Visual estimation versus quantitative assessment of left ventricular ejection fraction: A comparison by cardiovascular magnetic resonance imaging

Sievers, Burkhard; Kirchberg, Simon; Franken, Ulrich; Puthenveettil, Binu-John; Bakan, Asli; Trappe, Hans‐Joachim

doi:10.1016/j.ahj.2004.11.017

Cited by 40 publications

(27 citation statements)

References 21 publications

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“…Compared with data in the literature regarding inter-and intraobserver variability of left ventricular volumetry [17], measurement of right ventricular volumetry seems to be more error prone, owing to the complex geometry and the thin wall of the RV.…”

Section: Discussionmentioning

confidence: 80%

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Tricuspid annular plane systolic excursion assessed using MRI for semi-quantification of right ventricular ejection fraction

Speiser¹,

Hirschberger²,

Pilz³

et al. 2012

BJR

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Objective: Accurate determination of right ventricular volume and ejection fraction (RVEF) is established using MRI. Automatic contour detection of the right ventricular endocardial border is not established in clinical practice, resulting in considerable manual efforts to quantify RVEF. Using transthoracic echocardiography (TTE), the tricuspid annular plane systolic excursion (TAPSE) has proved its worth for quantification of RVEF and risk prediction. Therefore, the aim of this study was to clarify whether TAPSE assessed with MRI as a fast and easily obtainable parameter correlated with volumetric quantification of RVEF. Methods: Right ventricular volumes and RVEF were measured with the standardised slice-summation method at MRI. MRI-TAPSE was defined as maximum apical excursion of lateral tricuspid annular plane and measured in a four-chamber view using steadystate free precession sequences. Additionally, MRI-TAPSE was compared with TAPSE assessed using TTE. Results: 76 consecutive patients (aged 58¡17 years) were examined. At MRI, right end-diastolic volumes were 97¡36 ml, right end-systolic volumes were 57¡27 ml and the mean RVEF was 42¡14%. MRI-TAPSE was determined with 19¡6 mm and correlated well at linear regression analysis with volumetric RVEF (r50.72, p,0.001). Furthermore, MRI-TAPSE discriminated sufficiently between patients with impaired and normal RVEF. Multiplying MRI-TAPSE by 2.5 led to values close to the RVEF by volumetry. Additionally, MRI-TAPSE correlated well with TAPSE determined using TTE. The inter-and intra-observer variabilities of MRI-TAPSE determination were low (3.1% and 1.8%). Conclusion: TAPSE assessed with MRI is a fast and easily obtainable parameter which correlates well with volumetric quantification of RVEF. In the past decade, improved determination of right ventricular volume and function has enabled understanding of the pathophysiology of the right ventricle (RV), and favoured new therapeutic options in patients with pulmonary hypertension, myocardial infarction, acute and chronic heart failure, cardiac transplantation or congenital heart disease [1][2][3][4][5][6][7].Today, echocardiography presents the most widely used non-invasive technique for right ventricular imaging. However, exact echocardiographic evaluation of the right ventricular function is limited by the complex geometrical shape and the reduced endocardial border delineation of the RV. A simplified echocardiographic method to estimate right ventricular ejection fraction (RVEF) by means of analysing the tricuspid annular plane systolic excursion (TAPSE) towards the cardiac apex has been described by Kaul et al [8]. Despite the fact that TAPSE presents only a one-dimensional echocardiographic method, previously published studies have demonstrated an accurate and easy estimation of RVEF [9][10][11][12][13] and the prognostic impact of RVEF as assessed by TAPSE [14,15].On the other hand, cardiac MRI has been shown to be the gold standard for the assessment of RVEF [16]. MRI permits precise determination of the r...

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Section: Discussionmentioning

confidence: 80%

“…MRI permits precise determination of the right ventricular volume, function and mass, with good reproducibility [16][17][18]. Nevertheless, the routine use of cardiac MRI for determination of right ventricular volume and function remains a time-consuming procedure.…”

mentioning

confidence: 99%

Tricuspid annular plane systolic excursion assessed using MRI for semi-quantification of right ventricular ejection fraction

Speiser¹,

Hirschberger²,

Pilz³

et al. 2012

BJR

View full text Add to dashboard Cite

show abstract

“…Although providing what is now considered to be the most reliable and reproducible method of determining ejection fraction, CMR analysis requires time-consuming manual post-processing. Visual assessment of cardiac images is a quick method of determining LVEF and is widely used with all imaging modalities in cardiology, though the accuracy of this subjective method has been questioned [7][8][9]. Therefore, we aimed to determine the reliability of visual (eyeball) assessment of LVEF, compared to formal quantitative analysis.…”

Section: Introductionmentioning

confidence: 99%

A comparison of visual and quantitative assessment of left ventricular ejection fraction by cardiac magnetic resonance

Holloway

Edwards

Rider

et al. 2010

Int J Cardiovasc Imaging

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To determine the accuracy of visual analysis of left ventricular (LV) function in comparison with the accepted quantitative gold standard method, cardiac magnetic resonance (CMR). Cine CMR imaging was performed at 1.5 T on 44 patients with a range of ejection fractions (EF, 5-80%). Clinicians (n = 18) were asked to visually assess EF after sequentially being shown cine images of a four chamber (horizontal long axis; HLA), two chamber (vertical long axis; VLA) and a short axis stack (SAS) and results were compared to a commercially available analysis package. There were strong correlations between visual and quantitative assessment. However, the EF was underestimated in all categories (by 8.4% for HLA, 8.4% for HLA + VLA and 7.9% for HLA + VLA + SAS, P all < 0.01) and particularly underestimated in mild LV impairment (17.4%, P < 0.01), less so for moderate (4.9%) and not for severe impairment (1%). Assessing more than one view of the heart improved visual assessment of LV, EF, however, clinicians underestimated EF by 8.4% on average, with particular inaccuracy in those with mild dysfunction. Given the important clinical information provided by LV assessment, quantitative analysis is recommended for accurate assessment.

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“…This study also demonstrated the reproducibility of MRI volume measurements with excellent intraobserver and interobserver variability of LV measurements. In 111 normal subjects, Sievers et al (79) determined normal values of left atrial measurements.…”

Section: Ventricular Functionmentioning

confidence: 99%

The Year in Cardiac Imaging

Gibbons

Araoz

Williamson

2006

Journal of the American College of Cardiology

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Visual estimation versus quantitative assessment of left ventricular ejection fraction: A comparison by cardiovascular magnetic resonance imaging

Cited by 40 publications

References 21 publications

Tricuspid annular plane systolic excursion assessed using MRI for semi-quantification of right ventricular ejection fraction

Tricuspid annular plane systolic excursion assessed using MRI for semi-quantification of right ventricular ejection fraction

A comparison of visual and quantitative assessment of left ventricular ejection fraction by cardiac magnetic resonance

The Year in Cardiac Imaging

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