Consistency of left ventricular ejection fraction measurements in the early time course of STEMI

Area of Science:

• Cardiology
• Medical Imaging
• Cardiovascular Research

Background:

• Left ventricular (LV) function assessment after ST-segment elevation myocardial infarction (STEMI) is complicated by early LV remodeling and microvascular dysfunction.
• Accurate LV function evaluation is critical for guiding treatment and predicting outcomes post-STEMI.

Purpose of the Study:

• To compare left ventricular ejection fraction (LVEF) and stroke volume (SV) measurements using various imaging modalities in the early phase after STEMI.
• To determine the interchangeability of different imaging techniques for assessing LV function post-STEMI.

Main Methods:

• Serial imaging (24 hours and 5 days) was performed in 82 STEMI patients.
• Techniques included cineventriculography (CVG), 2-dimensional echocardiography (2DE), and 2D/3D cardiovascular magnetic resonance (CMR).
• LVEF and SV were calculated and compared across modalities.

Main Results:

• Two-dimensional LVEF measurements were consistent across CVG, 2DE, and 2D CMR at both time points.
• SV measurements by CVG and 2DE were comparable, but 2D CMR yielded higher values due to increased LV end-diastolic volume (LVEDV).
• 3D CMR showed higher volumetric measurements than 2D CMR, irrespective of infarct characteristics.

Conclusions:

• Two-dimensional LVEF assessment is robust and interchangeable between CVG, 2DE, and 2D CMR early after STEMI.
• Significant discrepancies in SV measurements exist between imaging techniques, primarily driven by differences in volumetric quantification.
• Standardization of volumetric measurements is needed for consistent SV assessment across different imaging modalities post-STEMI.