COMPARISON OF LEFT-VENTRICULAR EJECTION FRACTION IN CONGENITAL HEART-DISEASE BY VISUAL VERSUS ALGORITHMIC DETERMINATION

Two-dimensional (2D) echocardiographic visual estimation of left ventr icular (LV) ejection fraction (EF) in patients with acquired heart dis ease yields results that are comparable to those obtained by recommend ed algorithms. However, there is no information concerning its accurac y in congenital heart disease. This study compares applicability, accu racy, and reproducibility of LVEF by visual estimation with that by cu rrently used algorithms (cylinder hemiellipsoid, ellipsoid biplane, an d biplane method of disks) in 92 consecutive patients with congenital heart disease but unrepaired complete atrioventricular septal defect, univentricular heart, and hypoplastic left ventricle, using 3D echocar diography as the reference method. Visual estimation of LVEF could be applied in all cases. Because of technically inadequate 2D echocardiog raphic images for volume measurement, analysis for comparison could be performed in 71 patients (77%), aged 1 day to 47 years. The correlati on between 3D echocardiographic and visual estimation was 0.91 (SEE 3. 3%), cylinder hemiellipsoid, 0.86 (SEE 3.9%), ellipsoid biplane 0.87 ( SEE 3.9%), and biplane method of disks 0.93 (SEE 3.2%), Intraobserver variability was similar for all 2D echo methods. Interobserver variabi lity was greater for visual estimation. In conclusion, visual estimati on of LVEF is applicable to most patients with congenital heart diseas e, yielding results that are comparable to those obtained by currently used 2D echocardiographic algorithms. (C) 1997 by Excerpta Medica, In c.