Estimation of left ventricular function using echocardiography and cardiac magnetic resonance imaging: implications for icd therapy

Abstract

Background Estimation of left ventricular (LV) ejection fraction (LVEF) is critical in deciding upon implantable cardioverter-defibrillator (ICD) therapy. We compared visually estimated and calculated LVEF from standard 2-dimensional (2D) echocardiographic (echo) and cardiac magnetic resonance (CMR) views. Methods 20 potential MADIT-II candidates with a previous myocardial infarction and visually estimated LVEF 4 yrs echo experience visually estimated LVEF from apical 4-chamber and 2-chamber LV views obtained using both CMR and transthoracic echocardiography. Results (Bland-Altman analysis) Bias (95% limits) View this table: LVEF calculated from echo View this table: Conclusion Visual estimations of LVEF from CMR and echo as well as calculations of LVEF from M-mode and 2-dimensional echo are in poor agreement with CMR-derived values, even with experienced observers. Echocardiographically-derived LVEF is inadequate in the identification of appropriate candidates for ICD therapy.