• Brian Cowie, Leah Wright, Ben Costello, Kristel Janssens, Erin Howden, Darragh Flannery, Steve Foulkes, Roman Kluger, and Andre La Gerche.
• Department of Anaesthesia, St. Vincent's Hospital, Melbourne, Australia; Sports Cardiology, Baker Heart and Diabetes Institute, Melbourne, Australia; Department of Critical Care, University of Melbourne, Melbourne, Australia. Electronic address: Brian.cowie@svha.org.au.
• J. Cardiothorac. Vasc. Anesth. 2023 Sep 1; 37 (9): 163916451639-1645.

ObjectivesThe authors aimed to compare the assessment of left ventricular (LV) stroke volume with transthoracic echocardiography (TTE) using 2- and 3-dimensional (2D and 3D) Doppler and volumetric techniques with gold standard cardiac magnetic resonance imaging (CMR).DesignAn observational study.SettingA medical research institute.ParticipantsA total of 187 volunteer participants free of known structural heart disease.InterventionsNone.Measurements And Main ResultsLV stroke volume was measured with TTE using the following 4 techniques: LV outflow tract (LVOT) pulsed wave Doppler with 2D LVOT area, LVOT pulsed wave Doppler with 3D LVOT area, 2D volumetric (Simpson's biplane), and 3D volumetric techniques. This was compared with gold standard CMR. Stroke volume measured with echocardiography underestimated stroke volume compared to CMR by all techniques (p < 0.001 for all values compared to CMR). The LVOT Doppler stroke volume with a 3D area most closely agreed with CMR, with a bias of 6.35%. This bias progressively increased with 3D volumetric (13.4%), LVOT Doppler with a 2D area (15.1%), and 2D volumetric (18.3%) stroke volume techniques, with wider limits of agreement.ConclusionOf the 4 echocardiographic LV stroke volume measurement methods the authors assessed, stroke volume with LVOT Doppler using 3D measurement of LVOT area most closely approximates gold standard CMR.Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.

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