Faculty Collaboration Database

Comparison of echocardiography using tissue harmonics and contrast harmonics with radionuclide angiography for the assessment of left ventricular function. J Investig Med 2003 Nov;51(6):366-72

Date

12/23/2003

Pubmed ID

14686640

DOI

10.1136/jim-51-06-33

Scopus ID

2-s2.0-0344737627 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

BACKGROUND: Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and mortality; however, the optimal noninvasive modality for the quantitative determination of LVEF is not apparent.

HYPOTHESIS: We verified the hypothesis that the various echocardiographic methods of assessing LVEF using the Method of Discs with contrast (Optison human albumin microspheres; Amersham Health, Princeton, NJ) and visual assessment of LVEF using tissue harmonics and contrast harmonics compare favorably with radionuclide angiography (RNA).

METHODS: In a prospective analysis, 24 consecutive patients scheduled to undergo RNA had an echocardiogram using tissue harmonics and contrast harmonics on the same day. LVEF was assessed by RNA by an experienced, blinded reader using manual determination of the region of interest. LVEF was calculated using the Method of Discs (Simpson's Rule) by a blinded sonographer. LVEF was visually estimated by two blinded readers using echocardiography with tissue harmonics and contrast harmonics on separate occasions.

RESULTS: By linear regression analysis, LVEF determination by echocardiography with contrast using the Method of Discs correlated well with RNA (r = .835, p < .0005). Using Bland-Altman analysis, the second echocardiogram reader had excellent agreement with RNA, whereas the first reader had a mean difference of 5.25% (CI 1.3-9.2; p = .012) with visual assessment using tissue harmonics and a mean difference of 4.67% (CI 0.4-8.8; p = .031) with visual assessment using contrast harmonics compared with RNA. Thus, a small difference in agreement between RNA and echocardiographic visual estimation was noted that appeared to be primarily reader dependent.

CONCLUSIONS: LVEF determination with echocardiography with contrast using the Method of Discs correlated well with RNA and provided agreement across a range of cardiac functions. Visual echocardiographic assessment of LVEF with both tissue harmonics and contrast harmonics correlated well with RNA, but contrast harmonics did not appear to offer an advantage over tissue harmonics alone.

Author List

Almeda FQ, Hendel RC, Macioch JE, Sandelski J, Parrillo JE, Meyer PM, Johnson M, Daniels ML, Go VU, Feinstein SB

Author

James Macioch DO, MBA Emeritus Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Echocardiography
Female
Humans
Male
Middle Aged
Prospective Studies
Radionuclide Angiography
Reproducibility of Results
Stroke Volume
Ventricular Function, Left