Cardiac MRI Versus Echocardiography for Left Ventricular Ejection Fraction Assessment: a Prospective Comparative...

Area of Science:

• Cardiology
• Medical Imaging
• Diagnostic Techniques

Background:

• Accurate left ventricular ejection fraction (LVEF) assessment is crucial for cardiovascular disease management.
• Cardiac magnetic resonance imaging (CMR) is the reference standard, but echocardiography and global longitudinal strain (GLS) are more accessible alternatives.
• This study evaluates LVEF assessment methods in Northeast Indian patients.

Purpose of the Study:

• To compare the accuracy of LVEF measurements using CMR, 2D Echo, 3D Echo, and GLS.
• To assess the agreement between these imaging modalities.
• To evaluate the incremental diagnostic value of GLS in cardiovascular disease patients.

Main Methods:

• A prospective observational study of 50 cardiovascular disease patients at a tertiary care center.
• LVEF was measured using CMR, 2D Echo, and 3D Echo.
• Agreement was analyzed using Bland-Altman analysis and intraclass correlation coefficient (ICC).

Main Results:

• CMR-LVEF averaged 48.5 ± 12.3%.
• 3D Echo demonstrated superior agreement with CMR (ICC 0.93) compared to 2D Echo (ICC 0.89).
• GLS strongly correlated with CMR-LVEF and identified subclinical dysfunction in 35% of patients.

Conclusions:

• CMR remains the gold standard for LVEF quantification.
• 3D Echo offers better agreement with CMR than 2D Echo for LVEF assessment.
• GLS provides valuable incremental diagnostic information beyond LVEF, supporting a multimodality imaging approach.