OBJECTIVES
The aim of the study was to evaluate congestive heart failure (HF) patients with real-time three-dimensional echocardiography (3DE) to investigate why some of them present with acute decompensation despite having two-dimensional echocardiographic (2DE) parameters with compensated HF patients.

STUDY DESIGN
The study population consisted of 36 patients with decompensated HF (24 males, 12 females; mean age 65.8±10.4 years) and 30 patients with compensated HF (21 males, 9 females; mean age 63.2±11.5 years).The levels of pro-brain natriuretic peptide (pro-BNP), serum electrolytes, renal function tests and complete blood counts were determined. All patients underwent 2DE and 3DE evaluations.

RESULTS
Heart rate and blood urea nitrogen levels were higher in patients with decompensated HF than those with compensated HF (95.8±21.4 vs. 81.2±14.9, p=0.002; 28.3±15.7 mg/dl vs. 18±6.8 mg/dl, p=0.001, respectively). Pro-BNP levels and NYHA class were significantly higher in patients with decompensated heart failure [4925 pg/ml (2199-8711) vs. 330 pg/ml (197-756), p<0.0001 and 2.3±0.6 vs. 1.2±0.4, p<0.0001, respectively]. Although 2DE parameters were similar between groups, left ventricular ejection fraction was lower in patients with decompensated HF while end-diastolic and end-systolic volumes by 3DE were significantly higher in the same group (26.3±3.8% vs. 30.3±4.0%; 205.6±55.5 ml vs. 145.0±33.7 ml; 178.4±55.6 ml vs. 115.7±32.5 ml, all p<0.0001, respectively). However, systolic volume was higher in patients with compensated HF (52.0±15.5 ml vs. 62±12 ml, p=0.005).

CONCLUSION
We think that 3DE provides more reliable information about left ventricular volume and functions in the evaluation of patients with HF.

Keywords: Echocardiography, three-dimensional /methods, heart ventricles; heart failure; magnetic resonance imaging; ventricular function, left/physiology

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