Title

Are ejection fraction measurements by echocardiography and left ventriculography equivalent

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine

Date

8-25-2009

Document Type

Article

Medical Subject Headings

Aged; *Angiocardiography; *Echocardiography; Female; Heart Catheterization; Humans; Male; Myocardial Infarction; *Stroke Volume; Ventricular Dysfunction, Left

Disciplines

Life Sciences | Medicine and Health Sciences

Abstract

BACKGROUND: Left ventricular ejection fraction (EF) is an important parameter in the diagnosis and treatment of patients with coronary heart disease. Previous studies comparing echocardiography and contrast left ventriculography (CVG) for the measurement of EF have shown considerable variation in results, yet, in clinical practice, EF measurements are used interchangeably. The purpose of this study was to assess the concordance between echocardiography and CVG for the determination of EF in routine clinical practice and to identify factors associated with variation in test results.

METHODS: We reviewed the medical records of 5,385 patients hospitalized for acute myocardial infarction between 1997 and 2005 as part of a community-based surveillance project. Of these, 741 patients had EF measurements recorded by both echocardiography and CVG during hospitalization.

RESULTS: While good correlation (r = 0.73) and no systematic bias were noted between the measurement of EF by echocardiogram compared to CVG, there was wide variation between the 2 methods for any given patient. In approximately one third of patients with acute myocardial infarction, the measurement of EF by echocardiography and CVG differed by >10 points, while in approximately 1 in 20 patients, EF measurements by echocardiography and CVG differed by >20 points. The number of days between tests to measure EF, level of EF, temporal order of EF testing, and patient-related factors made only a minor contribution to the variation in test results.

CONCLUSIONS: Our results demonstrate that, in routine clinical practice, EF determinations obtained by echocardiography and CVG may vary widely, with potentially important clinical implications.

Rights and Permissions

Citation: Am Heart J. 2009 Sep;158(3):496-502. Epub 2009 Aug 4. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Comments

Medical student Samuel Joffe participated in this study as part of the Senior Scholars research program.