Sensitivity and specificity of left ventricular ejection fraction by echocardiographic automated border detection: Comparison with radionuclide ventriculography

Richard J. Lucariello, Ying Sun, Guldeniz Doganay, Salvatore A. Chiaramida

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background: Echocardiographic automated border detection (ADD) provides on-line, beat-to-beat estimation of left ventricular (LV) ejection fraction (EF). Sensitivity and specificity of using ABD-EF for diagnosing LV dysfunction in routine clinical situations have not been previously studied: Hypothesis: Analysis of ABD-EF data based on receiver operating characteristic (ROC) should provide useful information about sensitivity and specificity for clinical diagnosis of LV function based on ABD-EF. Methods: The study group included 50 consecutive patients with EF measured by both ADD and radionuclide ventriculography (RVG). ABD-EF was recorded for 25 consecutive heart beats in the apical four-chamber view. Data were analyzed statistically by linear regression, Bland-Airman plot, and ROC. In ROC analysis, abnormal LV function was defined RVG-EF ≤ 40%. Results: ADD and RVG showed a moderate correlation in the EF measurements: slope = 0.93, intercept = 17%, r = 0.79 (n = 50). Interbeat variability in ADD was diminished by averaging consecutive beats; standard error of estimate (SEE) decreased from 15.6% without averaging to 12.5% with 25-beat averaging. Bland-Airman analysis indicated that ABD-EF compared unfavorably with RVG-EF with limits of agreement from -11% to 39%. ABD-EF showed a systematic overestimation (p < 0.005), which was compensated by increasing the threshold for abnormal ABD-EF to 56%. With the optimized threshold, ABD-EF provided 89% sensitivity and 89% specificity (85% overall diagnostic accuracy) for diagnosing abnormal LV function. Conclusion: This study explored the limitations of on-line echocardiographic measurement of EF in a clinical setting and provided useful data for assessing interbeat variability, sensitivity, and specificity.

Original languageEnglish (US)
Pages (from-to)943-948
Number of pages6
JournalClinical Cardiology
Volume20
Issue number11
DOIs
StatePublished - Nov 1997
Externally publishedYes

Keywords

  • Automated border detection
  • Bland-Altman plot
  • Echocardiography
  • Interbeat variability
  • Receiver operating characteristic
  • Sensitivity and specificity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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