Comparison of Left Ventricular Ejection Fraction Measurements by Echocardiography and Contrast Ventriculography: A Study on a Large Hospitalized Population


1 Tehran University of Medical Sciences, Dr Shariati Hospital, Tehran, IR Iran

2 Tehran University of Medical Sciences, Sina Hospital, Tehran, IR Iran.


Background: The evaluation of the left ventricular ejection fraction (LVEF) is important for predicting
mortality and identifying high-risk patients. We aimed to identify factors affecting the variation
in the LVEF measurement via echocardiography and contrast left ventriculography (CVG).
Methods: A total of 4422 patients (mean age=59.0±10.52 y, range=22–88) who underwent
echocardiography and CVG within the same hospitalization period (0- to 14-day intervals) were
included. Data were obtained from the Echocardiography Data Bank and the Coronary
Angiography Data Bank in Tehran Heart Center.
Results: The correlation between the estimation of the EF by echocardiography and CVG was good
(r=0.716); however, there was no point-by-point agreement. In 21.5% of the patients,
echocardiography and CVG estimated the EF equally, and a difference greater than 20% was
found in 1.8% of the patients. The differences between the 2 measurements were remarkable
either in the patients with EFs greater than 50% or in those with EFs of 50% or less by CVG
(59.71±3.72 by CVG vs 55.96±7.57% by echocardiography in EFs>50% and 40.69±8.96 by
CVG vs 43.90±10.71% by echocardiography in EFs≤50%). By linear regression analysis, the
presence of pathologic Q wave, atrial fibrillation and left bundle branch block, moderate and
severe mitral regurgitation, increased LV size, and increased interventricular septal diameter
resulted in a higher EF value via CVG, whereas in those with EFs of 50% or less, the EF by
echocardiography was higher. No effect of time gap between the measurements was found.
Conclusions: According to our study, the EF measurements obtained by echocardiography and CVG
varied on an individual basis. The level of the EF was the most important factor correlating with
the difference between the measurements by the methods.