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Reproducibility of left ventricular size, shape and mass with echocardiography, magnetic resonance imaging and radionuclide angiography in patients with anterior wall infarction

A plea for core laboratories

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Abstract

After myocardial infarction, left ventricular volume and ejection fraction can be assessed by echocardiography, magnetic resonance imaging and radionuclide angiography to guide therapy and determine prognosis. Whether a measured parameter gives the same results irrespective of the method used and the observer who performs the analysis is only partly known. Intra-observer and inter-observer variability were determined for echo and magnetic resonance imaging. Left ventricular ejection fraction measured by these techniques was related to radionuclide angiograms performed in the same period. Intra-observer variability for both echo and MRI was low and in most instances below 5%. Inter-observer variability for the echo and MRI measurements were substantially higher than intra-observer variability. Comparison of the three imaging modalities revealed systematic differences. Therefore, in clinical studies, left ventricular volume and function parameters have to be measured with the same technique and by the same observer in qualified core laboratories.

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References

  1. Produfit WL, Bruschke AVG, Sones FM. Natural history of obstructive coronary artery disease: ten-year study of 601 non-surgical cases. Prog Cardiovasc Dis 1978; 21: 53–78.

    Google Scholar 

  2. White HD, Norris RM, Brown MA, Takayama M, Maslowski A, Bass NM, Orniston JA, Whitlock T. Left ventricular endsystolic volume is the major determinant of survival after recovery from myocardial infarction. Circulation 1987; 76: 44–51.

    Google Scholar 

  3. Lee KS, Marwick TH, Cook SA, Go RT, Fix JS, James KB, Sapp SH, MacIntyre WJ, Thomas JD. Prognosis of patients with left ventricular dysfunction, with and without viable myocardium after myocardial infarction. Circulation 1994; 90: 2687–94.

    Google Scholar 

  4. Pfeffer MA, Braunwald E, Moye LA, Basta L, Brown EJ, Cuddy TE, Davis BR, Geltman EM, Goldman S, Flaker G, Klein M, Lamas GA, Packer M, Rouleau J, Rouleau JL, Rutherford J, Wertheimer JH. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. N Engl J Med 1992; 327: 669–77.

    Google Scholar 

  5. Lindsay HSJ, Zaman AG, Cowan JC. ACE inhibitors after myocardial infarction: patient selection or treatment for all? Br Heart J 1995; 73: 397–400.

    Google Scholar 

  6. Cohn PF, Levine JA, Bergerson GA, Gorlin R. Reproducibility of the angiographic left ventricular ejection fraction in patients with coronary artery disease. Am Heart J 1974; 88: 713–20.

    Google Scholar 

  7. Wackers FJ, Berger HJ, Johnstone DE, Goldman L, Reduto LA, Langou RA, Gottschalk A, Zaret BL. Multiple gated cardiac blood pool imaging for left ventricular ejection fraction: validation of the technique and assessment of variability. Am J Cardiol 1979; 43: 1159–65.

    Google Scholar 

  8. Doherty III NE, Seelos K, Suzuki J, Caputo GR, O'Sullivan M, Sobol SM, Cavero P, Chatterjee K, Parmley WW, Higgins CB. Application of cine nuclear magnetic resonance imaging for sequential evaluation of response to angiotensin-converting enzyme inhibitor therapy in dilated cardiomyopathy. J Am Coll Cardiol 1992; 19: 1294–302.

    Google Scholar 

  9. Eaton LW, Weiss JL, Bulkley BH, Garrison JB, Weisfeldt ML. Regional cardiac dilatation after acute myocardial infarction: recognition by two-dimensional echocardiography. N Engl J Med 1979; 300: 57–64.

    Google Scholar 

  10. Sharpe N, Smith H, Murphy J., Hannan S. Treatment of patients with symptomless left ventricular dysfunction after myocardial infarction. Lancet 1988; i: 255–9.

    Google Scholar 

  11. St John Sutton M, Pfeffer MA, Plappert T, Rouleau J, Moye LA, Dagenans GR, Lamas GA, Klein M, Sussex B, Goldman GR, Menapace FJ, Parker JO, Lewis S, Sestier F, Gordon DF, McEwan P, Bernstein V, Braunwald E. Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. Circ 1994; 89: 68–75.

    Google Scholar 

  12. Baur LHB, Schipperheyn JJ, Baan J, van der Laarse A, Buis B, van der Wall EE, Manger Cats V, van Dijk A, Blokland JAK, Frölich M, Bruschke AVG: Influence of angiotensin converting enzyme inhibition on pump function and cardiac contractility in patients with chronic congestive heart failure. Br Heart J 1991; 65: 137–42.

    Google Scholar 

  13. Underwood R, Gibson C, Tweddel A, Flint J on behalf of the British Nuclear Cardiology Group. A survey of nuclear cardiology practice in Great Brittain. Br Heart J 1992; 67: 273–7.

    Google Scholar 

  14. Ray SG, Metcalfe MJ, Oldroy KG, Pye M, Martin W, Christie J, Dargie HJ, Cobbe SM. Do radionuclide and echocardiographic techniques give a universal cut off value for left ventricular ejection fraction that can be used to select patients for treatment with ACE inhibitors after myocardial infarction? Br Heart J 1995; 73: 466–9.

    Google Scholar 

  15. Pietro DA, Gene Voelkel A, Ray BJ, Parisi AF: Reproducibility of echocardiography. Chest 1981; 79: 29–32.

    Google Scholar 

  16. Gordon EP, Schnittger I, Fitzgerald P, Williams P, Popp RL. Reproducibility of left ventricular volumes with two dimensional echocardiography. JACC 1983; 2: 506–13.

    Google Scholar 

  17. Kuecherer HF, Kee LL, Modin G, Cheitlin MD, Schiller NB. Echocardiography in serial evaluation of left ventricular systolic and diastolic function: Importance of image acquisition, quantitation and physiologic variability in clinical and investigational applications. J Am Soc Echo 1991; 4: 203–14.

    Google Scholar 

  18. Schiller NB, Shah PM, Crawford M, DeMaria A, Devereux R, Feigenbaum H: Recommendations for quantitation of the left ventricle by two dimensional echocardiography. J Am Soc Echo 1989; 2: 358–67.

    Google Scholar 

  19. Reichek N, Helak J, Plappert T, St John Sutton M, Weber KT. Anatomic validation of left ventricular mass estimates from clinical two-dimensional echocardiography: initial results. Circulation 1983; 67: 348–52.

    Google Scholar 

  20. Geest van der RJ, Jansen E, Buller VGM, Reiber JHC. Automated detection of left ventricular epi- and endocardial contours in short-axis MR images. Comp Cardiol 1994. Bethesda, Maryland: IEEE Computer Society Press, 1994: 245–8.

    Google Scholar 

  21. Van Dijkman PRM, Hold KM, van der Laarse A, Holman ER, Ozdemir HI, van der Nat TH, de Roos A, van der Wall EE. Sequential analysis of infarcted and normal myocardium in piglets using in vivo gadolinium enhanced MR images. Magn Res Imaging 1993; 11: 207–18.

    Google Scholar 

  22. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–10.

    Google Scholar 

  23. Gordon EP, Schnittger I, Fitzgerald PJ, Williams P, Popp RL. Reproducibility of left ventricular volumes by two-dimensional echocardiography. J Am Coll Cardiol 1983; 2: 506–13.

    Google Scholar 

  24. Amico AF, Lichtenberg GS, Reisner SA, Stone CK, Schwartz RG, Meltzer RS. Superiority of visual versus computerized echocardiographic estimation of randionuclide left ventricular ejection fraction. Am Heart J 1989; 118: 1259–65.

    Google Scholar 

  25. Vandenberg B, Rath LS, Stuhlmuller P, Melton HE, Skorton DJ. Estimation of left ventricular area with an on-line, semiautomated echocardiographic edge detection system. Circulation 1992; 86: 159–66.

    Google Scholar 

  26. Martin RP, Rakowski H, Kleiman JH, Beaver W, London E, Poop RL. Reliability and reproducibility of two dimensional echocardiographic measurement of the stenotic mitral valve orifice area. Am J Cardiol 1979; 43: 560–8.

    Google Scholar 

  27. Force TL, Folland ED, Aebischer N, Sharma S, Parisi AF. In: Marcus ML, Schelbert HR, Skorton DJ, Wolf GL (eds) Cardiac Imaging. Philadelphia: W.B. Saunders 1991: 374–401.

    Google Scholar 

  28. Dumesnil JG, Shoucri RM. Effect of the geometry of the left ventricle on the calculation of ejection fraction. Circulation 1982; 65: 91–8.

    Google Scholar 

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Baur, L.H.B., Schipperheyn, J.J., van der Velde, E.A. et al. Reproducibility of left ventricular size, shape and mass with echocardiography, magnetic resonance imaging and radionuclide angiography in patients with anterior wall infarction. Int J Cardiac Imag 12, 233–240 (1996). https://doi.org/10.1007/BF01797736

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  • DOI: https://doi.org/10.1007/BF01797736

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