Sievers Burkhard, Kirchberg Simon, Franken Ulrich, Puthenveettil Binu-John, Bakan Asli, Trappe Hans-Joachim
Department of Cardiology and Angiology, Marienhospital, University of Bochum, Herne, Germany.
Am Heart J. 2005 Oct;150(4):737-42. doi: 10.1016/j.ahj.2004.11.017.
The aim of this study was to compare the visual and quantitative assessment for left ventricular ejection fraction (LVEF) in normal subjects and patients with impaired LV function.
One hundred subjects (40 normal subjects, 40 patients with ischemic cardiomyopathy, and 20 patients with nonischemic cardiomyopathy) were investigated using a 1.5-T cardiovascular magnetic resonance imager. Images were acquired by a fast gradient-echo sequence with steady-state free precession using the standard short-axis method. Left ventricular EF was calculated from the sums of the outlined areas using the Simpson rule. Interobserver variability between the calculated and the visual EF was assessed. Analyses were performed randomly and blinded by 2 independent observers.
Left ventricular EF was significantly underestimated by the visual read in all 3 groups (mean difference: normal subjects -2.6% +/- 2.6%, ischemic cardiomyopathy -1.7% +/- 2.1%, and nonischemic cardiomyopathy -1.2% +/- 2.1%; P < or = .02). The difference was larger in normal subjects than in patients with cardiomyopathy (P = .04). The interobserver variability was smaller for the quantitative assessment than for the visual estimation.
Left ventricular EF is underestimated by visual estimation compared with the quantitative assessment. The visual approach for EF assessment may be used for rapid assessment of left ventricular function in clinical practice where accuracy is of less concern. For most accurate analysis, the quantitative standard short axis approach is required.
本研究旨在比较正常受试者和左心室功能受损患者左心室射血分数（LVEF）的视觉评估和定量评估。
使用1.5-T心血管磁共振成像仪对100名受试者（40名正常受试者、40名缺血性心肌病患者和20名非缺血性心肌病患者）进行研究。采用标准短轴方法，通过快速梯度回波序列和稳态自由进动采集图像。使用辛普森法则根据勾勒区域的总和计算左心室射血分数。评估计算得到的射血分数和视觉评估的射血分数之间的观察者间变异性。由2名独立观察者随机且盲法进行分析。
在所有3组中，视觉评估均显著低估了左心室射血分数（平均差异：正常受试者为-2.6%±2.6%，缺血性心肌病患者为-1.7%±2.1%，非缺血性心肌病患者为-1.2%±2.1%；P≤0.02）。正常受试者中的差异大于心肌病患者（P=0.04）。定量评估的观察者间变异性小于视觉估计。
与定量评估相比，视觉估计低估了左心室射血分数。在对准确性关注较少的临床实践中，用于评估射血分数的视觉方法可用于快速评估左心室功能。为了进行最准确的分析，需要采用定量标准短轴方法。
