Review of novel clinical applications of advanced, real-time, 3-dimensional echocardiography.

Advances in computer processing speed and memory along with the advent of the microbeam former that can sample an entire crystal of the ultrasound transducer made possible the performance of 3-dimensional echocardiography in real time (RT3DE). The miniaturization of a 3-dimensional transducer permitting its extension to transesophageal mode rapidly expanded its use in a variety of conditions. Recent development of user-friendly automated/semiautomated cropping and display software may make it rather simple, even for the novice to gather useful information from RT3DE. We discuss the background, technique, and cutting-edge research and novel clinical applications of advanced RT3DE, including left ventricular dyssynchrony assessment, 3-D speckle tracking, myocardial contrast echocardiography, complete 4-dimensional (4-D) shape and motion analysis of the left ventricle, 4-D volumetric analysis of the right ventricle, 3-D volume rendering of the mitral valve, and other percutaneous and surgical procedural applications.

[1]  Imran Syed,et al.  Real-time three-dimensional transesophageal echocardiography in the intraoperative assessment of mitral valve disease. , 2009, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[2]  L. Sugeng,et al.  Real-time 3-dimensional echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of sources of error. , 2008, JACC. Cardiovascular imaging.

[3]  M. Simon Right ventricular adaptation to pressure overload , 2010, Current opinion in critical care.

[4]  Hiroyuki Okura,et al.  Comprehensive evaluation of left ventricular strain using speckle tracking echocardiography in normal adults: comparison of three-dimensional and two-dimensional approaches. , 2009, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[5]  G. Pedrazzini,et al.  Complications of percutaneous edge-to-edge mitral valve repair: the role of real-time three-dimensional transesophageal echocardiography. , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[6]  N. Pandian,et al.  Quantitation of Right Ventricular Volumes and Ejection Fraction by Three‐Dimensional Echocardiography in Patients: Comparison with Magnetic Resonance Imaging and Radionuclide Ventriculography , 2006, Echocardiography.

[7]  T. Marwick,et al.  Reproducibility and accuracy of echocardiographic measurements of left ventricular parameters using real-time three-dimensional echocardiography. , 2004, Journal of the American College of Cardiology.

[8]  L. Fusini,et al.  Feasibility of intraoperative three-dimensional transesophageal echocardiography in the evaluation of right ventricular volumes and function in patients undergoing cardiac surgery. , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[9]  Xubo B. Song,et al.  Defining left ventricular apex-to-base twist mechanics computed from high-resolution 3D echocardiography: validation against sonomicrometry. , 2010, JACC. Cardiovascular imaging.

[10]  V. Jeevanandam,et al.  Quantitative analysis of mitral valve apparatus in mitral valve prolapse before and after annuloplasty: a three-dimensional intraoperative transesophageal study. , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[11]  J. Zamorano,et al.  Real-time three-dimensional echocardiography for rheumatic mitral valve stenosis evaluation: an accurate and novel approach. , 2004, Journal of the American College of Cardiology.

[12]  J. Simpson,et al.  Three-dimensional echocardiography in congenital heart disease. , 2011, Archives of cardiovascular diseases.

[13]  E. Schwammenthal,et al.  Mechanism of ischemic mitral regurgitation with segmental left ventricular dysfunction: three-dimensional echocardiographic studies in models of acute and chronic progressive regurgitation. , 2001, Journal of the American College of Cardiology.

[14]  Hiromi Nakai,et al.  Pitfalls of anatomical aortic valve area measurements using two-dimensional transoesophageal echocardiography and the potential of three-dimensional transoesophageal echocardiography. , 2010, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[15]  A R Jayaweera,et al.  Quantification of myocardial blood flow with ultrasound-induced destruction of microbubbles administered as a constant venous infusion. , 1998, Circulation.

[16]  B. Paul,et al.  Thrombosis of a bileaflet prosthetic mitral valve: a real-time three-dimensional transesophageal echocardiography perspective , 2010, The International Journal of Cardiovascular Imaging.

[17]  James D. Thomas,et al.  3D echocardiography: a review of the current status and future directions. , 2007, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[18]  Wojciech Zareba,et al.  Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia: Proposed Modification of the Task Force Criteria , 2010, Circulation.

[19]  Michael Jerosch-Herold,et al.  Anatomically oriented right ventricular volume measurements with dynamic three-dimensional echocardiography validated by 3-Tesla magnetic resonance imaging. , 2007, Journal of the American College of Cardiology.

[20]  Andrew P. Miller,et al.  Real-time three-dimensional myocardial contrast echocardiography in assessment of myocardial perfusion defects. , 2004, Chinese medical journal.

[21]  Attila Nemes,et al.  Assessment of left atrial volume and function by real-time three-dimensional echocardiography. , 2008, International journal of cardiology.

[22]  S. Kaul,et al.  Relation between myocardial oxygen consumption and myocardial blood volume: a study using myocardial contrast echocardiography. , 2002, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[23]  Sanjiv J. Shah,et al.  Real-time three-dimensional transesophageal echocardiography of the left atrial appendage: initial experience in the clinical setting. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[24]  Angelo Auricchio,et al.  Anatomy of right atrial structures by real-time 3D transesophageal echocardiography. , 2010, JACC. Cardiovascular imaging.

[25]  G. Cerri,et al.  Left ventricular twist: comparison between two- and three-dimensional speckle-tracking echocardiography in healthy volunteers. , 2011, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[26]  R. Levine,et al.  Assessing mitral valve area and orifice geometry in calcific mitral stenosis: a new solution by real-time three-dimensional echocardiography. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[27]  Oben Baysan,et al.  Live/Real Time Three‐Dimensional Transthoracic Echocardiographic Assessment of Left Ventricular Volumes, Ejection Fraction, and Mass Compared with Magnetic Resonance Imaging , 2007, Echocardiography.

[28]  Jeroen J. Bax,et al.  Quantification of functional mitral regurgitation by real-time 3D echocardiography: comparison with 3D velocity-encoded cardiac magnetic resonance. , 2009, JACC. Cardiovascular imaging.

[29]  I. Kronzon,et al.  Imaging atrial septal defects by real-time three-dimensional transesophageal echocardiography: step-by-step approach. , 2010, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[30]  L. Weinert,et al.  Valvular heart disease. The value of 3-dimensional echocardiography. , 2011, Journal of the American College of Cardiology.

[31]  Masood Ahmad,et al.  Real-time three-dimensional dobutamine stress echocardiography in assessment of ischemia: comparison with two-dimensional dobutamine stress echocardiography , 2001 .

[32]  Yasuhiko Takemoto,et al.  Non-invasive assessment of myocardial ischaemia using new real-time three-dimensional dobutamine stress echocardiography: comparison with conventional two-dimensional methods. , 2005, European heart journal.

[33]  A. Bethencourt,et al.  Real-time three-dimensional transesophageal echocardiographic imaging of cor triatriatum and persistent left superior vena cava. , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[34]  Carolyn Apperson-Hansen,et al.  Annular geometry and motion in human ischemic mitral regurgitation: novel assessment with three-dimensional echocardiography and computer reconstruction. , 2004, The Annals of thoracic surgery.

[35]  Victor Mor-Avi,et al.  Feasibility of left ventricular shape analysis from transthoracic real-time 3-D echocardiographic images. , 2009, Ultrasound in medicine & biology.

[36]  Otto Kamp,et al.  Three-dimensional speckle tracking echocardiography for automatic assessment of global and regional left ventricular function based on area strain. , 2011, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[37]  N. Nanda,et al.  Usefulness of Live/Real Time Three‐Dimensional Transthoracic Echocardiography in Evaluation of Prosthetic Valve Function , 2009, Echocardiography.

[38]  T. Marwick,et al.  Measurement of left ventricular dyssynchrony in patients with ischaemic cardiomyopathy: a comparison of real-time three-dimensional and tissue Doppler echocardiography , 2007, Heart.

[39]  M. Strudwick,et al.  Reproducibility of right ventricular volumes and ejection fraction using real-time three-dimensional echocardiography: comparison with cardiac MRI. , 2007, Chest.

[40]  L. Badano,et al.  Right ventricle in pulmonary arterial hypertension: haemodynamics, structural changes, imaging, and proposal of a study protocol aimed to assess remodelling and treatment effects. , 2010, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[41]  S. Saba,et al.  Comparative mechanical activation mapping of RV pacing to LBBB by 2D and 3D speckle tracking and association with response to resynchronization therapy. , 2010, JACC. Cardiovascular imaging.

[42]  S. Kapetanakis,et al.  Real-time three-dimensional myocardial contrast echocardiography: is it clinically feasible? , 2008, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[43]  R. Kerber,et al.  Real-time 3D fusion echocardiography. , 2010, JACC. Cardiovascular imaging.

[44]  Michael Becker,et al.  Relation of optimal lead positioning as defined by three-dimensional echocardiography to long-term benefit of cardiac resynchronization. , 2007, The American journal of cardiology.

[45]  K. Gauvreau,et al.  Variables influencing the accuracy of right ventricular volume assessment by real-time 3-dimensional echocardiography: an in vitro validation study. , 2007, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[46]  Cardiac Axis-Oriented Full-Volume Data Acquisition in Real-Time Three-Dimensional Transesophageal Echocardiography to Facilitate On-Cart Analysis , 2011, Anesthesia and analgesia.

[47]  James D. Thomas,et al.  Quantification of myocardial segmental function in acute and chronic ischemic heart disease and implications for cardiovascular cell therapy trials: a review from the NHLBI-Cardiovascular Cell Therapy Research Network. , 2011, JACC. Cardiovascular imaging.

[48]  Xiaokui Li,et al.  Live real-time three-dimensional echocardiography for the visualization of myocardial perfusion--a pilot study in open-chest pigs. , 2005, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[49]  N. Nanda,et al.  Real Time Three‐Dimensional Transthoracic Echocardiography in Congenital Heart Disease , 2012, Echocardiography.

[50]  A. Cheng,et al.  Subvalvular Repair: The Key to Repairing Ischemic Mitral Regurgitation? , 2005, Circulation.

[51]  Tomoko Ishizu,et al.  Validation of 3-Dimensional Speckle Tracking Imaging to Quantify Regional Myocardial Deformation , 2009, Circulation. Cardiovascular imaging.

[52]  S. Fazel,et al.  Ultrasound-targeted gene delivery induces angiogenesis after a myocardial infarction in mice. , 2009, JACC. Cardiovascular imaging.

[53]  Shunichi Homma,et al.  Echocardiography-guided interventions. , 2009, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[54]  J. Noble,et al.  Multiview fusion 3-D echocardiography: improving the information and quality of real-time 3-D echocardiography. , 2011, Ultrasound in medicine & biology.

[55]  Jeroen J. Bax,et al.  Real-time three-dimensional echocardiography as a novel approach to assess left ventricular and left atrium reverse remodeling and to predict response to cardiac resynchronization therapy. , 2008, Heart rhythm.

[56]  David S. Hirsh,et al.  Real-time 3-dimensional transesophageal echocardiography in the evaluation of post-operative mitral annuloplasty ring and prosthetic valve dehiscence. , 2009, Journal of the American College of Cardiology.

[57]  Piero Zardini,et al.  Determinants and prognostic value of left atrial volume in patients with dilated cardiomyopathy. , 2002, Journal of the American College of Cardiology.

[58]  Non-invasive assessment of mitral valve area during percutaneous balloon mitral valvuloplasty: role of real-time 3D echocardiography. , 2004 .

[59]  M. Henein,et al.  Differential right ventricular regional function and the effect of pulmonary hypertension: three-dimensional echo study , 2011, Heart.

[60]  R. Levine,et al.  Reverse Ventricular Remodeling Reduces Ischemic Mitral Regurgitation: Echo-Guided Device Application in the Beating Heart , 2002, Circulation.

[61]  Manjula V. Burri,et al.  Live/Real Time Three‐Dimensional Transthoracic Echocardiographic Assessment of Tricuspid Valve Pathology: Incremental Value over the Two‐Dimensional Technique , 2007, Echocardiography.

[62]  Denisa Muraru,et al.  High volume-rate three-dimensional stress echocardiography to assess inducible myocardial ischemia: a feasibility study. , 2010, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[63]  C. Stefanadis,et al.  Value of real-time three-dimensional adenosine stress contrast echocardiography in patients with known or suspected coronary artery disease. , 2011, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[64]  X. Shu,et al.  Usefulness of real-time three-dimensional echocardiography to quantify global left ventricular function and mechanical dyssynchrony after heart transplantation , 2011 .

[65]  S. Kaul,et al.  Noninvasive Imaging of Myocardial Reperfusion Injury Using Leukocyte-Targeted Contrast Echocardiography , 2002, Circulation.

[66]  Raisa Z Freidlin,et al.  Quantitative assessment of left ventricular perfusion defects using real-time three-dimensional myocardial contrast echocardiography. , 2002, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[67]  Carlos Ruiz,et al.  Use of real time three-dimensional transesophageal echocardiography in intracardiac catheter based interventions. , 2009, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[68]  Jun Kwan,et al.  Geometric Differences of the Mitral Apparatus Between Ischemic and Dilated Cardiomyopathy With Significant Mitral Regurgitation: Real-Time Three-Dimensional Echocardiography Study , 2002, Circulation.

[69]  Richard D. White,et al.  The accuracy of left ventricular mass determined by real-time three-dimensional echocardiography in chronic animal and clinical studies: a comparison with postmortem examination and magnetic resonance imaging. , 2005, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[70]  V. Jeevanandam,et al.  Real-time three-dimensional transesophageal echocardiography in valve disease: comparison with surgical findings and evaluation of prosthetic valves. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[71]  N. Nanda,et al.  Effect of Alcohol‐Induced Septal Ablation on Left Atrial Volume and Ejection Fraction Assessed by Real Time Three‐Dimensional Transthoracic Echocardiography in Patients with Hypertrophic Cardiomyopathy , 2008, Echocardiography.

[72]  S. Schindera,et al.  Accuracy of Real‐time Three‐dimensional Echocardiography for Quantifying Right Ventricular Volume , 2002, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[73]  I Schnittger,et al.  Reproducibility of left ventricular volumes by two-dimensional echocardiography. , 1983, Journal of the American College of Cardiology.

[74]  Victor Mor-Avi,et al.  Fast Measurement of Left Ventricular Mass With Real-Time Three-Dimensional Echocardiography: Comparison With Magnetic Resonance Imaging , 2004, Circulation.

[75]  James B Seward,et al.  Left atrial size: physiologic determinants and clinical applications. , 2006, Journal of the American College of Cardiology.

[76]  M. Simoons,et al.  Rapid and accurate measurement of LV mass by biplane real-time 3D echocardiography in patients with concentric LV hypertrophy: comparison to CMR. , 2007, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[77]  S. Kapetanakis,et al.  Real-Time Three-Dimensional Echocardiography: A Novel Technique to Quantify Global Left Ventricular Mechanical Dyssynchrony , 2005, Circulation.

[78]  F. Carreras,et al.  Mechanical left ventricular dyssynchrony detection by endocardium displacement analysis with 3D speckle tracking technology , 2010, The International Journal of Cardiovascular Imaging.

[79]  M. Gladwin,et al.  Right ventricular function and failure: report of a National Heart, Lung, and Blood Institute working group on cellular and molecular mechanisms of right heart failure. , 2006, Circulation.

[80]  Raimund Erbel,et al.  Direct assessment of size and shape of noncircular vena contracta area in functional versus organic mitral regurgitation using real-time three-dimensional echocardiography. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[81]  Kiyoshi Yoshida,et al.  Real-time 3-dimensional echocardiographic assessment of left ventricular dyssynchrony: pitfalls in patients with dilated cardiomyopathy. , 2009, JACC. Cardiovascular imaging.

[82]  Gloria Tamborini,et al.  Head-to-head comparison of two- and three-dimensional transthoracic and transesophageal echocardiography in the localization of mitral valve prolapse. , 2006, Journal of the American College of Cardiology.

[83]  B. Gerber,et al.  Assessment of left ventricular mass and volumes by three-dimensional echocardiography in patients with or without wall motion abnormalities: comparison against cine magnetic resonance imaging , 2007, Heart.

[84]  Nathaniel Reichek,et al.  Normal values of right ventricular size and function by real-time 3-dimensional echocardiography: comparison with cardiac magnetic resonance imaging. , 2007, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[85]  Michael Jerosch-Herold,et al.  Three-dimensional shape analysis of right ventricular remodeling in repaired tetralogy of Fallot. , 2008, The American journal of cardiology.

[86]  H. Ihlen,et al.  Left atrial volumes assessed by three- and two-dimensional echocardiography compared to MRI estimates , 1999, The International Journal of Cardiac Imaging.

[87]  C. Lamberti,et al.  Quantification of regional left ventricular wall motion from real-time 3-dimensional echocardiography in patients with poor acoustic windows: effects of contrast enhancement tested against cardiac magnetic resonance. , 2006, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[88]  Weichih Hu,et al.  Left ventricular 4D echocardiogram motion and shape analysis. , 2002, Ultrasonics.

[89]  H. Kasanuki,et al.  Accuracy of measurement of left ventricular volume and ejection fraction by new real-time three-dimensional echocardiography in patients with wall motion abnormalities secondary to myocardial infarction. , 2004, The American journal of cardiology.

[90]  Jøger Hansegård,et al.  Semi-automated quantification of left ventricular volumes and ejection fraction by real-time three-dimensional echocardiography , 2009, Cardiovascular ultrasound.

[91]  I. Kronzon,et al.  Percutaneous closure of a post-myocardial infarction ventricular septal defect guided by real-time three-dimensional echocardiography. , 2009, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[92]  T. Kawamoto,et al.  Three-dimensional quantitation of mitral valve coaptation by a novel software system with transthoracic real-time three-dimensional echocardiography. , 2008, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.

[93]  Victor Mor-Avi,et al.  Characterization of Degenerative Mitral Valve Disease Using Morphologic Analysis of Real-Time Three-Dimensional Echocardiographic Images: Objective Insight Into Complexity and Planning of Mitral Valve Repair , 2011, Circulation. Cardiovascular imaging.

[94]  S. Kapetanakis,et al.  Real-time 3D echo in patient selection for cardiac resynchronization therapy. , 2011, JACC. Cardiovascular imaging.

[95]  Denisa Muraru,et al.  Validation of a novel automated border-detection algorithm for rapid and accurate quantitation of left ventricular volumes based on three-dimensional echocardiography. , 2010, European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology.

[96]  P. Buser,et al.  Dynamic assessment of right ventricular volumes and function by real-time three-dimensional echocardiography: a comparison study with magnetic resonance imaging in 100 adult patients. , 2010, Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.