Evaluating the Correlation and Reliability of a New Left Ventricular Segmental Wall Motion Score With Conventional Left Ventricular Ejection Fraction Measures in Echocardiography and Cardiac Magnetic Resonance Imaging.

Background: Left ventricular ejection fraction (LVEF) remains essential for evaluating systolic function. Although three-dimensional (3D) echocardiography and cardiac magnetic resonance (CMR) offer precise measurements, they are limited by cost, accessibility, and patient cooperation. In contrast, wall motion score (WMS) analysis is a simpler, faster alternative requiring no specialized equipment. This study compared LVEF-derived WMS by transthoracic echocardiography (TTE) with values obtained via CMR and standard echocardiography.

Methods: The study analyzed 78 participants who underwent both TTE and cardiac CMR and 118 who had comprehensive TTE with 3D echocardiography, 2D biplane Simpson's method, and visual LVEF assessment. Each of the 16 LV segments was weighted equally in calculating global LVEF. Dividing the normal LVEF range by 16 gives the average segmental contribution: 3.25%-4.625% for normokinetic, 1.62%-2.31% for hypokinetic, and 0% for akinetic or dyskinetic segments. Global LVEF was the sum of these values.

Results: WMS-LVEF correlates positively with CMR-LVEF (r = 0.98), 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 segmental WMS-LVEF technique correlated well with CMR and conventional echocardiography, establishing its reliability for estimating left ventricular function.