The International Journal of Cardiovascular Imaging

, Volume 27, Issue 4, pp 563–569

A comparison of visual and quantitative assessment of left ventricular ejection fraction by cardiac magnetic resonance

  • Cameron J. Holloway
  • Lindsay M. Edwards
  • Oliver J. Rider
  • Angela Fast
  • Kieran Clarke
  • Jane M. Francis
  • Saul G. Myerson
  • Stefan Neubauer
Original Paper

DOI: 10.1007/s10554-010-9706-0

Cite this article as:
Holloway, C.J., Edwards, L.M., Rider, O.J. et al. Int J Cardiovasc Imaging (2011) 27: 563. doi:10.1007/s10554-010-9706-0

Abstract

To determine the accuracy of visual analysis of left ventricular (LV) function in comparison with the accepted quantitative gold standard method, Cardiac Magnetic Resonance (CMR). Cine CMR imaging was performed at 1.5 T on 44 patients with a range of ejection fractions (EF, 5–80%). Clinicians (n = 18) were asked to visually assess EF after sequentially being shown cine images of a four chamber (horizontal long axis; HLA), two chamber (vertical long axis; VLA) and a short axis stack (SAS) and results were compared to a commercially available analysis package. There were strong correlations between visual and quantitative assessment. However, the EF was underestimated in all categories (by 8.4% for HLA, 8.4% for HLA + VLA and 7.9% for HLA + VLA + SAS, P all < 0.01) and particularly underestimated in mild LV impairment (17.4%, P < 0.01), less so for moderate (4.9%) and not for severe impairment (1%). Assessing more than one view of the heart improved visual assessment of LV, EF, however, clinicians underestimated EF by 8.4% on average, with particular inaccuracy in those with mild dysfunction. Given the important clinical information provided by LV assessment, quantitative analysis is recommended for accurate assessment.

Keywords

Cardiac magnetic resonanceLeft ventricular functionLeft ventricular analyses

Abbreviations

EF

Ejection fraction

HLA

Horizontal long axis

SA

Short axis

LV

Left ventricle

VLA

Vertical long axis

CMR

Cardiac magnetic resonance

Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Cameron J. Holloway
    • 1
    • 2
  • Lindsay M. Edwards
    • 3
  • Oliver J. Rider
    • 2
  • Angela Fast
    • 2
  • Kieran Clarke
    • 1
  • Jane M. Francis
    • 2
  • Saul G. Myerson
    • 2
  • Stefan Neubauer
    • 2
  1. 1.Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
  2. 2.University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), Level 0, John Radcliffe HospitalOxfordUK
  3. 3.School of MedicineUniversity of TasmaniaHobartAustralia