Assessment of Left Ventricular Ejection Fraction by Applying a New Left Ventricular Segmental Wall Motion Score in Echocardiography Compared to Cardiac Magnetic Resonance and Other Echocardiographic Imaging Methods

Background Left ventricular (LV) ejection fraction (EF) is a crucial indicator of left ventricular systolic function in several cardiology fields. Having said that, it also has several key limitations. Assessment of the LV segmental wall motion score (WMS) can substitute for the traditional LVEF for evaluating left ventricular systolic function. This retrospective study intends to investigate the validity of assessing LVEF by utilising a new echocardiographic LV segmental WMS method in comparison with cardiac magnetic resonance (CMR) imaging and other echocardiographic modalities. Methods In the CMR group, 78 individuals were enrolled, while 118 others were enrolled in the transthoracic echocardiography group. Based on the assumption that each segment contributes proportionally to the global LVEF, each normokinetic and hypokinetic segment will be scored at an average of 4% and 2%, respectively. In comparison, dyskinetic and akinetic segments will be scored at 0%. Results WMS-LVEF correlates positively with CMR-LVEF ( r = 0.98), three-dimensional (3D) echocardiography ( r = 0.98), the 2D biplane Simpson’s ( r = 0.96), and visual assessment of LVEF ( r = 0.97) with P < 0.001. In general, WMS-LVEF provided a good agreement with a relatively small mean bias and narrow standard deviation (SD) of LVEF compared to CMR-LVEF (bias: 0.83%, SD: 2.8), 3D-echocardiography (bias: 0.43%, SD: 1.96), the 2D biplane Simpson’s (bias: 0.74%, SD: 2.39%), and visual assessment of LVEF (bias: 0.20%, SD: 2.39%). Conclusions The new WMS-LVEF derived by transthoracic echocardiography has a great correlation and level of agreement with other benchmark echocardiography and CMR-LVEF approaches.