Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging

Siri Malm, Sigmund Frigstad, Einar Sagberg, Henrik Larsson, Terje Skjaerpe

286 Citationer (Scopus)

Abstract

OBJECTIVES: We evaluated the accuracy and reproducibility of contrast echocardiography versus tissue harmonic imaging for measurements of left ventricular (LV) volumes and ejection fraction (EF) compared to magnetic resonance imaging (MRI).

METHODS: Digital echo recordings of apical LV views before and after intravenous contrast were collected from 110 consecutive patients. Magnetic resonance imaging of multiple short-axis LV sections was performed with a 1.5-T scanner. Left ventricular volumes and EF were calculated offline by method of discs. Thirty randomly selected patients were reanalyzed for intraobserver and interobserver variability.

RESULTS: Compared with baseline, contrast echo increased feasibility for single-plane and biplane volume analysis from 87% to 100% and from 79% to 95%, respectively. The Bland-Altman analysis demonstrated volume underestimation by echo, but much less pronounced with contrast. Limits of agreement between echo and MRI narrowed significantly with contrast: from -18.1% to 8.3% to -7.7% to 4.1% (EF), from -98.2 to -11.7 ml to -59.0 to 10.7 ml (end-diastolic volume), and from -58.8 to 21.8 ml to -38.6 to 23.9 ml (end-systolic volume). Ejection fraction from precontrast echo and MRI differed by > or =10% (EF units) in 23 patients versus 0 after contrast (p < 0.001). At intraobserver and interobserver analysis, limits of agreement for EF narrowed significantly with contrast.

CONCLUSIONS: The two-dimensional echocardiographic evaluation of LV volumes and EF in non-selected cardiac patients was found to be more accurate and reproducible when adding an intravenous contrast agent.

OriginalsprogEngelsk
TidsskriftJournal of the American College of Cardiology
Vol/bind44
Udgave nummer5
Sider (fra-til)1030-5
Antal sider6
ISSN0735-1097
DOI
StatusUdgivet - 1 sep. 2004
Udgivet eksterntJa

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