Advanced Assessment of the Left Ventricle

Abstract

The left ventricle has a unique shape that changes unpredictably in pathological conditions, and a complex mechanics due to a peculiar architectural arrangement of myocardial fibers. Both left ventricular geometry and mechanics cannot be comprehensively analyzed by exploring it with a tomographic imaging technique such as two-dimensional echocardiography (2DE). The need of making assumptions about left ventricular shape and mechanics to calculate geometrical and functional parameters from simple linear dimensions and area measurements is a major limitation of 2DE. Three-dimensional echocardiography, by encompassing the whole left ventricle in the acquisition volume, provides actual measurements of volumes, shape and mass, independent on any assumption about geometry, and allows to follow the motion of myocardial speckles frame-to-frame to allow actual measurement of the various components of myocardial deformation and ventricular torsion.