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Jaker S, Burgan A, Prakash V, et al. Sex differences in the agreement between left ventricular ejection fraction measured by myocardial perfusion scintigraphy and by echocardiography. JRSM Cardiovasc Dis. 2020;9:2048004020915393doi: 10.1177/2048004020915393.
Jaker, S., Burgan, A., Prakash, V., Birkinshaw, A., Moosai, K., Jacques, A., Fluck, D., MacGregor, M., Lazariashvili, O., Sharma, P., Fry, C. H., & Han, T. S. (2020). Sex differences in the agreement between left ventricular ejection fraction measured by myocardial perfusion scintigraphy and by echocardiography. JRSM cardiovascular disease, 92048004020915393. https://doi.org/10.1177/2048004020915393
Jaker, Sams, et al. "Sex differences in the agreement between left ventricular ejection fraction measured by myocardial perfusion scintigraphy and by echocardiography." JRSM cardiovascular disease vol. 9 (2020): 2048004020915393. doi: https://doi.org/10.1177/2048004020915393
Jaker S, Burgan A, Prakash V, Birkinshaw A, Moosai K, Jacques A, Fluck D, MacGregor M, Lazariashvili O, Sharma P, Fry CH, Han TS. Sex differences in the agreement between left ventricular ejection fraction measured by myocardial perfusion scintigraphy and by echocardiography. JRSM Cardiovasc Dis. 2020 Mar 24;9:2048004020915393. doi: 10.1177/2048004020915393. eCollection 2020. PMID: 32269771; PMCID: PMC7093695.
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JRSM Cardiovasc Dis. 2020 Mar 24;9:2048004020915393. doi: 10.1177/2048004020915393. eCollection 2020.

Sex differences in the agreement between left ventricular ejection fraction measured by myocardial perfusion scintigraphy and by echocardiography.

JRSM cardiovascular disease

Sams Jaker, Amjad Burgan, Vineet Prakash, Alexander Birkinshaw, Kishan Moosai, Adam Jacques, David Fluck, Mark MacGregor, Otar Lazariashvili, Pankaj Sharma, Christopher H Fry, Thang S Han

Affiliations

  1. Department of Radiology, Ashford & St Peter's Foundation Trust, Chertsey, UK.
  2. Department of Cardiology, Ashford & St Peter's Foundation Trust, Chertsey, UK.
  3. Department of Anesthesia, Ashford & St Peter's Foundation Trust, Chertsey, UK.
  4. Institute of Cardiovascular Research, Royal Holloway, University of London, Egham, UK.
  5. School of Physiology, Pharmacology and Neuroscience, University of Bristol, Bristol, UK.

PMID: 32269771 PMCID: PMC7093695 DOI: 10.1177/2048004020915393

Abstract

BACKGROUND: Left ventricular ejection fraction (LVEF) is generally measured by echocardiography but is increasingly available with myocardial perfusion scintigraphy. With myocardial perfusion scintigraphy, the threshold of LVEF below which there is a risk for myocardial infarct or sudden cardiac death is higher for women (51%) than for men (43%). We tested the hypothesis that such a sex difference may also occur with echocardiography and myocardial perfusion scintigraphy.

METHODS: Four hundred and four men, mean age = 67.7 ± SD = 12.3 yr; 339 women, 67.7 ± 11.7 yr had separate myocardial perfusion scintigraphy and echocardiography examinations within six months. A subset of 327 of these patients (181 men, 68.8 ± 12.1 yr; 146 women, 66.4 ± 12.1 yr) had examinations within one month and were additionally analysed as this sub-group. Myocardial perfusion scintigraphy and echocardiography were used to measure LVEF at rest and their agreement (neither considered as a reference method) was assessed by Bland-Altman plots: LVEF difference (myocardial perfusion scintigraphy minus echocardiography ) against average LVEF (

RESULTS: Of patients who had myocardial perfusion scintigraphy and echocardiography performed within six months, mean LVEF difference = +1.1% (95% limits of agreement: -19.3 to +21.6) in men but +10.9% (-10.7 to +32.5) in women. LVEF difference diverged from zero marginally in men (mean difference = +1.1, 95%CI  = +0.1 to +2.1,

CONCLUSIONS: Caution should be taken when interpreting LVEF measured by different techniques due to their wide limits of agreement and systematic bias, more markedly in women.

© The Author(s) 2020.

Keywords: Methods; bias; cardiology; nuclear medicine

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