Comparison of four echocardiographic techniques for measuring left ventricular ejection fraction

Area of Science:

• Cardiology
• Medical Imaging
• Echocardiography

Background:

• Accurate left ventricular ejection fraction (LVEF) measurement via 2D echocardiography is challenged by subjective endocardial border detection.
• Contrast microbubbles and harmonic imaging enhance endocardial border delineation compared to fundamental imaging.

Purpose of the Study:

• To correlate LVEF quantification using four 2D echocardiography techniques with radionuclide angiography.
• To evaluate the effectiveness of fundamental and harmonic imaging, with and without contrast, for LVEF assessment.

Main Methods:

• Fifty patients with radionuclide EF measurements underwent 2D echocardiography using four methods: fundamental alone, fundamental with contrast, harmonic alone, and harmonic with contrast.
• Three blinded echocardiologists independently measured biplane LVEF, comparing results against radionuclide angiography.

Main Results:

• Correlation between echocardiographic and radionuclide EF improved incrementally with each imaging technique.
• The closest correlation was achieved with harmonic imaging combined with contrast microbubbles (r = 0.95-0.96).

Conclusions:

• Harmonic imaging with contrast microbubbles significantly improves the accuracy of 2D echocardiographic LVEF quantification.
• This advanced technique offers a more reliable alternative for LVEF assessment, especially in technically challenging cases.