title: Feasibility and accuracy of left ventricular volumes and ejection fraction determination by fundamental, tissue harmonic, and intravenous contrast imaging in difficult-to-image patients.
abstract: The need to enhance the echocardiographic determination of left ventricular ejection fraction is greatest in patients with suboptimal images. Intravenous contrast (CON) and tissue harmonic imaging (THI) are 2 important methods for enhancing endocardial border definition. However, the comparative feasibility and accuracy of THI and contrast-enhanced power harmonic imaging in difficult-to-image patients have not been examined. We assessed the comparative accuracy of THI and CON in determining EF and ventricular volumes in patients with suboptimal fundamental images. We demonstrated that CON is feasible and exhibits a greater correlation with ejection fraction and ventricular volumes determined by radionuclide angiography (standard of comparison) than THI in this difficult-to-image population, with no reported side effects. For both ejection fraction and ventricular volumes, the observer variability was least for CON, intermediate with THI, and greatest for fundamental imaging.
authors.affiliation: Division of Cardiology, Department of Medicine, University Health Network, University of Toronto.
authors.forename: E H
authors.initials: EH
authors.lastname: Yu
authors.forename: C E
authors.initials: CE
authors.lastname: Sloggett
authors.forename: R M
authors.initials: RM
authors.lastname: Iwanochko
authors.forename: H
authors.initials: H
authors.lastname: Rakowski
authors.forename: S C
authors.initials: SC
authors.lastname: Siu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002306:Cardiac Volume; D003287:Contrast Media / Q000008:administration & dosage*; D004452:Echocardiography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011134:Polysaccharides / Q000008:administration & dosage; D011446:Prospective Studies; D011875:Radionuclide Angiography / Q000379:methods*; D015203:Reproducibility of Results; D013318:Stroke Volume; D014003:Tin Polyphosphates / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D011134:Polysaccharides; D014003:Tin Polyphosphates; C059891:SHU 508