Original Research Article
Year: 2018 | Month: December | Volume: 5 | Issue: 12 | Pages: 421-429
Comparative Assessment of Wall Motion Score Index and Left Ventricular Ejection Fraction in Patients with Ischemic Heart Disease Using Transthoracic: 2 D Echocardiography and Cardiac MRI
Dr. Saikat Bhattacharjee1, Dr. Narendra Kumar Jain2, Dr. Samar Chatterjee2, Dr. Nitin Bajaj3, Dr. Rajesh Uddandam2
1Department of Radiology, Military Hospital Cardiothoracic Center Pune.
2Department of Radiology, Armed Forces Medical College, Pune.
3Department of Cardiology, Command Hospital (NC), Pune.
Corresponding Author: Dr. Narendra Kumar Jain
ABSTRACT
Purpose: To compare the Left Ventricular Wall Motion Abnormalities (LVWMA) and Left Ventricular Ejection Fraction(LVEF) using transthoracic echocardiography with Cardiac Magnetic Resonance Imaging (CMRI) in patient with myocardial infarction.
Materials and methods: In this prospective, observational, comparative study fifty patients with ischemic heart disease (IHD) detected to have regional wall motion abnormality (RWMA) on echocardiography were subjected to CMRI. Left ventricle was divided into seventeen segments. LVWMA was calculated for each of these seventeen segments using both the modalities. LVWMA and LVEF calculated using both echocardiography and CMRI were compared using appropriate statistical tools.
Results: CMRI detected RWMA in all fifty patients. Segment wise comparison of WMA for each of the seventeen segments between CMRI and 2D showed a significant correlation. The distribution of total score of seventeen segments for RWMA on CMRI varied from 19 to 42 with a mean score of 29.2, while on echocardiography the score varied from 17 to 39 with a mean score of 26.52.On 2 D echo 34(68%) patients had an abnormal ejection fraction and 16(32%) patients had a normal ejection fraction. On MRI 39(78%) patients had an abnormal ejection fraction and 11(22%) had a normal ejection fraction. The distribution of calculated ejection fraction on MRI varied from 21 % to 68% with a mean ejection fraction value of 42.38, while the distribution of calculated ejection fraction on ECHO varied from 35 % to 69% with a mean ejection fraction value of 48.68%. A significant association was found between CMRI and 2d Echocardiography in the calculation of ejection fraction.
Conclusion: The study shows that CMRI can be used to assess the RWMA abnormalities and ejection fraction, which have prognostic implications in patients of IHD, with a very high degree of sensitivity, specificity and accuracy.
Key words: Cardiac MRI, Left ventricular ejection fraction, Regional wall motion abnormality, Ischemic heart disease
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