Nonvolumetric assessment of ventricular function by two-dimensional echocardiography in patients with coronary artery disease.

Left ventricular ejection fraction (EF) was prospectively predicted by nonvolumetric parameters obtained by M-mode and two-dimensional (2DE) echocardiography in 55 patients with angiographically proven coronary artery disease. In particular, the mitral E-point to septum separation (EPSS) could predict the angiographic ejection fraction (EF) according to the formula %EF = 74 - 2 (EPSS) with a correlation of 0.81 and a standard error of the estimate (SEE) of 12%. An EPSS of greater than 10 mm predicted ventricular dysfunction with a sensitivity of 0.81 and a specificity of 0.93. A Wall Motion Score (WMS), obtained by summing segmental wall motion assessed as normal = 4, hypokinetic = 3, akinetic = 2, dyskinetic = 1, for each of seven segments and dividing by seven (the number of segments evaluated), also correlated with the angiographic EF (r = .76). An abnormal WMS was found to be less than 3.3 and together with an EPSS greater than 10 mm, these parameters had a sensitivity of 0.90, a specificity of 0.92, and predictive value of 0.90 for ventricular dysfunction, as evidenced by an EF of less than 0.51. We conclude that the EPSS has a great a predictive value for the EF as the more vigorous quantitative volumetric echocardiographic estimates. Together with the WMS, these parameters are of considerable clinical value in detecting ventricular dysfunction.