Document Detail


Left ventricular ejection fraction measurements: accuracy and prognostic implications in a large population of patients with known or suspected ischemic heart disease.
MedLine Citation:
PMID:  18615270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We sought to compare the reliability and prognostic implications of left ventricular (LV) ejection fraction (EF) measurements obtained in routine clinical practice. We retrospectively selected from our clinical database a group of 422 patients with known or suspected ischemic heart disease, studied by two-dimensional echocardiography, gated single-photon emission computed tomography (SPECT) and left ventriculography (LVG) for clinical purposes. In each diagnostic procedure LVEF was measured as done routinely. The LVEF values obtained by the three methods were similar and closely related. The correlation coefficient r was equal to 0.83 between echocardiographic and LVG, to 0.75 between gated SPECT and LVG and to 0.81 between echocardiographic and SPECT. During follow-up (median 41 months), 31 patients died. The values of LVEF obtained by echocardiography, gated-SPECT and LVG were all powerful predictors of all-cause mortality: chi(2) = 12.3 for echocardiography, 14.4 for gated SPECT and 14.5 for LVG. However, including LVEF values into a model based on patient age, sex, history of angina, evidence of previous infarction and number of stenotic coronary arteries, the ability to predict patient survival significantly increased only including LVEF values measured by gated SPECT (chi(2) = 40.6, P = 0.039). Thus, in a large cohort of unselected patients with known or suspected ischemic heart disease, the values of LVEF routinely measured by echocardiography, gated SPECT and LVG were closely correlated, and provided a powerful prognostic information, that was incremental to clinical variables for gated SPECT.
Authors:
Alessia Gimelli; Patrizia Landi; Paolo Marraccini; Rosa Sicari; Paolo Frumento; Antonio L'Abbate; Daniele Rovai
Publication Detail:
Type:  Journal Article     Date:  2008-07-09
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  24     ISSN:  1569-5794     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-10-27     Completed Date:  2009-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  793-801     Citation Subset:  IM    
Affiliation:
CNR, Clinical Physiology Institute, San Cataldo Research Area, Via Moruzzi 1, Pisa, Italy. gimelli@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Echocardiography
Female
Humans
Linear Models
Male
Myocardial Ischemia / physiopathology*,  radionuclide imaging,  ultrasonography
Prognosis
Proportional Hazards Models
Radionuclide Ventriculography
Reproducibility of Results
Retrospective Studies
Stroke Volume / physiology*
Tomography, Emission-Computed, Single-Photon
Ventricular Dysfunction, Left / physiopathology*,  radionuclide imaging,  ultrasonography
Comments/Corrections
Comment In:
Int J Cardiovasc Imaging. 2008 Dec;24(8):807-10   [PMID:  18763050 ]
Int J Cardiovasc Imaging. 2008 Dec;24(8):803-5   [PMID:  18651240 ]

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