Measurement of left ventricular volumes and ejection fraction by quantitative gated SPET, contrast ventriculography and magnetic resonance imaging: a meta-analysis

Kondo, Chisato; Fukui, Kenji; Kusakabe, Kiyoko

doi:10.1007/s00259-003-1146-9

Cited by 36 publications

(34 citation statements)

References 26 publications

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“…Consistent with other studies comparing noninvasive and invasive techniques used to assess LVEF, [8][9][10][11][12][13][14][15] data from our study indicate that LVEFs measured by noninvasive techniques are lower than LVEFs measured by angiography. Explanations for the lower LVEFs have been discussed in the literature.…”

Section: Discussionsupporting

confidence: 91%

“…Other investigators have postulated that the inclusion of greater outflow tract amounts in standard angiographic models results in overestimations of true ventricular volumes. 8,9 Others have speculated that the noninvasive methods underestimate ventricular volumes as a result of their inability to visualize precise endocardial border contours and the inherent systematic temporal under-sampling that occurs with SPECT. [8][9][10][11]14 Between the two noninvasive procedures used to measure LVEF in this study, LVEF values obtained by echocardiography were slightly higher than those obtained by SPECT which is also consistent with other studies.…”

Section: Discussionmentioning

confidence: 99%

“…8,9 Others have speculated that the noninvasive methods underestimate ventricular volumes as a result of their inability to visualize precise endocardial border contours and the inherent systematic temporal under-sampling that occurs with SPECT. [8][9][10][11]14 Between the two noninvasive procedures used to measure LVEF in this study, LVEF values obtained by echocardiography were slightly higher than those obtained by SPECT which is also consistent with other studies. 15 From the data obtained in our study, LVEFs obtained by echocardiography and SPECT are approximately 5% and 8% lower, respectively than the angiographic LVEFs.…”

Section: Discussionmentioning

confidence: 99%

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Accuracy of Noninvasive Ejection Fraction Measurement in a Large Community-Based Clinic

Habash-Bseiso¹,

Rokey²,

Berger³

et al. 2005

Clinical Medicine & Research

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Objective: Compare the agreement of two dimensional echocardiography (echocardiography) and electrocardiogram (ECG)-gated single photon emission computed tomography (SPECT), with left ventricular contrast angiography (angiography) for the evaluation of left ventricular ejection fraction (LVEF).Design: Retrospective cohort study.Data Source: American College of Cardiology National Cardiovascular Data Registry TM (ACC-NCDR). Participants:Patients from a large, community-based clinic in central Wisconsin. Methods:Consecutive patients (1999)(2000)(2001)(2002) were identified from the ACC-NCDR dataset who underwent angiography and echocardiography or SPECT within 1 month of each other for evaluation of LVEF. Noninvasive LVEF values were compared to those obtained by angiography using the paired t-test.Regression analysis was used to assess the relation between the compared methods. Bland-Altman analyses were performed to assess the agreement between LVEF values obtained by the noninvasive techniques and angiography. Sensitivity and specificity of detecting depressed LVEF were determined for noninvasive techniques. Regression equations were determined for estimating angiographic values from the echocardiographic or SPECT values.Results: Five hundred thirty-four patients underwent 542 angiographic studies: SPECT in all 534 patients, combined SPECT and echocardiographic studies in 201 patients, and combined angiographic and echocardiographic studies in 202 patients. Correlation of angiographic LVEFs with both echocardiographic and SPECT LVEFs was significant (r = 0.70 and r = 0.69, respectively; p<0.0001). Echocardiographic LVEFs were lower than those determined by angiography (49% ± 1.0% versus 54% ± 1.0%; p<0.0001). SPECT LVEFs were also lower than angiographic LVEFs (49% ± 0.6% versus 57% ± 0.6%; p<0.0001). For 201 patients who underwent both SPECT and echocardiography, SPECT LVEFs were lower (47% ± 1.0% for SPECT versus 49% ± 1.0% for echocardiography; p<0.05). Bland-Altman analysis revealed widely varying differences between techniques with broad confidence intervals. Nonetheless, sensitivity and specificity for determining LVEFs of <40% for SPECT and echocardiography were 90% and 86%, and 75% and 89%, respectively. LVEF of ≤35% was correctly assessed by both SPECT and echocardiography. Sensitivity and specificity for SPECT were 82% and 89%, and 81% and 88% for echocardiography. Conclusion:At our institution, LVEFs obtained noninvasively by echocardiography or SPECT are lower than angiographic LVEFs with widely fluctuating differences. Regression equations can be used to correct the noninvasive readings. Although lower, noninvasive techniques appear to accurately assess depressed LVEFs (<40% and <35%).The accuracy of noninvasive techniques for the evaluation of LVEF should be considered when managing and determining prognoses of patients with cardiac conditions. Individual institutions should determine the validity of the noninvasive techniques they use to assess LVEF.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Accuracy of Noninvasive Ejection Fraction Measurement in a Large Community-Based Clinic

Habash-Bseiso¹,

Rokey²,

Berger³

et al. 2005

Clinical Medicine & Research

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“…Various modalities, including quantitative echocardiography (ECHO), semiquantitative ECHO, radionuclide ventriculography (RNA), methoxyisobutyl isonitrile scanning, angiography, computed tomography (CT), positron emission tomography and magnetic resonance imaging (MRI), exist for estimating LVEF (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). In clinical practice, ECHO is often used as the first-line test for screening patients for decreased LVEF (17).…”

mentioning

confidence: 99%

Limitations in the current screening practice of assessing left ventricular ejection fraction for a primary prophylactic implantable defibrillator in southern Ontario

Lane

Dorian

Ghosh

et al. 2010

Canadian Journal of Cardiology

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“…The results, showing that LVEFs obtained by echocardiography were significantly lower than those obtained by angiography, were consistent with a previous report. 9 The correlation coefficient was significant (r = 0.70, P<0.0001). When comparing SPECT to LV angiography, the correlation coefficient was also significant (r = 0.69, P<0.0001).…”

mentioning

confidence: 86%

Ejection Fraction Derived by Noninvasive Modalities Versus Left Ventricular Angiographic Determination

Tak

2005

Clinical Medicine & Research

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Sever al studies have examined the correlation and agreement between noninvasive measurement of ejection fraction (EF) and that derived with left ventricular (LV) angiography. [1][2][3][4] The noninvasive modalities include echocardiography, radionuclide methods, and magnetic resonance imaging. 5 Echocardiography has been widely used for the evaluation of EF as it is readily available and relatively less expensive than other techniques. M-mode derivations of EF are wrought with errors in patients with technically difficult studies and regional wall motion abnormalities. Simpson's biplane method is nearly reliable, but again is highly dependent on good endocardial border definition. 6 Although quantitative echocardiography methods are available, visual estimation is known to provide good information to experienced echocardiographers. 7 Intracardiac opacification (contrast) agents are now being used more frequently and allow better visualization of LV cavity and endocardial boundaries. 3 In this issue of Clinical Medicine & Research, present a retrospective analysis of determination of EF in 534 patients from a single institution who had undergone LV angiography, echocardiography, and nuclear perfusion imaging. They excluded patients who had testing occurring more than 30 days apart. For echocardiography, Simpson's two-dimensional methodology was utilized for deriving left ventricular ejection fraction (LVEF). This method is most helpful for obtaining LV volumes when the LV geometry is distorted. 6 Radionuclide determination of EF was performed with a single-dose of technetium-99m Sestamibi (Cardiolite). LV angiography was acquired by the single plane method. The endocardial borders of the left ventricle were traced manually by carefully outlining the ventricular silhouette and then converting to area.Combined LV angiography and echocardiography studies were performed on 202 patients. Similarly, combined single photon emission computed tomography (SPECT) studies and echocardiographic studies were performed on 201 patients. For both groups, studies were performed within 1 month of each other. The results, showing that LVEFs obtained by echocardiography were significantly lower than those obtained by angiography, were consistent with a previous report. 9 The correlation coefficient was significant (r = 0.70, P<0.0001). When comparing SPECT to LV angiography, the correlation coefficient was also significant (r = 0.69, P<0.0001).

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Measurement of left ventricular volumes and ejection fraction by quantitative gated SPET, contrast ventriculography and magnetic resonance imaging: a meta-analysis

Cited by 36 publications

References 26 publications

Accuracy of Noninvasive Ejection Fraction Measurement in a Large Community-Based Clinic

Accuracy of Noninvasive Ejection Fraction Measurement in a Large Community-Based Clinic

Limitations in the current screening practice of assessing left ventricular ejection fraction for a primary prophylactic implantable defibrillator in southern Ontario

Ejection Fraction Derived by Noninvasive Modalities Versus Left Ventricular Angiographic Determination

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