Dipartimento di Radiologia e Cardiologia, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43100 Parma, Italy.
Radiol Med. 2010 Oct;115(7):1015-27. doi: 10.1007/s11547-010-0542-z. Epub 2010 Mar 9.
This study compared cardiac computed tomography (CT) and two-dimensional transthoracic echocardiography (ECC) for assessing left ventricular ejection fraction (LVEF) using real-world data from a large patient population.
We studied 450 patients (284 males; mean age 64±12 years; range 12-88) who underwent CT and ECC due to suspected coronary artery disease. For CT, we used multiphase short-axis reconstructions and evaluated them with a dedicated software tool that uses Simpson's rule to compute LV volumes. For ECC, computation was based on the biplane Simpson's method. Results in terms of EF were compared with the paired Student's t test, Pearson's correlation coefficient (r), and Bland-Altman analysis.
EF was 52%±15% for CT and 55%±13% for ECC. Statistically significant differences, albeit with good correlation, were observed between the measurements (r=0.71; p<0.05). ECC showed a slight tendency to overestimate EF. When the population was divided into subgroups according to EF, this was underestimated by ECC in the subgroup with EF >50% and overestimated in those with EF 35%-50% and <35%, with consistently significant differences between ECC and CT (p<0.05) and progressively lower levels of agreement.
In the real-world assessment of EF, ECC provides significantly different data from CT, with a bias that increases proportionally to LV systolic dysfunction.
本研究通过大样本患者的真实世界数据,比较心脏计算机断层扫描(CT)和二维经胸超声心动图(ECC)评估左心室射血分数(LVEF)的效果。
我们研究了 450 例疑似冠心病患者(284 例男性;平均年龄 64±12 岁;年龄范围 12-88 岁),这些患者均同时接受了 CT 和 ECC 检查。对于 CT,我们使用多期短轴重建,并使用专用软件工具评估,该工具使用辛普森法则计算 LV 容积。对于 ECC,计算基于双平面辛普森法。EF 的结果通过配对学生 t 检验、Pearson 相关系数(r)和 Bland-Altman 分析进行比较。
CT 的 EF 为 52%±15%,ECC 的 EF 为 55%±13%。尽管相关性良好,但两种测量方法之间存在显著差异(r=0.71;p<0.05)。ECC 有轻微高估 EF 的趋势。当根据 EF 将人群分为亚组时,ECC 在 EF>50%的亚组中低估 EF,在 EF 为 35%-50%和<35%的亚组中高估 EF,ECC 和 CT 之间存在显著差异(p<0.05),一致性逐渐降低。
在 EF 的实际评估中,ECC 与 CT 提供的数据存在显著差异,且这种偏差随 LV 收缩功能障碍的增加而呈比例增加。