Clinical Insights into the Use of 3D Echocardiography for LVEF Reporting: A Study of Influencing Factors

Abstract

Three-dimensional (3D) echocardiography has revolutionized cardiac imaging by enhancing the precision and reproducibility of left ventricular ejection fraction (LVEF) assessment. However, despite its proven advantages over two-dimensional (2D) methods, its integration into routine clinical workflows remains inconsistent. This study aims to identify and evaluate the multifactorial determinants—technological, operator-based, institutional, and patient-specific—that influence the adoption and utilization of 3D echocardiography for LVEF assessment in real-world clinical environments. Through a mixed-methods approach involving quantitative data analysis of 250 clinical cases and qualitative interviews with 30 cardiologists and sonographers across five institutions, we present a comprehensive evaluation of barriers and enablers. The results reveal a complex interplay of factors including device availability, operator training, patient characteristics, institutional priorities, and reimbursement policies. Understanding these variables is essential for optimizing the implementation of 3D echocardiography to enhance diagnostic accuracy and patient outcomes in cardiac care.