Right ventricular ejection fraction determined in three projections

Brynjolf, I; Gjørup, T; Vestergaard, Birgit; Am, Jensen; Munck, O.

doi:10.1097/00006231-198505000-00006

Cited by 2 publications

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“…Various procedures have been suggested to compensate for this, among these, background subtraction by a narrow area in the region of the tricuspid valve plane [2], subtraction of one half of the right atrial counts from the right ventricular counts [13], and definition of right ventricular edges by functional images [6,14], special computer algorithms [11], or from pictures obtained by means of a slant hole collimator [6,8]. In a single report [25], similar first-pass RVEF values were found in both the anterior and the RAO and LAO views, but in all projections RVEF was measured by the fixed area principle, which is apt to introduce underestimation of EF because of inclusion during systole of extraventricular activity into the fixed ventricular region of interest [7,20]. Countrate limitations during first-pass studies with singlecrystal cameras [3,4] can be improved by gated acquisition [7,26], yielding results comparable to those obtained from ungated studies [5].…”

Section: Previous Investigationsmentioning

confidence: 99%

Reproducibility of determination of right ventricular ejection fraction by radionuclide imaging: Assessment by the statistical method of variance components

et al. 1987

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Confidence limits for single and repeat measurements of right ventricular ejection fraction (RVEF) were established by means of a model based on the statistical method of variance components. A total of 80 subjects (age 23 to 74 years) were examined by two radionuclide methods 1) gated first-pass (fp) technique performed in a standard 30 degrees right anterior oblique projection, and 2) multigated equilibrium imaging (muga) in an individual left anterior oblique view, applying with both methods separate end-diastolic and end-systolic ventricular regions of interest. Values obtained by fp technique were clearly higher than those measured by the muga approach, and the correlation between them was only fair: RVEFmuga = 0.48 RVEFfp + 0.13; r = 0.73; SEE = 0.08. The 95% confidence limits for a single measurement were with the fp technique: 'true' RVEF = measured RVEF +/- 6 EF-units compared to +/- 16 units with the muga method. At repeat determination within an interval of four weeks, the minimal changes in measured RVEF that were statistically significant at the 5% level were with the fp technique +/- 8 units with the same observer on both occasions and +/- 9 units with different observers. Corresponding figures with the muga method were +/- 16 and +/- 22 units, respectively. The minimal changes in a subject's 'true' RVEF necessary to produce a significant change in measured RVEF were with fp technique +/- 14 units for the same observer and +/- 17 units for different observers, compared to +/- 30 and +/- 41 units with the muga method. In conclusion, the variability with the muga approach was far greater than with the fp technique and the consequent reproducibility so poor as to preclude meaningful measurement of RVEF by the muga method.

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Section: Previous Investigationsmentioning

confidence: 99%

Reproducibility of determination of right ventricular ejection fraction by radionuclide imaging: Assessment by the statistical method of variance components

et al. 1987

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Prospective evaluation of chronic cardiotoxicity due to high-dose epirubicin or combination chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil

Havsteen

Brynjolf

Svahn

et al. 1989

Cancer Chemother. Pharmacol.

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In a prospective study the left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), systolic blood pressure, ECG, and heart rate were recorded at rest and during submaximal work to compare the cardiotoxic effect of epirubicin with a combination chemotherapy without known cardiotoxicity. A total of 14 females with advanced breast cancer were treated with epirubicin at a median cumulative dose of 827 mg/m2 (range, 550-1244). These patients had previously received cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) or cyclophosphamide alone as adjuvant treatment, or CMF for advanced disease. The control group consisted of 11 females with advanced breast cancer given CMF only. The systolic blood pressure at rest as well as during submaximal work was significantly lower (P less than 0.05) after treatment in the epirubicin group than in the CMF controls. With regard to LVEF, the median value of 54% at rest was significantly lower after treatment in the epirubicin group than in the controls (59%). There was a significant fall in LVEF at rest and during exercise in the epirubicin group, whereas no such changes were found in the CMF controls after treatment. The RVEF was unaffected. In the epirubicin-treated group one patient developed fatal congestive heart failure, and in the remaining 13 patients treatment was discontinued due to progression of the cancer and not to cardiotoxicity. Thus, the cardiotoxicity of epirubicin changed the clinical outcome in only 1 of 14 patients with advanced breast cancer.

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Right ventricular ejection fraction determined in three projections

Cited by 2 publications

References 0 publications

Reproducibility of determination of right ventricular ejection fraction by radionuclide imaging: Assessment by the statistical method of variance components

Reproducibility of determination of right ventricular ejection fraction by radionuclide imaging: Assessment by the statistical method of variance components

Prospective evaluation of chronic cardiotoxicity due to high-dose epirubicin or combination chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil

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