Comparison of Echocardiography using Tissue Harmonics and Contrast Harmonics with Radionuclide Angiography for the Assessment of Left Ventricular Function

Francis Q. Almeda, Robert Hendel, James E. Macioch, Joanne Sandelski, Joseph E. Parrillo, Peter M. Meyer, Mahala Johnson, Maria L. Daniels, Vanessa U. Go, Steven B. Feinstein

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and mortality; however, the optimal noninvasive modality for the quantitative determination of LVEF is not apparent. Hypothesis: We verified the hypothesis that the various echocardiographic methods of assessing LVEF using the Method of Discs with contrast (Optison human albumin microspheres; Amersham Health, Princeton, NJ) and visual assessment of LVEF using tissue harmonics and contrast harmonics compare favorably with radionuclide angiography (RNA). Methods: In a prospective analysis, 24 consecutive patients scheduled to undergo RNA had an echocardiogram using tissue harmonics and contrast harmonics on the same day. LVEF was assessed by RNA by an experienced, blinded reader using manual determination of the region of interest. LVEF was calculated using the Method of Discs (Simpson's Rule) by a blinded sonographer. LVEF was visually estimated by two blinded readers using echocardiography with tissue harmonics and contrast harmonics on separate occasions. Results: By linear regression analysis, LVEF determination by echocardiography with contrast using the Method of Discs correlated well with RNA (r = .835, p < .0005). Using Bland-Altman analysis, the second echocardiogram reader had excellent agreement with RNA, whereas the first reader had a mean difference of 5.25% (CI 1.3-9.2; p = .012) with visual assessment using tissue harmonics and a mean difference of 4.67% (CI 0.4-8.8; p = .031) with visual assessment using contrast harmonics compared with RNA. Thus, a small difference in agreement between RNA and echocardiographic visual estimation was noted that appeared to be primarily reader dependent. Conclusions: LVEF determination with echocardiography with contrast using the Method of Discs correlated well with RNA and provided agreement across a range of cardiac functions. Visual echocardiographic assessment of LVEF with both tissue harmonics and contrast harmonics correlated well with RNA, but contrast harmonics did not appear to offer an advantage over tissue harmonics alone.

Original languageEnglish
Pages (from-to)366-372
Number of pages7
JournalJournal of Investigative Medicine
Volume51
Issue number6
StatePublished - Nov 1 2003
Externally publishedYes

Fingerprint

Radionuclide Angiography
Echocardiography
Angiography
Left Ventricular Function
Radioisotopes
Stroke Volume
Tissue
Microspheres
Linear regression
Regression analysis
Albumins
Linear Models
Health
Regression Analysis

Keywords

  • Contrast harmonics
  • Echocardiography
  • Left ventricular function
  • Radionuclide angiography
  • Tissue harmonics

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Almeda, F. Q., Hendel, R., Macioch, J. E., Sandelski, J., Parrillo, J. E., Meyer, P. M., ... Feinstein, S. B. (2003). Comparison of Echocardiography using Tissue Harmonics and Contrast Harmonics with Radionuclide Angiography for the Assessment of Left Ventricular Function. Journal of Investigative Medicine, 51(6), 366-372.

Comparison of Echocardiography using Tissue Harmonics and Contrast Harmonics with Radionuclide Angiography for the Assessment of Left Ventricular Function. / Almeda, Francis Q.; Hendel, Robert; Macioch, James E.; Sandelski, Joanne; Parrillo, Joseph E.; Meyer, Peter M.; Johnson, Mahala; Daniels, Maria L.; Go, Vanessa U.; Feinstein, Steven B.

In: Journal of Investigative Medicine, Vol. 51, No. 6, 01.11.2003, p. 366-372.

Research output: Contribution to journalArticle

Almeda, FQ, Hendel, R, Macioch, JE, Sandelski, J, Parrillo, JE, Meyer, PM, Johnson, M, Daniels, ML, Go, VU & Feinstein, SB 2003, 'Comparison of Echocardiography using Tissue Harmonics and Contrast Harmonics with Radionuclide Angiography for the Assessment of Left Ventricular Function', Journal of Investigative Medicine, vol. 51, no. 6, pp. 366-372.
Almeda, Francis Q. ; Hendel, Robert ; Macioch, James E. ; Sandelski, Joanne ; Parrillo, Joseph E. ; Meyer, Peter M. ; Johnson, Mahala ; Daniels, Maria L. ; Go, Vanessa U. ; Feinstein, Steven B. / Comparison of Echocardiography using Tissue Harmonics and Contrast Harmonics with Radionuclide Angiography for the Assessment of Left Ventricular Function. In: Journal of Investigative Medicine. 2003 ; Vol. 51, No. 6. pp. 366-372.
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abstract = "Background: Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and mortality; however, the optimal noninvasive modality for the quantitative determination of LVEF is not apparent. Hypothesis: We verified the hypothesis that the various echocardiographic methods of assessing LVEF using the Method of Discs with contrast (Optison human albumin microspheres; Amersham Health, Princeton, NJ) and visual assessment of LVEF using tissue harmonics and contrast harmonics compare favorably with radionuclide angiography (RNA). Methods: In a prospective analysis, 24 consecutive patients scheduled to undergo RNA had an echocardiogram using tissue harmonics and contrast harmonics on the same day. LVEF was assessed by RNA by an experienced, blinded reader using manual determination of the region of interest. LVEF was calculated using the Method of Discs (Simpson's Rule) by a blinded sonographer. LVEF was visually estimated by two blinded readers using echocardiography with tissue harmonics and contrast harmonics on separate occasions. Results: By linear regression analysis, LVEF determination by echocardiography with contrast using the Method of Discs correlated well with RNA (r = .835, p < .0005). Using Bland-Altman analysis, the second echocardiogram reader had excellent agreement with RNA, whereas the first reader had a mean difference of 5.25{\%} (CI 1.3-9.2; p = .012) with visual assessment using tissue harmonics and a mean difference of 4.67{\%} (CI 0.4-8.8; p = .031) with visual assessment using contrast harmonics compared with RNA. Thus, a small difference in agreement between RNA and echocardiographic visual estimation was noted that appeared to be primarily reader dependent. Conclusions: LVEF determination with echocardiography with contrast using the Method of Discs correlated well with RNA and provided agreement across a range of cardiac functions. Visual echocardiographic assessment of LVEF with both tissue harmonics and contrast harmonics correlated well with RNA, but contrast harmonics did not appear to offer an advantage over tissue harmonics alone.",
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T1 - Comparison of Echocardiography using Tissue Harmonics and Contrast Harmonics with Radionuclide Angiography for the Assessment of Left Ventricular Function

AU - Almeda, Francis Q.

AU - Hendel, Robert

AU - Macioch, James E.

AU - Sandelski, Joanne

AU - Parrillo, Joseph E.

AU - Meyer, Peter M.

AU - Johnson, Mahala

AU - Daniels, Maria L.

AU - Go, Vanessa U.

AU - Feinstein, Steven B.

PY - 2003/11/1

Y1 - 2003/11/1

N2 - Background: Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and mortality; however, the optimal noninvasive modality for the quantitative determination of LVEF is not apparent. Hypothesis: We verified the hypothesis that the various echocardiographic methods of assessing LVEF using the Method of Discs with contrast (Optison human albumin microspheres; Amersham Health, Princeton, NJ) and visual assessment of LVEF using tissue harmonics and contrast harmonics compare favorably with radionuclide angiography (RNA). Methods: In a prospective analysis, 24 consecutive patients scheduled to undergo RNA had an echocardiogram using tissue harmonics and contrast harmonics on the same day. LVEF was assessed by RNA by an experienced, blinded reader using manual determination of the region of interest. LVEF was calculated using the Method of Discs (Simpson's Rule) by a blinded sonographer. LVEF was visually estimated by two blinded readers using echocardiography with tissue harmonics and contrast harmonics on separate occasions. Results: By linear regression analysis, LVEF determination by echocardiography with contrast using the Method of Discs correlated well with RNA (r = .835, p < .0005). Using Bland-Altman analysis, the second echocardiogram reader had excellent agreement with RNA, whereas the first reader had a mean difference of 5.25% (CI 1.3-9.2; p = .012) with visual assessment using tissue harmonics and a mean difference of 4.67% (CI 0.4-8.8; p = .031) with visual assessment using contrast harmonics compared with RNA. Thus, a small difference in agreement between RNA and echocardiographic visual estimation was noted that appeared to be primarily reader dependent. Conclusions: LVEF determination with echocardiography with contrast using the Method of Discs correlated well with RNA and provided agreement across a range of cardiac functions. Visual echocardiographic assessment of LVEF with both tissue harmonics and contrast harmonics correlated well with RNA, but contrast harmonics did not appear to offer an advantage over tissue harmonics alone.

AB - Background: Left ventricular ejection fraction (LVEF) is a significant predictor of morbidity and mortality; however, the optimal noninvasive modality for the quantitative determination of LVEF is not apparent. Hypothesis: We verified the hypothesis that the various echocardiographic methods of assessing LVEF using the Method of Discs with contrast (Optison human albumin microspheres; Amersham Health, Princeton, NJ) and visual assessment of LVEF using tissue harmonics and contrast harmonics compare favorably with radionuclide angiography (RNA). Methods: In a prospective analysis, 24 consecutive patients scheduled to undergo RNA had an echocardiogram using tissue harmonics and contrast harmonics on the same day. LVEF was assessed by RNA by an experienced, blinded reader using manual determination of the region of interest. LVEF was calculated using the Method of Discs (Simpson's Rule) by a blinded sonographer. LVEF was visually estimated by two blinded readers using echocardiography with tissue harmonics and contrast harmonics on separate occasions. Results: By linear regression analysis, LVEF determination by echocardiography with contrast using the Method of Discs correlated well with RNA (r = .835, p < .0005). Using Bland-Altman analysis, the second echocardiogram reader had excellent agreement with RNA, whereas the first reader had a mean difference of 5.25% (CI 1.3-9.2; p = .012) with visual assessment using tissue harmonics and a mean difference of 4.67% (CI 0.4-8.8; p = .031) with visual assessment using contrast harmonics compared with RNA. Thus, a small difference in agreement between RNA and echocardiographic visual estimation was noted that appeared to be primarily reader dependent. Conclusions: LVEF determination with echocardiography with contrast using the Method of Discs correlated well with RNA and provided agreement across a range of cardiac functions. Visual echocardiographic assessment of LVEF with both tissue harmonics and contrast harmonics correlated well with RNA, but contrast harmonics did not appear to offer an advantage over tissue harmonics alone.

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KW - Left ventricular function

KW - Radionuclide angiography

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