Clinical Investigation
Ventricular Function
Clinical Validation of a Novel Speckle-Tracking–Based Ejection Fraction Assessment Method

https://doi.org/10.1016/j.echo.2011.05.004Get rights and content

Background

The aim of this study was to determine the feasibility, accuracy, and reproducibility of a novel tracking-based echocardiographic ejection fraction (EF) assessment method in comparison with traditional methods based on magnetic resonance imaging and echocardiography.

Methods

In a prospective assessment, apical echocardiographic grayscale image loops from 81 patients were read in random order by four experienced readers, blinded to any data of the cases. In three separate sessions, EFs were estimated using biplane tracking-based assessment and according to the modified Simpson’s rule, as well as by visual interpretation in three apical views. Data were compared with a reference EF derived from echocardiography and magnetic resonance imaging.

Results

On average, no significant difference was found between EF estimates of the different methods. Tracking-based EF assessments were possible in 90% of the patients. Tracking-based EF assessments showed slightly higher deviations from the reference EF than the modified Simpson’s rule, while interobserver and intraobserver variability of tracking-based assessment were significantly better. Visual interpretation allowed the fastest EF assessment. Tracking-based EF assessment was approximately twice as fast as the modified Simpson’s rule.

Conclusions

Tracking-based EF assessment is feasible, has lower interobserver and intraobserver variability, and is faster than traditional echocardiographic EF quantification. Its minimal demand on user interaction makes it a favorable alternative to traditional echocardiographic approaches, with a particular clinical advantage when reliable follow-up measurements are needed.

Section snippets

Population

We used prospective data from 81 hospitalized routine patients in whom both echocardiography and MRI were performed within 48 hours and who represented a wide range of LV global and regional functional abnormalities. Our study group comprised 75 patients with different locations, extents, and severities of ischemic functional impairment of the left ventricle, five patients with dilated cardiomyopathy, and one with amyloidosis. All patients were in sinus rhythm and in stable hemodynamic

Feasibility

Visual assessment of EF was deemed possible by the four echocardiographic readers in 76 to 79 patients (94%–98%). They succeeded with EF quantification according to the modified Simpson’s rule in 75 patients (93%). Tracking-based EF assessment was possible in 73 patients (90%). Failures to apply the latter method were due to poor image quality (n = 3), inadequate electrocardiographic tracing (n = 2), or too low a frame rate (n = 3).

Time Needed for Analysis

Visual inspection proved to be the fastest method for EF

Discussion

In this study, we investigated a new speckle-tracking–based, semiautomatic method of LV global systolic function assessment in comparison with the conventional echocardiographic approaches of EF estimation and MRI. The new method proved to be fast, feasible, reproducible, and robust, leading to a reliable quantitative global functional assessment with minimal user interaction.

Conclusions

AutoEF is a new speckle-tracking–based method to assess LV EF. Similar to traditional EF assessment according to the modified Simpson’s rule, it slightly underestimates EF. In contrast, however, the tracking-based EF assessment algorithm had much lower interobserver and intraobserver variability and proved to be faster than traditional methods of quantification. Tracking-based EF assessment is feasible. Its robustness and minimal demand on user interaction make it a favorable alternative to

References (23)

  • H.A. Dakik et al.

    Prognostic value of exercise 201Tl tomography in patients treated with thrombolytic therapy during acute myocardial infarction

    Circulation

    (1995)

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    Copyright © 2011 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.