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Reproducibility of wall motion score and its correlation with left ventricular ejection fraction in patients with acute myocardial infarction

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Abstract

Our results show that, in patients with myocardial infarction, experienced investigators reached a higher inter- and intraobserver reproducibility of WMS and a better correlation between WMS and ejection fraction using the 16-segment LV segmentation model than by using the 11-segment model.

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Cited by (22)

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    LV wall motion was analyzed using a 16-segment polar map, and segmental scores were assigned for normal wall motion (1), hypokinesia (2), akinesia (3), and dyskinesia (4). Segmental scores were added and divided by 16, providing an individual wall motion score index (WMSI), with an LV WMSI of 1 being normal and an LV WMSI of 4 ideally reflecting dyskinesia of all segments.14 Binary categorizations for the presence or absence of RV wall motion abnormalities and for mural thrombus were made (yes or no).

  • Validation of a novel modified wall motion score for estimation of left ventricular ejection fraction in ischemic and non-ischemic cardiomyopathy

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    However, these methods continue to require proprietary software, and are based heavily upon geometric assumptions that are not met in all patients [13], and do not take into account regional wall motion abnormalities sub-optimally represented within these views. The use of segmental wall motion scoring for the estimation of LVEF has been previously explored by several echocardiography studies [13–19]. These studies, all employing the scoring system currently endorsed by the ASE [4], were modest in size with the largest being performed in 243 consecutive patients undergoing both transthoracic echocardiography and radionuclide angiography (RNA) [13].

  • Reliability of Visual Assessment of Global and Segmental Left Ventricular Function: A Multicenter Study by the Israeli Echocardiography Research Group

    2010, Journal of the American Society of Echocardiography
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    Vermes et al13 also showed large interobserver variability (the left ventricle divided into 7 segments, 15 subjects, 2 readers, and 2 categories). An intraobserver difference of 7% was reported by Badano et al14 (the left ventricle divided into 16 segments, 105 subjects, only 2 readers, and 5 categories), similar to the 5.6 ± 2.9% of segments in our study that were assigned different scores by the same reader in duplicate readings. Hoffmann et al15 addressed the issue of variability in the detection of WM as a byproduct of a multicenter study on dobutamine stress echocardiography (which requires the ability to identify new WM abnormalities) and reported a κ coefficient of only 0.37 for interobserver variability (150 subjects, 5 readers, and 4 categories), although with better imaging, a κ coefficient of 0.55 was achieved.16

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The GISSI-3 Study was endorsed by Associazione Nazionale Medici Cardiologi Ospedalieri (A.N.M.C.O.) and Istituto di Ricerche Farmacologiche Mario Negri. The Echo substudy was conducted by the Centro Studi A.N.M.C.O., Firenze, Italy, and was supported by a grant from Cardiovascular Research Foundation, Bad Schwalbach, Switzerland.

1

Dr. Badano's address is: Centro Studi A.N.M.C.O., Via La Marmora, 36, 50121 Florence, Italy.

A list of participants is reported in the Appendix.

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