eCite Digital Repository

Performance of conventional echocardiographic parameters and myocardial measurements in the sequential evaluation of left ventricular function

Citation

Hare, JL and Brown, JK and Marwick, TH, Performance of conventional echocardiographic parameters and myocardial measurements in the sequential evaluation of left ventricular function, The American Journal of Cardiology, 101, (5) pp. 706-711. ISSN 0002-9149 (2008) [Refereed Article]

Copyright Statement

Copyright 2008 Elsevier

DOI: doi:10.1016/j.amjcard.2007.10.037

Abstract

Echocardiography is frequently used for sequential evaluation of left ventricular (LV) function, although the reproducibility of such conventional measurements as LV ejection fraction (EF) have been questioned. The utility of such newer measurements as tissue Doppler imaging and left atrial (LA) size in serial clinical testing are undefined. The magnitude and clinical relevance of changes in conventional and new measurements of LV function were investigated and compared in 346 consecutive patients undergoing sequential echocardiography. Change in LA area, LVEF, tissue E velocity (Em), and transmitral E to Em ratio (E/Em) were compared over 304 239 days. Changes within and between parameters (after mean correction to make measurements comparable) were assessed in groups designated as stable (n = 144) or unstable (n = 202) according to clinical progress. A single observer remeasured these parameters in stable patients individually and with paired studies side by side. Significant variability was seen in all measurements, with change in LVEF the only parameter differing between stable and unstable groups (6.4 8.9% vs 9.4 5.4%; p <0.001). Tissue Em and E/Em ratio were more variable than LA area or LVEF. In stable patients, LVEF changed the least and E/Em changed the most over time (p <0.05). With a single blinded observer, Em had improved reproducibility (1.5 1.9 vs 2.3 2.6 cm/s; p <0.001), as did visual EF. In conclusion, variability in all measurements was high irrespective of clinical status. Newer measurements were no better than LVEF in detecting changes in clinical status. Sequential LV assessment should be interpreted with caution, and more robust measurements are needed.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
Author:Marwick, TH (Professor Tom Marwick)
ID Code:90796
Year Published:2008
Web of Science® Times Cited:26
Deposited By:Menzies Institute for Medical Research
Deposited On:2014-04-24
Last Modified:2014-05-20
Downloads:0

Repository Staff Only: item control page