High-resolution two-dimensional echocardiography improves the quantification of left ventricular function.

It is not clear if newer echo technology prevents underestimation of ejection fraction in comparison with cineventriculography (CVG). Before undergoing CVG, 48 patients were studied with state-of-the-art, high-resolution two-dimensional echocardiography with a 3.5 MHz transducer, 96 crystals, and digital storing (slow motion and cine-loop). These data are compared with results published by us in 1983 (37 patients). Volumes were calculated using the biplane method of discs in a single area length. Exclusion criteria in 1990 were poor two-dimensional echocardiography quality (n = 6) and extra-systole during CVG (n = 4). The difference between the mean values of the angiography and echocardiography data in the new study (1990) were 4.7 ml/m2/body surface area (BSA) for the end-diastolic volume, 0.1 ml/m2 for the end-systolic volume, and 1.5% for the ejection fraction (all NS). The mean difference between both methods in the old study (1983) were -39.1 ml/m2/BSA (p less than 0.001) for end-diastolic volume, -17.4 ml/m2 (p less than 0.001) for end-systolic volume, and -7.2% for ejection fraction (p less than 0.001). The regression equation for determination of ejection fraction was y = 0.606x + 13, r = 0.803 for the old study, and y = 0.935x + 2.5; r = 0.935 for the new study. These results indicate that state-of-the-art, high-resolution two-dimensional echocardiography prevents the systematic underestimation of left ventricular volume and ejection fraction, most likely because of better delineation of endocardium in end-systole.