Agreement between visually estimated left ventricular ejection fraction on echocardiography and quantitative measurements using cardiac magnetic resonance.

Publisher: KARE publishing Country of Publication: Turkey NLM ID: 101652981 Publication Model: Print Cited Medium: Internet ISSN: 2149-2271 (Electronic) Linking ISSN: 21492263 NLM ISO Abbreviation: Anatol J Cardiol Subsets: MEDLINE

Publication: 2023- : İstanbul, Turkey : KARE publishing
Original Publication: İstanbul, Turkey : Aves, [2015]-

Ventricular Dysfunction, Left*/diagnostic imaging ; Ventricular Function, Left*; Echocardiography ; Humans ; Magnetic Resonance Imaging/methods ; Magnetic Resonance Spectroscopy ; Reproducibility of Results ; Stroke Volume

Objective: Visual estimation of left ventricular ejection fraction (LVEF) is still used in routine clinical practice. However, most of the studies evaluating the agreement between the visually estimated LVEF (ve-LVEF) and quantitatively measured LVEF (qm-LVEF) either have not used appropriate statistical methods or gold standard imaging modality. In this study, we aimed to assess the agreement between the ve-LVEF and qm-LVEF using contemporary statistical methods and cardiac magnetic resonance imaging (CMRI).
Methods: In 54 subjects who underwent 1.5-T CMRI, echocardiographic images were recorded after the CMRI procedure on the same day. Two independent observers estimated ve-LVEFs on echocardiographic records in a random and blinded fashion, and qm-LVEF was obtained by CMRI. Agreement between the ve-LVEF and qm-LVEF values and intra/interobserver ve-LVEF estimations were assessed using intraclass correlation coefficient (ICC), Bland-Altman analysis, and kappa statistics.
Results: There was a high agreement between the ve-LVEF and qm-LVEF (ICC 0.93, 95% confidence interval 0.88-0.96). Bland-Altman analysis also demonstrated a good agreement between ve-LVEF and qm-LVEF with ve-LVEF, on average, being 0.6% lower than that obtained by CMRI (mean -0.6, limits of agreement -10.5 and +9.3). A good agreement was also observed for LVEF categories ≤35%, 36%-54%, and ≥55% (unweighted kappa 0.71, linearly weighted kappa 0.76); and LVEF of <55% and ≥55% (kappa 0.80). Intra/inter observer agreement was good for ve-LVEFs (ICC value 0.96 and 0.91, respectively).
Conclusion: Visual approach for LVEF assessment may be used for rapid assessment of left ventricular systolic function in clinical practice, particularly in patients with good image quality.

Proc SPIE Int Soc Opt Eng. 2019 Feb;10955:. (PMID: 31186596)
J Am Coll Cardiol. 2021 Feb 2;77(4):e25-e197. (PMID: 33342586)
J Am Coll Cardiol. 2017 Aug 8;70(6):776-803. (PMID: 28461007)
J Cardiol. 2018 Jul;72(1):74-80. (PMID: 29472129)
Clin Cardiol. 1991 Nov;14(11):898-902. (PMID: 1764826)
Am Heart J. 1989 Dec;118(6):1259-65. (PMID: 2686380)
Avicenna J Med. 2018 Apr-Jun;8(2):41-45. (PMID: 29682476)
Circ Cardiovasc Imaging. 2016 Oct;9(10):. (PMID: 27729359)
Am Heart J. 2005 Oct;150(4):737-42. (PMID: 16209976)
Eur Heart J Cardiovasc Imaging. 2017 Dec 1;18(12):1301-1310. (PMID: 29045589)
Interv Cardiol Clin. 2017 Jul;6(3):417-426. (PMID: 28600094)
Am Heart J. 2003 Sep;146(3):388-97. (PMID: 12947354)
J Am Soc Echocardiogr. 2010 Mar;23(3):258-64. (PMID: 20138473)
Int J Cardiovasc Imaging. 2011 Apr;27(4):563-9. (PMID: 20886372)

Date Created: 20220222 Date Completed: 20220228 Latest Revision: 20220311

20250114

PMC8878925

10.5152/AnatolJCardiol.2021.367

35190361