Visually estimated ejection fraction by two dimensional and triplane echocardiography is closely correlated with quantitative ejection fraction by real-time three dimensional echocardiography

Shahgaldi, Kambiz; Gudmundsson, Petri; Manouras, Aristomenis; Brodin, Lars‐Åke; Winter, Reidar

doi:10.1186/1476-7120-7-41

Cited by 77 publications

(64 citation statements)

References 20 publications

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“…By the design of the present study, the LVEF assessment at the recruiting hospital was done either by visual assessment, Simpson's biplane or area length assessment, and thus the 95 % confidence interval of the differences do not represent a strict measurement of interobserver variability. Nevertheless, the variabilities in our study correspond to previously published values of interobserver variability [19,20], while others have published lower values [21][22][23]. An important difference A B C Fig.…”

Section: Interobserver Reliabilitycontrasting

confidence: 33%

How reliable are left ventricular ejection fraction cut offs assessed by echocardiography for clinical decision making in patients with heart failure?

Kaufmann

Min

Goetschalckx

et al. 2012

Int J Cardiovasc Imaging

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We aimed to study the potential influence of the variability in the assessment of echocardiographically measured left ventricular ejection fraction (LVEF) on indications for the implantation of internal cardioverter defibrillator and/or cardiac resynchronization devices in heart failure patients. TIME-CHF was a multicenter trial comparing NT-BNP versus symptom-guided therapy in patients aged C60 years. Patients had their LVEF assessed at the recruiting centre using visual assessment, the arealength or biplane Simpson's method. Echocardiographic data were transferred to the study core-lab for re-assessment. Re-assessment in the core-lab was done with biplane Simpson's method, and included an appraisal of image quality. 413 patients had the LVEF analyzed at the recruiting centre and at the core lab. Image quality was optimal in 191 and suboptimal in 222. Overall, the correlation between LVEF at the recruiting centres and at the core-lab was good, independent of image quality (R 2 = 0.62). However, when a LVEF B30 % or C30 % was used as a cut-off, about 20 % of all patients would have been re-assigned to having either a LVEF above or below the cutoff, this proportion was not significantly influenced by image quality. We conclude that correlation between LVEF assessed by different centres based on the same ultrasound data is good, regardless of image quality. However, one fifth of patients would have been re-assigned to a different category when using the clinically important cut-off of 30 %.

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Section: Interobserver Reliabilitycontrasting

confidence: 33%

How reliable are left ventricular ejection fraction cut offs assessed by echocardiography for clinical decision making in patients with heart failure?

Kaufmann

Min

Goetschalckx

et al. 2012

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

show abstract

“…LVEF was calculated using Simpson's biplane method, taking great care to avoid foreshortening when acquiring apical images. CVs of our laboratory for Simpon's biplane method have been published previously as intraobserver CV: 2.3-3.8% and interobserver CV: 7.5-8.4% (45). Dynamic mitral regurgitation was specifically excluded using Doppler imaging (32) Color-coded tissue Doppler data were obtained by postprocessing at a dedicated workstation (EchoPAC; GE Healthcare, Horten, Norway) All cardiac dimensions, blood flow, and velocities were analyzed in triplicate.…”

Section: Methodsmentioning

confidence: 99%

Arterial vasodilatory and ventricular diastolic reserves determine the stroke volume response to exercise in elderly female hypertensive patients

Sahlén

Abdula

Norman

et al. 2011

American Journal of Physiology-Heart and Circulatory Physiology

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“…Instead, worldwide availability of echocardiography is surely greater. Furthermore, several recent studies have shown the excellent interobserver and intraobserver reproducibility of echocardiographic evaluation on LVEF [15,16]. This has been evaluated as similar to that of cardiac magnetic resonance (CMR), even in patients with TM [17].…”

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confidence: 93%

Long‐term use of deferiprone significantly enhances left‐ventricular ejection function in thalassemia major patients

et al. 2012

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A multicenter randomized open-label long-term sequential deferiprone-deferoxamine (DFP-DFO) versus DFP alone trial (sequential DFP-DFO) performed in patients with thalassemia major (TM) was retrospectively reanalyzed to assess the variation in the left ventricular ejection fraction (LVEF) [1].Serial observations of LVEF over 3 years, in the same patient, were retrospectively assessed in 99 patients with TM during the sequential DFP-DFO multicenter randomized open-label trial [1]. A generalized estimating equation (GEE) model was used to demonstrate changes in mean LVEF over time [2].The regression coefficient of treatment suggested that the DFP-alone group showed a statistically significant increase in mean LVEF over time (coefficient 0.97, 95% CI (0.51; 1.44), P-value <0.0001).These findings suggest that long-term treatment with DFP-alone can significantly enhance LVEF over time. These findings agree with a survival analysis reporting a substantial decline in cardiac deaths during recent years, related to the switching of high-risk patients from DFO to chelation regimens that include the oral chelator DFP [3][4][5].Oral chelation treatment has improved greatly adherence and management of patients with TM [6,7].The improvement of the LVEF after 1-year DFP treatment has been reported [8][9][10][11].However, the effects of DFP on LVEF after long-term treatment have not been fully investigated.This letter reports a retrospective survey performed on patients with TM, previously enrolled in a long-term randomized open-label trial carrying ahead in Italy on the behalf of the Italian Society for the Study of Thalassaemia and Haemoglobinopathies (SoSTE) [1]. Ninety-nine out of 213 patients enrolled in the sequential DFP-DFO trial underwent longterm echocardiographic study of LVEF measured at baseline and every 12 months over three consecutive years (Fig. 1). Among these, 39 and 60 received sequential DFP (75 mg/kg for 4 days/week)-DFO (50 mg/kg for 3 days/week) or DFP-alone (75 mg/kg for 7 days/week) treatment, respectively (Table I).The hematological and clinical findings at enrollment are shown in Table I. No differences were observed at baseline between the two randomized groups. Particularly, the main findings of body iron overloading, expressed as serum ferritin at baseline, liver iron concentration (LIC), baseline LVEF <55%, and total number of blood transfusions were not statistically significantly different (Table I). Moreover, although baseline LVEF appears unlike between the two groups ( Fig. 1), this was not statistically significantly different (P-value 5 0.10, Table I).The DFP-alone group showed statistically significant increase over time in mean LVEF in comparison with sequential DFO-FP treatment (coefficient 0.97, 95% CI (0.51; 1.44), P-value <0.0001).Furthermore, the regression coefficient of treatment suggested that there was a statistically significant difference in mean LVEF between the two treated groups favoring the sequential group (coefficient 2.36, 95% CI (0.02; 4.71), P-value 5 0.047, but this ...

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Visually estimated ejection fraction by two dimensional and triplane echocardiography is closely correlated with quantitative ejection fraction by real-time three dimensional echocardiography

Cited by 77 publications

References 20 publications

How reliable are left ventricular ejection fraction cut offs assessed by echocardiography for clinical decision making in patients with heart failure?

How reliable are left ventricular ejection fraction cut offs assessed by echocardiography for clinical decision making in patients with heart failure?

Arterial vasodilatory and ventricular diastolic reserves determine the stroke volume response to exercise in elderly female hypertensive patients

Long‐term use of deferiprone significantly enhances left‐ventricular ejection function in thalassemia major patients

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