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Updated: Aug 29, 2026
Echocardiographic Assessment of Cardiac Anatomy and Function in Adult Rats
Published on: December 13, 2019
Comparison of echocardiography using tissue harmonics and contrast harmonics with radionuclide angiography for the
Francis Q Almeda1, Robert C Hendel, James E Macioch
1Department of Internal Medicine, Section of Cardiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA. falmeda@aol.com
Insights
Echocardiography with contrast, using the Method of Discs, accurately assesses left ventricular ejection fraction (LVEF). Visual assessment with tissue or contrast harmonics also correlates with radionuclide angiography, with reader variability noted.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Left ventricular ejection fraction (LVEF) is a critical prognostic indicator for cardiovascular disease.
- Optimal noninvasive methods for quantifying LVEF remain an area of active research.
- Accurate LVEF assessment is vital for patient management and treatment decisions.
Purpose of the Study:
- To compare echocardiographic methods for LVEF assessment against radionuclide angiography (RNA).
- To evaluate the efficacy of contrast-enhanced echocardiography (Method of Discs) and visual estimation (tissue/contrast harmonics) against RNA.
- To determine if contrast harmonics offer added value over tissue harmonics for LVEF assessment.
Main Methods:
- Prospective analysis of 24 patients undergoing radionuclide angiography (RNA).
- Echocardiography performed on the same day using tissue harmonics and contrast harmonics.
- LVEF calculated via Method of Discs (contrast-enhanced) and visually estimated by two blinded readers.
Main Results:
- Method of Discs with contrast showed strong correlation with RNA (r = .835, p < .0005).
- Visual assessment showed good agreement with RNA, with reader-dependent variations observed.
- Contrast harmonics did not demonstrate a significant advantage over tissue harmonics alone in visual LVEF estimation.
Conclusions:
- Contrast-enhanced echocardiography (Method of Discs) is a reliable method for LVEF determination, correlating well with RNA.
- Visual echocardiographic assessment of LVEF using tissue and contrast harmonics is feasible and correlates with RNA.
- Tissue harmonics alone may be sufficient for visual LVEF estimation, without a clear benefit from contrast harmonics.
Background:
Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and mortality; however, the optimal noninvasive modality for the quantitative determination of LVEF is not apparent.
Hypothesis:
We verified the hypothesis that the various echocardiographic methods of assessing LVEF using the Method of Discs with contrast (Optison human albumin microspheres; Amersham Health, Princeton, NJ) and visual assessment of LVEF using tissue harmonics and contrast harmonics compare favorably with radionuclide angiography (RNA).
Methods:
In a prospective analysis, 24 consecutive patients scheduled to undergo RNA had an echocardiogram using tissue harmonics and contrast harmonics on the same day. LVEF was assessed by RNA by an experienced, blinded reader using manual determination of the region of interest. LVEF was calculated using the Method of Discs (Simpson's Rule) by a blinded sonographer. LVEF was visually estimated by two blinded readers using echocardiography with tissue harmonics and contrast harmonics on separate occasions.
Results:
By linear regression analysis, LVEF determination by echocardiography with contrast using the Method of Discs correlated well with RNA (r = .835, p < .0005). Using Bland-Altman analysis, the second echocardiogram reader had excellent agreement with RNA, whereas the first reader had a mean difference of 5.25% (CI 1.3-9.2; p = .012) with visual assessment using tissue harmonics and a mean difference of 4.67% (CI 0.4-8.8; p = .031) with visual assessment using contrast harmonics compared with RNA. Thus, a small difference in agreement between RNA and echocardiographic visual estimation was noted that appeared to be primarily reader dependent.
Conclusions:
LVEF determination with echocardiography with contrast using the Method of Discs correlated well with RNA and provided agreement across a range of cardiac functions. Visual echocardiographic assessment of LVEF with both tissue harmonics and contrast harmonics correlated well with RNA, but contrast harmonics did not appear to offer an advantage over tissue harmonics alone.
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