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Comparison of radionuclide angiography with three echocardiographic parameters of left ventricular function in
A W van 't Hof1, C W Schipper, J G Gerritsen
1Department of Cardiology and Nuclear Medicine, Ziekenhuis de Weezenlanden Zwolle, The Netherlands.
Insights
Echocardiographic estimation of left ventricular ejection fraction (LVEF) is superior to wall motion scoring for assessing heart function after myocardial infarction. This method offers better correlation and reliability compared to radionuclide angiography.
Area of Science:
- Cardiology
- Medical Imaging
- Cardiac Function Assessment
Background:
- Left ventricular function is a critical outcome in coronary artery disease, especially post-myocardial infarction.
- Radionuclide angiography is a reliable method for assessing left ventricular function.
- Echocardiographic wall motion scoring presents a potential alternative for evaluating cardiac function.
Purpose of the Study:
- To compare the efficacy of echocardiographic left ventricular ejection fraction (LVEF) estimation and wall motion scoring (WMSI) against radionuclide angiography.
- To determine the preferred echocardiographic method for assessing left ventricular function in patients post-myocardial infarction.
Main Methods:
- 90 patients underwent radionuclide angiography and echocardiography four days after reperfusion therapy for acute myocardial infarction.
- Left ventricular ejection fraction (LVEF) was visually estimated and quantitatively traced; segmental wall motion scoring (WMSI) was also performed.
- Inter- and intra-observer variability and correlation with radionuclide angiography were assessed.
Main Results:
- Echocardiographic LVEF estimation showed better correlation with radionuclide angiography (r=0.71) than WMSI (r=-0.68) or quantitative tracing (r=0.59).
- Inter- and intra-observer variability favored LVEF estimation (19% and 15%) over WMSI (65% and 59%).
- Correlation accuracy depended on echocardiogram quality and coronary artery disease extent.
Conclusions:
- Simple echocardiographic LVEF estimation is superior to quantitative assessment and WMSI when compared to radionuclide angiography.
- Echocardiography provides a reliable and accessible alternative for evaluating left ventricular function post-reperfusion therapy.
- This finding supports the use of echocardiography for routine assessment of cardiac outcomes in myocardial infarction patients.
Aims:
Left ventricular function is an important outcome measure in patients with coronary artery disease, in particular in patients after myocardial infarction. It is reliably assessed by radionuclide angiography, but echocardiographic wall motion scoring might be an attractive alternative.
Methods:
Four days after reperfusion therapy for acute myocardial infarction both radionuclide angiography and echocardiography were performed in 90 patients. Segmental wall motion scoring (WMSI) and visual estimation of the left ventricular ejection fraction (LVEF) was done by 2 independent observers. Repeated analysis was performed 1 month after the first reading. In 41 patients the LVEF was assessed quantitatively by tracing of endocardial outlines of the left ventricle.
Results:
Both correlation with radionuclide angiography (estimated LVEF: r = 0.71, WMSI: r = -0.68, Tracing: r = 0.59) and inter- and intra-observer variability (estimated LVEF: 19% and 15%, WMSI: 65% and 59%) were in favour of the LVEF estimation method. Correlation with radionuclide angiography measurements was related to the quality of the echocardiogram and to the extent of coronary artery disease.
Conclusion:
Simple echocardiographic estimation of left ventricular ejection fraction in patients after reperfusion therapy for acute myocardial infarction proved to be superior to quantitative assessment of ejection fraction and to segmental wall motion scoring in comparison with radionuclide angiography.