Author + information
- Süleyman Karakoyun1,
- Mustafa Ozan Gürsoy2,
- Kamuran Kalkan3,
- Zakir Lazoğlu3,
- Halil İbrahim Tanboğa3 and
- Tayyar Gökdeniz4
The assessment of LVEF is dependent on the calculation method and the operator's experience. In this study, we aimed to investigate the relationship between LVEF evaluated by 3 methods (Teicholz, biplane Simpson and visual assessment) and left ventricule longitudinal strain values calculated with the utility of speckle tracking echocardiography.
This prospective study was comprised of 107 patients who were admitted to cardiology clinic between November 2012 and April 2013. Exclusion criteria included age < 18 years, atrial fibrillation, severe valvular stenosis or insufficiency, concomitant systemic disease, constrictive pericarditis, restrictive or hypertrophic cardiomyopathy and poor visual quality. All patients provided written informed consent prior to transthoracic echocardiographic examination. LVEF measurements were performed by Teicholz and biplane Simpson and visual assessment based on current recommendations. 2D echocardiography images were obtained from LV apical 4-chamber (4C), LAX (long axis) and 2-chamber (2C) views. Strain measurements were reported as the peak longitudinal strain (LS) for 4C, LAX, and 2C views, and global strain (GS) was calculated by the average of the three apical views. Statistical analysis were conducted using MedCalc (MedCalc, version 22.214.171.124, statistical software).
The mean age of the study population was 58±13 (F:62, M: 45). Twenty-nine patients (31.2%) had hypertension, 9 (9.2%) had diabetes mellitus, 21 (22.6%) had hyperlipidemia, 20 (21.5%) had history of smoking and 56 (52%) had coronary artery disease. The LVEF values measured by biplane Simpson, Teicholz, and visual assessment were 59±11, 63±17 and 57±10, respectively. Area under curve (AUC) was 0.685, 95% CI:0.580-0.777 for biplane Simpson method whereas AUC for visual assesment and Teicholz were 0.657, 95% CI:0.551-0.752 and 0.531, 95% CI:0.425-0.635, respectively. The ROC curve analysis of LVEF values measured by the three methods were compared. There was significant statistical difference between biplane Simpson and Teicholz methods (p:0.020), whereas there was no statistical difference between biplane Simpson and visual assessment or between visual assessment and Teicholz (p:0.261 and p:0.070, respectively). Significant correlation was observed between LVEF measured by biplane Simpson and GS (r:-0.445, p<0.001).
The biplane Simpson method, which is used for the evaluation of LVEF, has higher correlation with GS compared to Teicholz method and visual assessment.