Global and regional left ventricular function: a comparison between gated SPECT, 2D echocardiography and multi-slice computed tomography

Abstract

Global and regional left ventricular (LV) function are important indicators of the cardiac status in patients with coronary artery disease (CAD). Therapy and prognosis are to a large extent dependent on LV function. Multi-slice computed tomography (MSCT) has already earned its place as an imaging modality for non-invasive assessment of the coronary arteries, but since retrospective gating to the patient's ECG is performed, information on LV function can be derived. In 49 patients with known or suspected CAD, coronary angiography with MSCT imaging was performed, in addition to gated SPECT and 2D echocardiography. LV end-diastolic and LV end-systolic volumes and LV ejection fraction were analysed with dedicated software (CMR Analytical Software System, Medis, Leiden, The Netherlands for MSCT; gated SPECT by QGS, Cedars-Sinai Medical Center, Los Angeles, CA, USA), and by the biplane Simpson's rule for 2D echocardiography. Regional wall motion was evaluated according to a 17-segment model and a three-point score system. Correlations were fairly good between gated SPECT and MSCT (LVEDV: r=0.65; LVESV: r=0.63; LVEF: r=0.60), and excellent between 2D echocardiography and MSCT (LVEDV: r=0.92; LVESV: r=0.93; LVEF: r=0.80). Agreement for regional wall motion was 95% (kappa=0.66) between gated SPECT and MSCT, and 96% (kappa=0.73) between 2D echocardiography and MSCT. Global and regional LV function and LV volumes can be adequately assessed with MSCT. Correlations with 2D echocardiography are stronger than with gated SPECT.