On-Line Assessment of Left Ventricular Function by Automated Border Detection Echocardiography : Comparison with Gated Cardiac Blood Pool Scintigraphy

摘要

Background Automated border detection(ABD) is a new echocardiographic modality providing continuous on-line measurements of left ventricular(LV) cavitary ares, volume, and ejection fraction(EF) throughout the cardiac cycle. Previous study showed that LV volume and EF measurements with ABD system approximate manually traced LV volume and EF obtained with conventional 2-dimensional echocardiography. But further clinical validation needs a comparison of LV function between the ABD system and established methods. The purpose of this study is to compare EF, peak ejection rate(PER) and peak filling rate(PFR) between on-line ABD system and the gated cardiac blood pool scinitigraphy. Method 27 patients with an apical 4 chamber view of LV in which at least 75% of the endocardium was clearly seen were selected for this study. They had a normal sinus rhythm and underwent echocardiographic study on the same day of or one day before gated cardiac blood pool scintigraphic study. The off-line estimation of LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view and EF_off was calculated. Also on that view the ABD system was turned on, and EF_ABD, PE_ABD, PE_ABD were calculated automatically from LV volume curve. They were compared with EF_RI, PER_RI, and PER_RI obtained by the gated cardiac blood pool scintigraphy. Results 1) EF_off and EF_ABD were highly correlated with EF_RI(r=0.78, 0.90 respectively : pRI and EF_off was 4±9%, and the limits of agreement between EF_RI and EF_off were -16~22%, EF_off were less than EF_RI(pRI and EF_ABD was 5±7%, and the limits of agreement between EF_RI and EF_off were -9~+19%. EF_ABD was also less than EF_RI(p 2) PER_ABD and PER_ABD were highly correlated with PER_RI and PER_RI(r=0.74, 0.60, respectively ; pRI and PER_ABD was -0.1±0.7EDV(enddiastolic volume)/sec, and the limits of agreement were -1.5~+1.3EDV/sec. PE_ABD was slightly greater than PER_RI(p>0.05). The mean difference between PER_RI and PE_ABD was -0.8±0.8EDV/sec, and the limits of agreement were -2.4~+0.8EDV/sec. PE_ABD were greater than PER_RI(p Conclusion EF, PER, PER measurements by the ABD system and the gated cardiac blood pool scintigraphy have significant correlations. Thus ABD echocardiography is a useful method for assessement of LV function.