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Year : 2018  |  Volume : 8  |  Issue : 2  |  Page : 41-45

Visual versus fully automated assessment of left ventricular ejection fraction

1 Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center Qassim, King Fahad Specialist Hospital, Buraydah, Al-Qassim, Saudi Arabia
2 Department of Cardiology, Tanta University Hospital, Tanta, Egypt; Department of Cardiology, King Saud Medical City, Riyadh, Saudi Arabia
3 Qassim College of Medicine, Qassim University, Buraydah, Al-Qassim, Saudi Arabia
4 Department of Cardiology, King Saud Medical City, Riyadh, Saudi Arabia

Correspondence Address:
Rami Mahmood Abazid
Department of Cardiology, Prince Sultan Cardiac Center Qassim, Buraydah, Al-Qassim
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajm.AJM_209_17

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Introduction: The aim of this study is to compare three different echocardiographic methods commonly used in the assessment of left ventricle (LV) ejection fraction (EF). Methods: All patients underwent full echocardiography including LVEF assessed using M-mode, automated EF (Auto-EF), and visual estimation by two readers. Results: We enrolled 268 patients. Auto-EF measurement was feasible in 240 (89.5%) patients. The averaged LVEF was (52% ± 12) with the visual assessment, (51% ± 11) with Auto-EF and (57% ± 13) with M-mode. Using Bland-Altman analysis, we found that the difference between the mean visual and the Auto-EF was not significant (−0.3% [−0.5803–0.0053], P = 0.054). However, the mean EF was significantly different when comparing visual versus M-mode and Auto-EF versus M-mode with the mean differences: (−2.4365 [−2.9946–−1.8783], P < 0.0001) and (−2.1490 [−2.7348–−1.5631], P < 0.0001) respectively. Inter-observer variability analysis of the visual EF assessment between the two readers showed that intraclass correlation coefficient was 0.953, (95% confidence interval: 0.939–0.965, P < 0.0001), with excellent correlation between the two readers: R = 0.911, P < 0.0001). Conclusion: The two-dimensional echocardiographic methods using Biplane Auto-EF or visual assessment were significantly comparable, whereas M-mode results in an overestimation of the LVEF.

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