Left ventricular volumes (LVVs) and ejection fraction (LVEF) are key elements in the evaluation and follow-up of patients with heart failure with reduced ejection fraction (HFrEF). Therefore, a feasible and reproducible imaging method to be used by both experienced and in-training echocardiographers is mandatory. Our aim was to establish if, in a large echo lab, echocardiographers in-training provide feasible and more reproducible results for the evaluation of patients with HFrEF when using 3-dimensional echocardiography (3-DE) versus 2-dimensional echocardiography (2-DE). Sixty patients with HFrEF (46 males, age: 58 ± 17 y) underwent standard transthoracic 2-D acquisitions and 3-D multibeat full volumes of the left ventricle. One expert user in echocardiography (expert) and three echocardiographers with different levels of training in 2-DE (beginner, medium and advanced) measured the 2-D LVVs and LVEFs on the same consecutive images of patients with HFrEF. Afterward, the expert performed a 1-mo training in 3-DE analysis of the users, and both the expert and trainees measured the 3-D LVVs and LVEF of the same patients. Measurements provided by the expert and all trainees in echo were compared. Six patients were excluded from the study because of poor image quality. The mean end-diastolic LVV of the remaining 54 patients was 214 ± 75 mL with 2-DE and 233 ± 77 mL with 3-DE. Mean LVEF was 35 ± 10% with 2-DE and 33 ± 10% with 3-DE. Our analysis revealed that, compared with the expert user, the trainees had acceptable reproducibility for the 2-DE measurements, according to their level of expertise in 2-DE (intra-class coefficients [ICCs] ranging from 0.75 to 0.94). However, after the short training in 3-DE, they provided feasible and more reproducible measurements of the 3-D LVVs and LVEF (ICCs ranging from 0.89–0.97) than they had with 2-DE. 3-DE is a feasible, rapidly learned and more reproducible method for the assessment of LVVs and LVEF than 2-DE, regardless of the basic level of expertise in 2-DE of the trainees in echocardiography. In echo labs with a wide range of staff experience, 3-DE might be a more accurate method for the follow-up of patients with HFrEF.

左心室容积 (LVV) 和射血分数 (LVEF) 是评估和随访射血分数降低的心力衰竭 (HFrEF) 患者的关键因素。因此，必须有经验丰富的和正在接受培训的超声心动图医师使用的可行且可重复的成像方法。我们的目标是确定在大型超声实验室中，在使用 3 维超声心动图 (3-DE) 与 2 维超声心动图 (2-DE) 时，受训的超声心动图技师是否能够为 HFrEF 患者的评估提供可行且可重复的结果）。60 名 HFrEF 患者（46 名男性，年龄：58 ± 17 岁）接受了标准的经胸 2-D 采集和左心室的 3-D 多搏全容积。一名超声心动图专家（专家）和三名接受过 2-DE（初级、中级和高级）不同培训水平的超声心动图医师在 HFrEF 患者的相同连续图像上测量了 2-D LVV 和 LVEF。随后，专家对用户进行了 1 个月的 3-DE 分析培训，专家和学员均测量了同一患者的 3-D LVV 和 LVEF。对专家和所有受训人员提供的测量结果进行了比较。6 名患者因图像质量差而被排除在研究之外 对专家和所有受训人员提供的测量结果进行了比较。6 名患者因图像质量差而被排除在研究之外 对专家和所有受训人员提供的测量结果进行了比较。6 名患者因图像质量差而被排除在研究之外.其余 54 名患者的平均舒张末期 LVV 为 214 ± 75 mL（2-DE）和 233 ± 77 mL（3-DE）。2-DE 的平均 LVEF 为 35±10%，3-DE 的平均 LVEF 为 33±10%。我们的分析表明，与专家用户相比，受训者根据他们在 2-DE 方面的专业水平（类内系数 [ICC] 的范围从 0.75 到 0.94）对 2-DE 测量具有可接受的再现性。然而，在 3-DE 中进行短期培训后，与 2-DE 相比，他们提供了可行且可重复的 3-D LVV 和 LVEF（ICC 范围为 0.89-0.97）的测量值。与 2-DE 相比，3-DE 是一种可行、快速学习且可重复的评估 LVV 和 LVEF 的方法，无论超声心动图学员的 2-DE 专业知识水平如何。在拥有广泛员工经验的 echo 实验室中，