Circulation, Vol 64, 744-753, Copyright © 1981 by American Heart Association
MA Quinones, AD Waggoner, LA Reduto, JG Nelson, JB Young, WL Winters Jr, LG Ribeiro and RR Miller
A new method to determine left ventricular (LV) ejection fraction (EF) with
wide-angle, two-dimensional echocardiography (2-D echo) has been developed
using the parasternal long-axis, apical four-chamber and apical long-axis
views. End-diastolic and end-systolic measurements of LV short axes at the
base and mid-LV cavity in the parasternal long- axis view and at the upper,
middle and lower thirds of the cavity in the apical views are made, from
which an averaged minor axis at end- diastolic and at end-systole is
calculated. Fractional shortening of the LV long axis (delta L) is
estimated from apical contraction. Satisfactory 2-D echoes were obtained in
55 of 58 nonselected patients (all three views in 32 patients, two views in
22 and one view in one); 42 of 55 patients had coronary artery disease. EF
by 2-D echo was compared with EF by gated cardiac blood pool imaging in all
patients (r = 0.927, SEE = 6.7%) and to EF by single-plane cineangiography
(angio) in 35 of 55 patients (r = 0.913, SEE = 7.4%). LV dyssynergy was
frequently present and involved the apex in 29 of 55 patients. Using angio
as the standard for evaluating wall motion at the apex, 2-D echo was 100%
sensitive and specific in detecting abnormal apical wall motion. We
conclude that EF can be determined accurately with 2-D echo in a large
group of patients with and without dyssynergy by a simple method that
eliminates the need for planimetry or computer assistance.
ARTICLES
A new, simplified and accurate method for determining ejection fraction with two-dimensional echocardiography
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