Assessment of left ventricular function: comparison of cardiac multidetector-row computed tomography with two-dimension standard echocardiography for assessment of left ventricular function
To compare global Left Ventricular (LV) systolic function assessment by 16-detector row Computed Tomography (MDCT) with Two-Dimensional Standard Echocardiography (2DSE) in a routine cardiology practice setting and to ascertain the degree of correlation between LV volumes and measurements obtained by 2DSE with those measured by MDCT.
In 52 patients with suspected coronary artery disease, a contrast enhanced MDCT study was performed using retrospective gating without dose modulation for better endocardial delineation. Eight phases of the cardiac cycle were analyzed to identify the end-diastolic and end-systolic phases. 2DSE was performed on the same day. Left ventricular systolic and diastolic volumes and ejection fraction were calculated in 4-chamber, 2-chamber and biplane (average of the two) views. Endocardial tracing was used to measure ventricular volumes by area length method for CT and Simpson’s method for echocardiography.
On MDCT, mean LV ejection fraction (LVEF) in 4-chamber, 2-chamber and biplane views were 58.4 ± 12, 59.3 ± 12 and 59.7 ± 12% respectively. On 2DSE, mean LVEF in 4-chamber, 2-chamber and biplane views were 58 ± 14, 57 ± 16 and 58 ± 13% respectively. LVEF correlated best using the biplane views (r = 0.59 and P < 0.01) compared to 2-chamber (r = 0.57 and P < 0.01) and 4-chamber views (r = 0.32 and P = 0.02). Biplane measurement by these two techniques correlated well for LV volumes in both diastole (r = 0.69 and P < 0.01) and systole (r = 0.73 and P < 0.01), although MDCT consistently gave higher values.
MDCT can be a useful tool to measure LVEF while patients are undergoing CT coronary angiography.
KeywordsComputed tomography Echocardiography Left ventricular ejection fraction
Coronary artery disease
Cardiac magnetic resonance imaging
Left ventricular ejection fraction
Left ventricular end-diastolic volume
Left ventricular end-systolic volume
Multi-detector row computed tomography
Two dimensional standard echocardiography
- 1.Risk stratification and survival after myocardial infarction. N Engl J Med 1983 309:331–336Google Scholar
- 2.Corbett JR, Dehmer GJ, Lewis SE, Woodward W, Henderson E, Parkey RW, Blomqvist CG, Willerson JT (1981) The prognostic value of submaximal exercise testing with radionuclide ventriculography before hospital discharge in patients with recent myocardial infarction. Circulation 64:535–544PubMedGoogle Scholar
- 4.Semelka RC, Tomei E, Wagner S, Mayo J, Caputo G, O’Sullivan M, Parmley WW, Chatterjee K, Wolfe C, Higgins CB (1990) Interstudy reproducibility of dimensional and functional measurements between cine magnetic resonance studies in the morphologically abnormal left ventricle. Am Heart J 119:1367–1373PubMedCrossRefGoogle Scholar
- 5.Salm LP, Schuijf JD, de Roos A, Lamb HJ, Vliegen HW, Jukema JW, Joemai R, van der Wall EE, Bax JJ (2006) Global and regional left ventricular function assessment with 16-detector row CT: comparison with echocardiography and cardiovascular magnetic resonance. Eur J Echocardiogr 7(4):308-314Google Scholar
- 10.Sugeng L, Mor-Avi V, Weinert L, Niel J, Ebner C, Steringer-Mascherbauer R, Schmidt F, Galuschky C, Schummers G, Lang RM, Nesser HJ (2006) Quantitative assessment of left ventricular size and function: side-by-side comparison of real-time three-dimensional echocardiography and computed tomography with magnetic resonance reference. Circulation 114(7):654–661 PubMedCrossRefGoogle Scholar
- 11.Halliburton SS, Petersilka M, Schvartzman PR, Obuchowski N, White RD (2003) Evaluation of left ventricular dysfunction using multiphasic reconstructions of coronary multi-slice computed tomography data in patients with chronic ischemic heart disease: validation against cine magnetic resonance imaging. Int J Cardiovasc Imaging 19(1):73–83 PubMedCrossRefGoogle Scholar