307 Comparison of Left Ventriculography and Transthoracic Echocardiography in the Assessment of Left Ventricular Systolic Function Post Myocardial Infarction - A Single Centre Retrospective Analysis

Abstract

Left ventricular systolic function (LVSF) provides prognostic information in patients post myocardial infarction (MI). We compared the accuracy of LVSF assessment by invasive contrast ventriculography (LVG) to transthoracic echocardiogram (TTE) in patients presenting with ST-segment elevation MI (STEMI). A retrospective audit of consecutive patients over a 12 month period with confirmed STEMI at Alfred Health was performed. All patients who had LVG and TTE during their index presentation were included. A total of 168 consecutive patients with confirmed STEMI who underwent coronary angiogram were included. Median age was 64 years (IQR 56-74), with 79% males. 76 patients (45%) had LVG, and of these 67 (88%) had an inpatient TTE. There were 33 patients (49%) whose assessment of LVSF at time of LVG was consistent with that of the TTE. There were 30 cases (45%) who had an initial grading that differed by 1 category to TTE, 4 cases (6%) that differed by 2 categories to TTE, and no cases where the grading of severity differed by 3 categories. The mean lag-time between LVG and TTE was 1.7 days (IQR1-2).Table 1. TTE LVSFNormalMildModerateSevereNormal2141LVGMild1984LVSFModerate2121Severe112 Open table in a new tab LVG is infrequently performed in patients with STEMI. When performed, the LVSF categorical assessment agreed with TTE in only half of cases. Once timely access to TTE is established, it is likely that LVG will become a rare diagnostic tool.