Comparison of left ventricular volumes and ejection fraction assessment by two-dimensional echocardiography compared with gated myocardial spect in patients with ischemic cardiomyopathy

Abstract

Aim. The aim of this study was to assess accuracy of echocardiography in the measurement of left ventricular ejection fraction (LVEF), enddiastolic volume (EDV) and endsystolic volume (ESV) compared with gated SPECT. Methods. A total of 70 patients with left ventricular systolic dysfunction were enrolled to study. Median of the time interval between gated SPECT and echocardiography was 1 hour. Results. Echocardiography was in good agreement with gated SPECT for quantification of LVEF by using Simpson's method in triplane (r=0.88, p<0.001), biplane (r=0.83, p<0.001) and monoplane apical four chamber projections (A4CH) (r=0.71, p<0,001). LVEF measured by SPECT (36.6±11.5%) was non-significantly higher then triplane (35.9±10%, median dif. 0.4%), biplane (35.7±10%, median dif. 0.7%), A4CH monoplane (36.6±12.2%, median dif. 0.1%). Echocardiography correlated with SPECT in quantification of EDV using triplane (r=0.8, p<0.001), biplane (r=0.81, p<0.001) and monoplane echocardiography (r=0.76, p<0.001). EDV measured by SPECT (201.1±72.5 ml) was significantly different and higher then triplane (174.4,5±60.8 ml, median dif. 22.8), biplane (170.9±58.4, median dif. 28 ml) and monoplane echocardiography (173.7±59.3, median dif. 85.7 ml). Echocardiography correlated with SPECT in quantification of ESV by triplane (r=0.87, p<0.001), biplane (r=0.86, p<0.001) and monoplane echocardiography (r=0.83, p<0.001). ESV measured by SPECT (133.1±64.3) was significantly different then triplane (115.1±52.1, median dif. 17 ml), biplane (113.2±51.5, median dif. 15.5 ml) and A4CH monoplane echocardiography (112.5±48.8, median dif. 17.2 ml). Conclusion. Echocardiography is a valid tool for LVEF assessment and systematically underestimates LV volumes compared with gated SPECT in patients with LV systolic dysfunction. © M. Hutyra, T. Skala, M. Kaminek, J. Zapletalova.