THE AGREEMENT BETWEEN VENTRICULAR VOLUMES AND EJECTION FRACTION BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY OR A COMBINED RADIONUCLEAR AND THERMODILUTION TECHNIQUE IN PATIENTS AFTER CORONARY-ARTERY SURGERY

Objectives: To study the reproducibility of and agreement between peri operative transesophageal echocardiographic: (TEE) and radionuclide (R N) assessment of ventricular volumes and ejection fraction (EF). Desig n: A prospective, blinded comparison of two methods of measurement. Se tting: A surgical intensive care unit in a university hospital. Partic ipants: Patients after coronary artery bypass surgery. Interventions: Left ventricular volumes and ejection fraction were simultaneously mea sured by radionuclide ventriculography and transesophageal echocardiog raphy. Two sets of measurements were made in rapid succession with a t hird set after an interval. Results: Reproducibilities of EF and ventr icular volumes by TEE and RN were similar. At each set of measurements , the bias for radionuclide EF and TEE Simpson's rule EF, 0.03 +/- 0.0 5, 0 +/- 0.06, -0.01 +/- 0.07, respectively, for radionuclide EF and T EE area length EF 0.01 +/- 0.05, -0.01 +/- 0.05, -0.03 +/- 0.08, respe ctively, were significantly less than for radionuclide EF and TEE FAC 0.07 +/- 0.05, 0.05 +/- 0.05, 0.03 +/- 0.09. Poor agreement was observ ed between RNTD-EDV, and both of the TEE EDV measurements. Conclusion: EF measured by TEE area length and Simpson's rule method are as repro ducible as TEE FAC and are more accurate estimates of RN EF. Poor agre ement between methods of measuring end-diastolic volume was observed. Copyright (C) 1996 by W.B. Saunders Company.