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Updated: Aug 15, 2026
Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging
Published on: May 24, 2021
Visual estimation versus quantitative assessment of left ventricular ejection fraction: a comparison by
Burkhard Sievers1, Simon Kirchberg, Ulrich Franken
1Department of Cardiology and Angiology, Marienhospital, University of Bochum, Herne, Germany. burkhard.sievers@gmx.de
Insights
Visual estimation underestimates left ventricular ejection fraction (LVEF) compared to quantitative assessment. Quantitative methods are required for accurate LVEF analysis, while visual assessment offers rapid, less precise evaluations.
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Techniques
Background:
- Left ventricular ejection fraction (LVEF) is a key indicator of cardiac function.
- Accurate LVEF assessment is crucial for diagnosing and managing heart conditions.
- Cardiovascular magnetic resonance (CMR) imaging is a primary tool for cardiac assessment.
Purpose of the Study:
- To compare visual and quantitative methods for assessing LVEF.
- To evaluate LVEF in normal subjects and patients with impaired left ventricular function.
- To determine the accuracy and variability of visual versus quantitative LVEF assessment.
Main Methods:
- 100 subjects (normal, ischemic cardiomyopathy, non-ischemic cardiomyopathy) underwent 1.5-T CMR.
- Standard short-axis views were acquired using a fast gradient-echo sequence.
- LVEF was calculated using the Simpson rule; visual and quantitative assessments were compared by two blinded observers.
Main Results:
- Visual LVEF estimation significantly underestimated quantitative LVEF across all groups.
- Underestimation was greater in normal subjects compared to cardiomyopathy patients.
- Quantitative assessment demonstrated lower interobserver variability than visual estimation.
Conclusions:
- Visual LVEF assessment consistently underestimates the true ejection fraction.
- Quantitative assessment using the standard short-axis method provides superior accuracy.
- Visual estimation may suffice for rapid clinical assessments where precision is less critical.
Purpose:
The aim of this study was to compare the visual and quantitative assessment for left ventricular ejection fraction (LVEF) in normal subjects and patients with impaired LV function.
Methods:
One hundred subjects (40 normal subjects, 40 patients with ischemic cardiomyopathy, and 20 patients with nonischemic cardiomyopathy) were investigated using a 1.5-T cardiovascular magnetic resonance imager. Images were acquired by a fast gradient-echo sequence with steady-state free precession using the standard short-axis method. Left ventricular EF was calculated from the sums of the outlined areas using the Simpson rule. Interobserver variability between the calculated and the visual EF was assessed. Analyses were performed randomly and blinded by 2 independent observers.
Results:
Left ventricular EF was significantly underestimated by the visual read in all 3 groups (mean difference: normal subjects -2.6% +/- 2.6%, ischemic cardiomyopathy -1.7% +/- 2.1%, and nonischemic cardiomyopathy -1.2% +/- 2.1%; P < or = .02). The difference was larger in normal subjects than in patients with cardiomyopathy (P = .04). The interobserver variability was smaller for the quantitative assessment than for the visual estimation.
Conclusion:
Left ventricular EF is underestimated by visual estimation compared with the quantitative assessment. The visual approach for EF assessment may be used for rapid assessment of left ventricular function in clinical practice where accuracy is of less concern. For most accurate analysis, the quantitative standard short axis approach is required.
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