Abstract 1849: Gender Differences in Left Ventricular Ejection Fraction Assessment between Transthoracic Echocardiography and Gated Single Photon Emission Computed Tomography: Data from 2704 Patients
BACKGROUND: Left ventricular ejection fraction (LV EF) has been used historically as a prognostic tool in patients with various ischemic and non-ischemic cardiomyopathies. More recently, its use has been expanded to determine eligibility for antitachycardia device implantation. Testing methods for assessing LV EF, however, have not been uniform. We have previously reported a general bias of approximately +9%-points for gated single photon emission computed tomography (SPECT) assessment of LV EF when compared to assessment by transthoracic echocardiography (TTE). We sought to identify the existence of a gender-related pattern to this bias.
METHODS: We identified 2704 consecutive patients from October 2004 to December 2005 who underwent both TTE and gated SPECT within 1 month’s time at our institution. Reported LV EF by gated SPECT was compared to that by TTE within gender groups using Spearman rank correlation analysis for non-parametric variables and the Bland-Altman method for assessing bias between measurement methods.
RESULTS: Correlation analysis among males yielded a correlation coefficient of 0.66 (95% confidence interval (CI) 0.63–0.69; p<0.0001) while analysis of females yielded a coefficient of 0.50 (95% CI 0.46 – 0.55; p<0.0001). Bias analysis among males yielded a gated SPECT bias of +8.31%-points (95% CI 7.82–8.79) while analysis of females yielded a bias of +9.97%-points (95% CI 9.22–10.72).
CONCLUSIONS: In women, LV EF as measured by gated SPECT is generally 10% higher than that measured by TTE; this disparity decreases among men. Further studies are necessary to clarify the clinical impact of this difference when determining device eligibility.