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Analysis of Regional Left Ventricular Function by Cineventriculography, Cardiac Magnetic Resonance Imaging, and Unenhanced and Contrast-Enhanced Echocardiography

A Multicenter Comparison of Methods

Rainer Hoffmann, MD^_*,_*, Stephan von Bardeleben, MD, Jaroslaw D. Kasprzak, MD, Adrian C. Borges, MD, Folkert ten Cate, MD^||, Christian Firschke, MD, FACC^¶, Stephane Lafitte, MD^#, Nidal Al-Saadi, MD^_**, Stefanie Kuntz-Hehner, MD, Georg Horstick, MD, Christian Greis, Marc Engelhardt, MD, Jean Louis Vanoverschelde, MD, FACC^|||| and Harald Becher, MD^¶¶

^_* University Rheinisch-Westfälischen Technischen Hochschule Aachen, Aachen, Germany
Clinic Johannes Gutenberg University Mainz, Mainz, Germany
Medical University, Lodz, Poland
University Charite, Berlin, Germany
^|| Academic Hospital Dijkzigt Rotterdam, the Netherlands
^¶ Deutsches Herzzentrum, Munich, Germany
^# Hopital du Haut Leveque, Pessac Cedex, France
^_** University Charite, Berlin, Germany
University Bonn, Bonn, Germany
Bracco-Altana-Pharma, Konstanz, Germany
Bracco Diagnostics, Princeton, New Jersey
^|||| Cliniques Universitaires Saint-Luc, Brussels, Belgium
^¶¶ John Radcliffe Hospital, Oxford, United Kingdom.

View larger version (47K): [in a new window]   Figure 1 Three-step decision algorithm used to define the standard of truth (expert panel decision) on the presence of regional wall motion abnormalities (RWMA). CE = contrast-enhanced echocardiography; CINE = cineventriculography; MRI = magnetic resonance imaging; NEG = negative; POS = positive; UE = unenhanced echocardiography.

View larger version (125K): [in a new window]   Figure 2 Multimodality comparison for regional wall motion abnormality in a 64-year-old patient with prior inferior myocardial infarction and occluded right coronary artery. Ejection fraction was normal (60%). There was concordance among magnetic resonance imaging (MRI), cineventriculography (CINE) and contrast-enhanced echocardiography (CE) in the detection of an inferior/posterior wall motion abnormality, which was not detected on unenhanced echocardiography (UE) owing to limited visualization of the inferior/posterior wall. LAO = left anterior oblique; RAO = right anterior oblique.