Three dimensional Parameters of Cardiac Structure and Function
Current guidelines recommend the use of 3D volumes in the quantification of LV size. This is due to several advantages of 3D over 2D imaging including minimal foreshortening and more accurate volumetric quantification (32). Of the included studies, only one study assessed 3D LVEDV and 3D LV mass, showing no significant difference between myocarditis populations and controls (17). The proposed reason for this negative finding is again likely due to the absence of chronicity and the acute pathogenesis of myocarditis and its effect on the myocardium (1). The other reason could relate to the inclusion of only populations with preserved LV systolic function, highlighting a non-severe myocarditis process in this cohort. Unfortunately, none of the included studies compared 3D left ventricular ejection fraction in myocarditis populations vs controls. The lack of any studies examining changes in 3D LVEF is not surprising since 3D echocardiography has only been studied in a handful of cardiac pathologies to date largely due to inter-vendor differences, lack of standardization and unclear feasibility or added clinical value