Conventional 2DE, being confined to several predefined views, actually shows only a very limited part of the whole LV myocardium (Fig. 11). Conversely, 3DE can display
the entire myocardial volume in a multi-slice panel, allowing a comprehensive assessment of the whole LV circumference (Fig. 6). This display modality can improve the accuracy of visual regional wall motion assessment, because even limited wall motion abnormalities, localized in regions that are not apparent in conventional 2D views, Inhibitors,research,lifescience,medical can be visualized. Furthermore, with 3DE, a quantitative www.selleckchem.com/products/SB-202190.html analysis of LV regional functional is possible by comparing regional volume variation of each pyramidal-shaped LV segment during the cardiac cycle (Fig. Inhibitors,research,lifescience,medical 8). A good correlation of quantitative 3DE analysis with 2DE regional wall motion score10) and CMR32) has been reported. Fig. 11 Schematic representation of the position of 3 apical views of left ventricle obtainable with conventional 2D echocardiography. As shown, the 3 longitudinal slices cover only a very limited part of left ventricular circumference and cannot be changed anymore … Very recently 3D speckle-tracking technology has been validated for regional wall motion analysis,33) providing an Inhibitors,research,lifescience,medical additional quantitative tool to objectively assess segmental myocardial
deformation. A more accurate evaluation of regional wall motion improves the diagnostic accuracy of pharmacological stress echocardiography in ischemic heart disease.34),35) Inhibitors,research,lifescience,medical In addition, since the recovery of wall motion abnormalities has been shown to occur fast in patients with limited coronary disease, the rapid acquisition of peak stress images is of paramount importance to detect single-vessel disease.
Latest generation 3DE scanners allow a rapid image acquisition during peak stress, which may decrease the potential risk of missing transitory ischemia.35) Using 3DE, the operator is able to acquire all views from a single transducer location, significantly shortening the acquisition time. The views obtained by automatically slicing the 3D data sets acquired Inhibitors,research,lifescience,medical at different steps of the stress echocardiographic protocol can be re-aligned at any moment after acquisition and automatically displayed side-by-side to allow an easier detection of new wall motion abnormalities or of changes in wall motion abnormalities detected at baseline. Casein kinase 1 Aggeli et al.34) and Badano et al.35) have reported an increased sensitivity of 3D stress echo to detect inducible ischemia in the territory of left anterior descendent coronary artery. 3DE is emerging as a promising tool to assess intraventricular mechanical dyssynchrony, to improve the selection of patients with heart failure who will benefit from biventricular pacing and to monitor post-implant LV remodeling.36),37) A systolic dyssynchrony index is calculated as the standard deviation of the time to minimum systolic volume of each LV segment (Fig. 8).