+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Criteria for the accurate interpretation of changes in left ventricular ejection fraction and cardiac volumes as assessed by rest and exercise gated radionuclide angiography



Criteria for the accurate interpretation of changes in left ventricular ejection fraction and cardiac volumes as assessed by rest and exercise gated radionuclide angiography



Journal of the American College of Cardiology 18(1): 112-119



Although serial left ventricular ejection fraction and volumetric measurements using gated radionuclide angiography are commonly used to evaluate clinical changes and therapeutic outcomes in individual patients, criteria are not available for accurately interpreting whether a change in any of these hemodynamic measurements is clinically meaningful. Accordingly, the magnitude of inherent variability among sequential measurements of hemodynamic variables assessed by gated radionuclide angiography was investigated in a double-blind placebo-controlled fashion in 39 patients during two placebo periods separated by 6 weeks. All patients analyzed had remained clinically stable during the study period. Although the mean values for all hemodynamic variables between the two placebo periods were minimally changed, the differences in individual patients were striking. Criteria were developed to allow meaningful interpretation of changes in hemodynamic variables by estimating the likelihood that an observed change is due to variability alone. On the basis of this analysis of placebo radionuclide angiographic data, variation due to chance alone is unlikely to account for all variability if a change observed between the two rest gated studies in a patient is .gtoreq. 7% units for left ventricular ejection fraction, .gtoreq. 45 ml/m2 for end-diastolic volume index, .gtoreq. 35 ml/m2 for end-systolic volume index, .gtoreq. 20 ml/m2 for stroke volume index and .gtoreq. 1.25 liters/min per m2 for cardiac index. An observed 4% unit change in left ventricular ejection fraction (increase or decrease) after a medical intervention in an individual patient occurs by random variation > 25% of the time. The criteria presented are applicable to clinical practive because they allow precise interpretation of hemodynamic changes measured by gated radionuclide angiography in individual patients whether the change is due to altered clinical status or to medical intervention.

(PDF emailed within 0-6 h: $19.90)

Accession: 007167220

Download citation: RISBibTeXText

PMID: 2050913

DOI: 10.1016/s0735-1097(10)80226-8


Related references

Range of normal values for left and right ventricular ejection fraction at rest and during exercise assessed by radionuclide angiocardiography. European Heart Journal 6(8): 647-655, 1985

Pre-chemotherapy values for left and right ventricular volumes and ejection fraction by gated tomographic radionuclide angiography using a cadmium-zinc-telluride detector gamma camera. Journal of Nuclear Cardiology 23(1): 87-97, 2016

Effect of exercise and isoprenaline on left ventricular ejection fraction in patients with angina pectoris as assessed by radionuclide angiography. Cardiology 69(2): 91-97, 1982

Normal values of left ventricular ejection fraction and left ventricular volumes measured by gated myocardial SPECT in women and men at rest and after bicycle or dipiridamole stress testing. Journal of Nuclear Medicine 41(5 Suppl ): 159P, 2000

Effect of oral propranolol on rest and exercise left ventricular ejection fraction, volumes, and segmental wall motion in patients with angina pectoris. Assessment with equilibrium gated blood pool imaging. British Heart Journal 45(6): 656-666, 1981

Accurate measures of left ventricular ejection fraction using electron beam tomography: a comparison with radionuclide angiography, and cine angiography. International Journal of Cardiac Imaging 16(5): 391-398, 2001

Accurate measures of left ventricular ejection fraction using electron beam tomography: A comparison with radionuclide angiography, and cine angiography. International Journal of Cardiovascular Imaging 16(5): 391-398, 2000

Good correlation between left ventricular ejection fraction and wall motion score assessed by gated SPECT as compared to left ventricular angiography. Journal of the American College of Cardiology 33(2 SUPPL A): 409A, 1999

Gated cardiac 13N-NH3 PET for assessment of left ventricular volumes, mass, and ejection fraction: comparison with electrocardiography-gated 18F-FDG PET. Journal of Nuclear Medicine 46(12): 2009-2013, 2005

Relationship of left ventricular contractile function to ejection fraction assessed using radionuclide angiography in man. American Heart Association Monograph (124): II-4, 1986

Differences in left ventricular ejection fraction and volumes measured at rest and poststress by gated sestamibi SPECT. Journal of Nuclear Cardiology 13(5): 668-674, 2006

Response to left ventricular ejection fraction to recovery from general anesthesia using gated radionuclide angiography. Anesthesiology 61(3 PART A): A75, 1984

Calculation of the left ventricular ejection fraction by gated radionuclide angiography without direct background correction. Radiology 144(2): 377-381, 1982

Does ECG-gated SPECT provide accurate measurement of left ventricular ejection fraction and volumes? A meta-analysis. Journal of the American College of Cardiology 39(5 Supplement A): 394A, March 6, 2002

Assessment of left ventricular ejection fraction measured by quantitative gated SPECT: correlation with left ventriculography and first-pass radionuclide angiography. International Journal of Cardiovascular Imaging 22(2): 223-230, 2005