Value of left ventricular regional ejection fraction determined by real-time three-dimensional echocardiography in diagnosis of aneurysm: compared with left ventriculography.
BACKGROUND
Regional ejection fraction (EF(R)) measured by real-time three-dimensional echocardiography (RT-3DE) provides a novel method for quantifying left-ventricular (LV) regional systolic function. We aimed to explore the diagnostic value of regional ejection fraction (EFR) derived from RT-3DE in detecting LV aneurysms in patients with myocardial infarction.


METHODS
Thirty-eight patients with myocardial infarction were prospectively enrolled and underwent electrocardiography (ECG), two-dimensional echocardiography (2-DE), RT-3DE and left ventriculography (LVG). Subjects with a negative EFR in at least one segment on RT-3DE were considered as having a ventricular aneurysm. We compared the sensitivity, specificity, Youden's index, and positive and negative predictive values of ECG, 2-DE and RT-3DE in determining LV aneurysm with detection by LVG.


RESULTS
On LVG an LV aneurysm was diagnosed in 16 (42.1%) patients. The sensitivity and specificity were 62.5% and 86.4% for ECG, 81.2% and 95.4% for 2-DE, and 100.0% and 90.9% for RT-3DE in diagnosing LV aneurysm. Youden's indexes for ECG, 2-DE and RT-3DE were 0.49, 0.77 and 0.91, respectively. Positive and negative predictive values were 76.9% and 76.0% for ECG, 92.9% and 87.5% for 2-DE, and 88.9% and 100.0% for RT-3DE.


CONCLUSIONS
RT-3DE-derived EFR provides a novel, reliable index in the diagnosis of LV aneurysm and has excellent sensitivity and specificity.
Li
Xiu-Chang
XC
Department of Cardiology, Affiliated Hospital of Taishan Medical University, Tai'an, Shandong 271000, China. lixiuchang2000@yahoo.cn
Yan
Cheng-Jun
CJ
Yao
Gui-Hua
GH
Zhang
Mei
M
Li
Ji-Fu
JF
Zhang
Yun
Y
D000328:Adult; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015635:Radionuclide Ventriculography / Q000379:methods*; D013318:Stroke Volume / Q000502:physiology*