Comparative accuracy of apical biplane cross-sectional echocardiography and gated equilibrium radionuclide angiography for estimating left ventricular size and performance.

Abstract

Measurements of left ventricular (LV) size and performance obtained by apical biplane cross-sectional echocardiography (CSE) and gated equilibrium radionuclide angiography (RNA) were compared. Patients (70) with heart disease, all of whom had single-plane and 30 of whom had biplane left ventricular cineangiography, were studied. Wide-angle, phased-array CSE images were obtained from 2 orthogonal apical views and LV volumes were calculated using a microprocessor-controlled, video light-pen system programmed for a Simpson''s rule algorithm. The average CSE end-diastolic volume (EDV) for all 70 patients of 158 .+-. 56 ml was less than the single-plane angiographic value of 176 .+-. 68 ml (P < 0.001, r = 0.80). The average CSE end-systolic volume (ESV) of 78 .+-. 57 ml was not different from the angiographic value of 84 .+-. 70 ml (r = 0.88). The average CSE and single-plane angiographic ejection fraction (EF) values of 55 .+-. 16 and 57 .+-. 19% were not different (r = 0.90). In the 30 patients who underwent biplane angiography, the average CSE EDV of 166 .+-. 62 ml was less than the biplane angiographic EDV of 217 .+-. 87 ml (P < 0.001, r = 0.81). The average CSE ESV of 89 .+-. 69 ml was less than the angiographic value of 114 .+-. 89 ml (P < 0.001, r = 0.92). The average CSE LV EF of 52 .+-. 19% was not different from the biplane angiographic value of 52 .+-. 17% (r = 0.87). In the 25 patients who underwent CSE, RNA and biplane angiography the average LVEF values were 51 .+-. 20, 46 .+-. 18 and 50 .+-. 17%, respectively. The CSE and RNA values correlated with the biplane angiographic value (r = 0.90 and 0.93, respectively). Apical biplane CSE estimates of left ventricular volume correlated linearly with single-plane and biplane cineangiographic determinations. This CSE technique compares favorably with gated equilibrium RNA for assessing LV performance.