Left ventricular ejection fraction and mitral regurgitation assessment: A comparison study between echocardiography and angiography

Introduction: Measurement of the left ventricular ejection fraction (LVEF) is a common tool for evaluating the left ventricle (LV) systolic function. The aim of this study was to evaluate and compare the LVEF and mitral regurgitation (MR) severity as estimated by angiography and echocardiography in patients with coronary artery disease (CAD) and LV systolic dysfunction. Methods: In this observational study, 39 men and 11 women at a mean age of 60 years were recruited. The patients underwent catheterization and echocardiography, and the data on the LVEF and MR by both methods were registered. Results: The mean LVEF by echocardiography and angiography was significantly correlated (correlation coefficient = 0.698; P < 0.0001). Although there was agreement between these methods in the estimation of the mean EF (mean difference in the LVEF = 1.23 ± 7.63% and 95% limit of agreement = −12.5–19) and the κ coefficient was 45.7% (P = 0.001), the estimated mean EF was 32.6 ± 10.25% by echocardiography and 29.8 ± 8.2% by angiography (P = 0.007). Furthermore, there was a statistically significant difference in the estimated MR severity between the two methods (P = 0.0001), with echocardiography reporting higher degrees of severity than angiography. Conclusions: In our patients with CAD and LV systolic dysfunction, after the exclusion of age, sex, number of diseased coronary arteries, and myocardial infarction history from the analysis, although the mean LVEF by echocardiography and angiography was significantly correlated, echocardiography estimated higher LVEF values than angiography, especially in the patients with triple-vessel disease. Moreover, echocardiography showed higher degrees of MR severity than angiography.