Ejection Fraction Derived by Noninvasive Modalities Versus Left Ventricular Angiographic Determination

Several studies have examined the correlation and agreement between noninvasive measurement of ejection fraction (EF) and that derived with left ventricular (LV) angiography.1-4 The noninvasive modalities include echocardiography, radionuclide methods, and magnetic resonance imaging.5 Echocardiography has been widely used for the evaluation of EF as it is readily available and relatively less expensive than other techniques. M-mode derivations of EF are wrought with errors in patients with technically difficult studies and regional wall motion abnormalities. Simpson’s biplane method is nearly reliable, but again is highly dependent on good endocardial border definition.6 Although quantitative echocardiography methods are available, visual estimation is known to provide good information to experienced echocardiographers.7 Intracardiac opacification (contrast) agents are now being used more frequently and allow better visualization of LV cavity and endocardial boundaries.3 In this issue of Clinical Medicine & Research, Habash-Bseiso et al.8 present a retrospective analysis of determination of EF in 534 patients from a single institution who had undergone LV angiography, echocardiography, and nuclear perfusion imaging. They excluded patients