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Assessment of LVEF using a new 16-segment wall motion score in echocardiography

Echo Research & Practice volume 5, pages 63–69 (2018)Cite this article

Abstract

Background: Simpson biplane method and 3D by transthoracic echocardiography (TTE), radionuclide angiography (RNA) and cardiac magnetic resonance imaging (CMR) are the most accepted techniques for left ventricular ejection fraction (LVEF) assessment. Wall motion score index (WMSI) by TTE is an accepted complement. However, the conversion from WMSI to LVEF is obtained through a regression equation, which may limit its use. In this retrospective study, we aimed to validate a new method to derive LVEF from the wall motion score in 95 patients.

Methods: The new score consisted of attributing a segmental EF to each LV segment based on the wall motion score and averaging all 16 segmental EF into a global LVEF. This segmental EF score was calculated on TTE in 95 patients, and RNA was used as the reference LVEF method. LVEF using the new segmental EF 15-40-65 score on TTE was compared to the reference methods using linear regression and Bland–Altman analyses.

Results: The median LVEF was 45% (interquartile range 32–53%; range from 15 to 65%). Our new segmental EF 15-40-65 score derived on TTE correlated strongly with RNA-LVEF (r = 0.97). Overall, the new score resulted in good agreement of LVEF compared to RNA (mean bias 0.61%). The standard deviations (s.d.s) of the distributions of inter-method difference for the comparison of the new score with RNA were 6.2%, indicating good precision.

Conclusion: LVEF assessment using segmental EF derived from the wall motion score applied to each of the 16 LV segments has excellent correlation and agreement with a reference method.

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Acknowledgments

The authors thank all medical staff from the Sacré-Coeur Hospital echocardiography laboratory who collaborated to the project. They gratefully acknowledge Sylvie Loranger for secretarial assistance, Lea Scaini and her colleagues for support with bibliographical search, and Jonathan Béland for his technical support.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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Authors and Affiliations

  1. Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, Canada

    Real Lebeau, Karim Serri MD, Maria Di Lorenzo, Claude Sauvé MD, Hoai Viet Van Le MD, Vicky Soulières MD, Malak El-Rayes MD, Maude Pagé MD, Chimène Zaïani MD & Frédéric Poulin MD MSc

  2. Institut cardiovasculaire Paris Sud, Massy, France

    Jérôme Garot MD

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  1. Real Lebeau
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Correspondence to Real Lebeau.

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Lebeau, R., Serri, K., Di Lorenzo, M. et al. Assessment of LVEF using a new 16-segment wall motion score in echocardiography. Echo Res Pract 5, 63–69 (2018). https://doiorg.publicaciones.saludcastillayleon.es/10.1530/ERP-18-0006

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Echo Research & Practice

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