Qualitative assessment of regional left ventricular function can predict MRI or radionuclide ejection fraction: an objective alternative to eyeball estimates.

PURPOSE Assessment of left ventricular function is important in patients with heart disease. We hypothesized that regional wall motion assessed qualitatively by cine magnetic resonance imaging (MRI) can predict the left ventricular ejection fraction (EF). METHODS The correlations between MRI EF and the American Society of Echocardiography (ASE) score index and a modified ASE score index were established in 117 subjects. The model was tested in the next 86 patients. Interobserver variability was studied in 30 patients. Radionuclide EF was compared in 81 patients. Cine MRI studies were performed on a 1.5 T scanner. RESULTS From the initial 117 patients, there was a linear correlation between the ASE score index and MRI (r = 0.85), but the relationship improved by including a category of hyperkinetic wall motion (r = 0.90). Using these correlations to predict MRI EF in the next 86 patients, there was a good agreement (r = 0.93 for the ASE score index and r = 0.97 for the modified ASE score index). Correlations between radionuclide EF and the EF predicted by the modified ASE score index or the MRI EF by planimetry were similar (r = 0.91 vs. r = 0.90, respectively). Four observers tested the model and achieved comparable results (r = 0.88 to 0.95). CONCLUSIONS There is a close relationship between ejection fraction and the ASE score index or modified ASE score index. This correlation can provide an objective prediction of ejection fraction based solely on a qualitative reading of regional wall thickening.