Baran A O, Rogal G J, Nanda N C
J Am Coll Cardiol. 1983 Jun;1(6):1471-8. doi: 10.1016/s0735-1097(83)80051-5.
A new method for determining ejection fraction by two-dimensional echocardiography was assessed in 60 patients undergoing angiography. In method A, the left ventricular minor axis was measured at the midventricular cavity level in end-systole and end-diastole using the apical four chamber view in the 60 patients. The left ventricular major axis was also measured from the left ventricular apex to the base of the mitral valve at end-systole and end-diastole. The ejection fraction was determined using a modified cylinder-ellipse algorithm. In method B, measurements of the left ventricular minor axis were made in 40 consecutive patients, at the upper, middle and lower thirds of the left ventricular cavity at end-systole and end-diastole of the same cardiac cycle and left ventricular major axis was measured as in method A. With use of the same algorithm, three regional ejection fractions were determined and averaged to yield the total ejection fraction. The two echocardiographic methods were compared with single plane cineangiography in all patients and with gated nuclear scanning in 14 patients. Reproducibility was assessed by interobserver comparison. Correlation was determined in all patients and then separately for those with echocardiographic wall motion abnormalities. The correlation coefficient for all patients was 0.79 (probability [p] less than 0.001) for method A and 0.90 (p less than 0.001) for method B. For patients with wall motion abnormalities, method A had a correlation coefficient of 0.38 (p less than 0.1) and method B showed much higher correlation with r = 0.82 (p less than 0.001). Corresponding values for methods A and B in patients without wall motion abnormality were 0.85 (p less than 0.001) and 0.88 (p less than 0.001), respectively. Unlike a previous study, this method directly measures fractional shortening of left ventricular major axis and ejection fraction values are not arbitrarily modified by type of wall motion abnormality. With this method, accurate measurement of ejection fraction can be made by two-dimensional echocardiography without planimetry. In the absence of echocardiographic wall motion abnormalities, a very simple method A suffices. If wall motion abnormalities are present, the regional ejection fraction method B provides excellent results.
在60例接受血管造影的患者中评估了一种通过二维超声心动图测定射血分数的新方法。在方法A中，使用心尖四腔心视图，于收缩末期和舒张末期在60例患者的心室腔中部水平测量左心室短轴。还在收缩末期和舒张末期从左心室心尖至二尖瓣瓣环测量左心室长轴。使用改良的圆柱 - 椭圆算法测定射血分数。在方法B中，在40例连续患者中，于同一心动周期的收缩末期和舒张末期在左心室腔的上、中、下三分之一处测量左心室短轴，左心室长轴测量方法同方法A。使用相同算法，测定三个节段射血分数并取平均值得出总射血分数。在所有患者中将这两种超声心动图方法与单平面电影血管造影进行比较，并在14例患者中与门控核素扫描进行比较。通过观察者间比较评估可重复性。在所有患者中确定相关性，然后对有超声心动图壁运动异常的患者单独进行相关性分析。方法A在所有患者中的相关系数为0.79（概率[p]小于0.001），方法B为0.90（p小于0.001）。对于有壁运动异常的患者，方法A的相关系数为0.38（p小于0.1），方法B显示出更高的相关性，r = 0.82（p小于0.001）。方法A和B在无壁运动异常患者中的相应值分别为0.85（p小于0.001）和0.88（p小于0.001）。与先前的研究不同，该方法直接测量左心室长轴的缩短分数，射血分数值不会因壁运动异常类型而被随意修改。使用该方法，无需面积测量即可通过二维超声心动图准确测量射血分数。在无超声心动图壁运动异常的情况下，非常简单的方法A就足够了。如果存在壁运动异常，节段射血分数方法B可提供出色的结果。
