Consistency of left ventricular ejection fraction measurements in the early time course of STEMI

Article type: Research Article

Authors: Georgieva, Lilyana^{a; 2} | Nienhaus, Fabian^{a; 2} | Haberkorn, Sebastian M.^{a; 2} | Erkens, Ralf^{a; 2} | Polzin, Amin^{a; 2} | Wischmann, Patricia^{a; 2} | Ipek, Rojda^{a; 2} | Marjani, Kian^{a; 2} | Christidi, Aikaterini^{a; b; 2} | Roden, Michael^{c; d; e; 2} | Jung, Christian^{a; 2} | Bönner, Florian^{a; 2} | Kelm, Malte^{a; f; 2} | Perings, Stefan^{a; 1; 2} | Gastl, Mareike^{a; 1; 2; *}

Affiliations: [a] Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany | [b] Cardiovascular Magnetic Resonance, Euromedica General Clinic, Thessaloniki, Greece | [c] Division of Endocrinology and Diabetology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany | [d] Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine University, Düsseldorf, Germany | [e] German Center for Diabetes Research, Partner Düsseldorf, Düsseldorf, Germany | [f] Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, Heinrich Heine University, Düsseldorf, Germany

Correspondence: [*] Corresponding author: Mareike Gastl, MD, Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. Tel.: +49 211 81 18800; Fax: +49 241 81 04855; E-mail: Mareike.Cramer@med.uni-duesseldorf.de.

Note: [1] These authors contributed equally to this work.

Note: [2] This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Abstract: BACKGROUND:Early after ST-segment elevation myocardial infarction (STEMI), initial LV reshaping and hypokinesia may affect analysis of LV function. Concomitant microvascular dysfunction may affect LV function as well. OBJECTIVE:To perform a comparative evaluation of left ventricular ejection fraction (LVEF) and stroke volume (SV) by different imaging modalities to assess LV function early after STEMI. METHODS:LVEF and SV were assessed using serial imaging within 24 h and 5 days after STEMI using cineventriculography (CVG), 2-dimensional echocardiography (2DE), 2D/3D cardiovascular magnetic resonance (CMR) (2D/3D) in 82 patients. RESULTS:2D analyses of LVEF using CVG, 2DE and 2D CMR yielded uniform results within 24 h and 5 days of STEMI. SV assessment between CVG and 2DE was comparable, whereas values for SV were higher using 2D CMR (p < 0.01 all). This was due to higher LVEDV measurements. LVEF by 2D versus 3D CMR was comparable, 3D CMR yielded higher volumetric values. This was not influenced by infarct location or infarct size. CONCLUSIONS:2D analysis of LVEF yielded robust results across all imaging techniques implying that CVG, 2DE, and 2D CMR can be used interchangeably early after STEMI. SV measurements differed substantially between imaging techniques due to higher intermodality-differences of absolute volumetric measurements.

Keywords: STEMI, LV function, cineventriculography, echocardiography, cardiovascular magnetic resonance

DOI: 10.3233/CH-231734

Journal: Clinical Hemorheology and Microcirculation, vol. 84, no. 1, pp. 89-101, 2023