# Correlation of 3D Echocardiography With Cardiac MRI in Patients With Acute Left Ventricular Dysfunction in the Age Group of One Month to 18 Years

## TL;DR

This study compares 3D echocardiography and cardiac MRI in children with heart issues, finding strong agreement in measuring heart function but underestimation in volume measurements.

## Contribution

The study provides novel evidence of 3D-ECHO's reliability for LVEF in pediatric acute LV dysfunction while highlighting its volumetric underestimation.

## Key findings

- 3D-ECHO and CMR showed strong correlation for LVEF (r = 0.887), EDV (r = 0.906), and ESV (r = 0.903).
- 3D-ECHO consistently underestimated EDV and ESV compared to CMR.
- LVEF measurements showed good agreement between 3D-ECHO and CMR.

## Abstract

Objectives

The objective of this study is to evaluate the correlation and agreement between three-dimensional echocardiography (3D-ECHO) and cardiac magnetic resonance imaging (CMR) in children with acute left ventricular (LV) dysfunction, specifically assessing end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) and to identify any associated systematic measurement errors.

Methods

An observational cohort study was conducted in New Delhi, India, over a period of 18 months from June 2021 to November 2022. A total of 16 children aged one month to 18 years with acute myocarditis or new-onset LV dysfunction were enrolled. Clinical details, laboratory parameters, echocardiography, and CMR findings were recorded. Correlations were assessed using Pearson’s coefficient, and agreement was analyzed using Bland-Altman plots.

Results

A very strong positive correlation was found between 3D-ECHO and CMR for LVEF (r = 0.887; p < 0.0001). EDV and ESV also showed strong correlations between 3D-ECHO and CMR (r = 0.906 and r = 0.903, respectively). However, the Bland-Altman analysis revealed that 3D-ECHO consistently underestimated EDV (mean difference = -18.86; p = 0.034) and ESV (mean difference = -21.77; p = 0.014) compared to CMR, while LVEF showed good agreement (p = 0.619).

Conclusion

3D-ECHO demonstrates strong correlation with CMR in assessing LVEF in children with acute LV dysfunction and may serve as a reliable bedside tool for systolic function evaluation. However, its underestimation of EDV and ESV highlights the continued role of CMR as the gold standard for precise volumetric assessment.