Comparison of Left Ventricular Ejection Fraction Measurements by Echocardiography and Contrast Ventriculography: A Study on a Large Hospitalized Population

Abstract

Background: The evaluation of the left ventricular ejection fraction (LVEF) is important for predicting<br />mortality and identifying high-risk patients. We aimed to identify factors affecting the variation<br />in the LVEF measurement via echocardiography and contrast left ventriculography (CVG).<br />Methods: A total of 4422 patients (mean age=59.0±10.52 y, range=22–88) who underwent<br />echocardiography and CVG within the same hospitalization period (0- to 14-day intervals) were<br />included. Data were obtained from the Echocardiography Data Bank and the Coronary<br />Angiography Data Bank in Tehran Heart Center.<br />Results: The correlation between the estimation of the EF by echocardiography and CVG was good<br />(r=0.716); however, there was no point-by-point agreement. In 21.5% of the patients,<br />echocardiography and CVG estimated the EF equally, and a difference greater than 20% was<br />found in 1.8% of the patients. The differences between the 2 measurements were remarkable<br />either in the patients with EFs greater than 50% or in those with EFs of 50% or less by CVG<br />(59.71±3.72 by CVG vs 55.96±7.57% by echocardiography in EFs>50% and 40.69±8.96 by<br />CVG vs 43.90±10.71% by echocardiography in EFs≤50%). By linear regression analysis, the<br />presence of pathologic Q wave, atrial fibrillation and left bundle branch block, moderate and<br />severe mitral regurgitation, increased LV size, and increased interventricular septal diameter<br />resulted in a higher EF value via CVG, whereas in those with EFs of 50% or less, the EF by<br />echocardiography was higher. No effect of time gap between the measurements was found.<br />Conclusions: According to our study, the EF measurements obtained by echocardiography and CVG<br />varied on an individual basis. The level of the EF was the most important factor correlating with<br />the difference between the measurements by the methods.