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Updated: Jul 4, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Biological factors and overestimation of left ventricular ejection fraction by gated SPECT
Marco Antônio Condé de Oliveira1, Paulo Schiavom Duarte, Maria Margarita C Gonzalez
1Seção de Medicina Nuclear, Fleury - Medicina e Saúde, São Paulo, SP - Brasil. marco.oliveira@fleury.com.br
Insights
Female gender and height are independently associated with overestimated left ventricular ejection fraction (LVEF) in gated SPECT scans. These biological factors influence LVEF overestimation, alongside systolic diameter.
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Overestimated left ventricular ejection fraction (LVEF) can occur in electrocardiogram-gated myocardial scintigraphy (gated SPECT).
- Understanding biological factors influencing LVEF overestimation is crucial for accurate cardiac assessment.
Purpose of the Study:
- To investigate the relationship between biological factors and the overestimation of LVEF in patients undergoing gated SPECT.
- To identify specific patient characteristics associated with inaccurate LVEF measurements.
Main Methods:
- Analysis of 3838 patients who underwent gated SPECT with normal perfusion and LVEF >= 50%.
- Logistic regression was used to calculate odds ratios for overestimated LVEF based on gender, age, height, weight, BMI, and echocardiographic diameters in a subgroup.
- Patients were categorized into normal LVEF (<=80%) and overestimated LVEF (>80%) groups.
Main Results:
- Female gender (OR=3.585), increased age (OR=1.020), and decreased height (OR=0.893) were significantly associated with overestimated LVEF (p < 0.005).
- Weight and BMI did not show a significant association with LVEF overestimation.
- In a subgroup, systolic diameter, gender, and height demonstrated a statistically significant influence on overestimated LVEF values.
Conclusions:
- Systolic diameter influences LVEF overestimation in gated SPECT.
- Patient gender and height are independent factors contributing to LVEF overestimation by gated SPECT, highlighting their importance in interpreting results.
Background:
Some patients present an overestimated left ventricular ejection fraction (LVEF) on electrocardiogram-gated myocardial scintigraphy (gated SPECT).
Objective:
To establish the relationship between biological factors and overestimated LVEF.
Methods:
We selected 3838 patients who underwent gated SPECT between May 20, 2000 and September 16, 2005 with normal perfusion images and LVEF > or =50%. The following variables were analyzed: gender (29.4% females and 70.6% males), age (from 20 to 94 years - mean: 56 years), weight (from 33.5 to 150 kg - mean: 79.6 kg), height (from 138 to 220 cm - mean: 171 cm) and BMI (from 13.9 to 54 - mean: 27.2). In a subgroup of 1002 patients who underwent echocardiogram, the diastolic diameter (from 36 to 68 mm - mean 47.5 mm) and systolic diameter (from 22 to 41 mm - mean 29.8 mm) variables were included. The patients were divided into two groups: normal LVEF (< or =80%) and overestimated LVEF (>80%). The odds ratio (OR) for presenting an overestimated LVEF was calculated for each variable using logistic regression.
Results:
The following odds ratios were found (p < 0.005): female gender OR = 3.585 (95%CI: 2.745 to 4.683), age in years OR = 1.020 (95%CI: 1.011 to 1.029) and height in cm OR = 0.893 (95%CI: 0.829 to 0.962). Weight and BMI were not significantly associated with LVEF (p>0.2). In the subgroup of 1002 patients, a statistically significant influence was found in overestimated LVEF values for the systolic diameter, gender and height variables.
Conclusion:
Although systolic diameter influences the overestimation of LVEF, the gender and height variables have an independent influence on LVEF overestimation by gated SPECT.
