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To compare measurements of left ventricular size and performance obtained by apical biplane cross-sectional echocardiography (CSE) and gated equilibrium radionuclide angiography (RNA), we studied 70 patients, all of whom had single-plane and 30 of whom had biplane left ventricular cineangiography. Wideangle, phased-array CSE images were obtained from two orthogonal apical views and left ventricular volumes were calculated using a microprocessor-controlled, video light-pen system programmed for a Simpson's rule algorithm. The average CSE end-diastolic volume (EDV) for all 70 patients of 158 ± 56 ml (± SD) was less than the single-plane angiographic value of 176 ± 68 ml (p < 0.001, r = 0.80). The average CSE end-systolic volume (ESV) of 78 ± 57 ml was not different from the angiographic value of 84 ± 70 ml (r = 0.88). The average CSE and single-plane angiographic ejection fraction (EF) values of 55 ± 16% and 57 ± 19% were not different (r = 0.90). In the 30 patients who underwent biplane angiography, the average CSE EDV of 166 ± 62 ml was less than the biplane angiographic EDV of 217 ± 87 ml (p < 0.001, r = 0.81), and the average CSE ESV of 89 ± 69 ml was also less than the angiographic value of 114 ± 89 ml (p < 0.001, r = 0.92). The average CSE LV EF of 52 ± 19% was not different from the biplane angiographic value of 52 ± 17% (r = 0.87). In the 25 patients who underwent CSE, RNA and biplane angiography, the average LVEF values were 51 ± 20%, 46 ± 18% and 50 ± 17%, respectively, and the CSE and RNA values correlated with the biplane angiographic value (r = 0.90 and 0.93, respectively). Therefore, apical biplane CSE estimates of left ventricular volume correlate linearly with single-plane and biplane cineangiographic determinations, and this CSE technique compares favorably with gated equilibrium RNA for assessing left ventricular performance.

circulation

Comparative accuracy of apical biplane cross-sectional echocardiography and gated equilibrium radionuclide angiography for estimating left ventricular size and performance.