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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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01. History of Cardiology
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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32. Cardiovascular Nursing
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Agreement in left ventricular ejection fraction measured by echocardiography, gated SPECT and cardiac magnetic resonance – a real-world analysis
Session:
Posters 2 - Écran 3 - Imagiologia Cardiovascular
Speaker:
Christopher Strong
Congress:
CPC 2019
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.6 Cross-Modality and Multi-Modality Imaging Topics
Session Type:
Posters
FP Number:
---
Authors:
Christopher Strong; António Miguel Ferreira; João Abecasis; Sara Guerreiro; Pedro Freitas; Carla Rodrigues Carvalho; Maria João Andrade; Regina Ribeiras; Manuel Canada; António Ventosa; João Calqueiro; Miguel Mendes
Abstract
<p><strong>Introduction </strong></p> <p>Left ventricular ejection fraction (LVEF) plays a decisive role in many important clinical decisions. The purpose of this study was to assess the agreement in LVEF measured by commonly used imaging modalities in a real-world setting.</p> <p><strong>Methods</strong></p> <p>Single-center retrospective study including patients with and without known coronary artery disease, undergoing any two of the following imaging modalities where LVEF was measured: non-contrast enhanced transthoracic echocardiography (TTE), gated single-photon emission computed tomography (SPECT), and cardiac magnetic resonance (CMR). Exclusion criteria were: time interval between tests >90 days, measurements taken within the 1st month from a cardiac event, and the occurrence of any cardiac event between tests. A separate analysis was conducted excluding patients with LVEF >55% by all modalities and those with >30 days between tests.</p> <p><strong>Results</strong></p> <p>A total of 260 patients were included: 117 patients underwent both TTE and CMR, 115 TTE and SPECT, and 28 SPECT and CMR, with a median time interval between exams of 20 days (IQR 5-50). The mean absolute difference of LVEF between tests was 65%. Bland-Altman analysis showed no systematic overestimation or underestimation of LVEF by any of the modalities. Overall, the correlation between different methods was good (Pearson’s r >0.8) - Figure. Nevertheless, the proportion of cases where the absolute LVEF difference was >10% ranged from 15-30%. Among patients with LVEF < 55% by any modality, there was disagreement in the categorization LVEF ≤35% vs. >35% in 13% of the cases (n=34). Subgroup analyses including only those patients with <30 days between tests and those with LVEF <55% yielded similar results.</p> <p><strong>Conclusions</strong></p> <p>Among patients assessed in a “real world” setting with all types of cardiac disease, the agreement between LVEF measurements using different imaging modalities was relatively good. Nevertheless, clinically meaningful discordance subsists in a small but significant proportion of patients.</p> <p> </p>
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