Evaluation of myocardial function is the basis for management of CAD patients. Patient prognosis is highly correlated with left ventricular ejection fraction (LVEF). Multiple imaging modalities may be used to assess required functional parameters.
Echocardiography is well suited for evaluation of myocardial function in patients with (suspected) CAD. Echo offers good delineation of endocardial and epicardial borders and enables assessment of left ventricular ejection fraction and wall motion analysis. New technologies including instantaneous full volume echo imaging will further improve global assessment of the heart and improve the diagnostic accuracy while reducing examination time. 1) 2)
Cardiovascular MR (CMR) is the current gold standard for non-invasive evaluation of cardiac function. Image quality in CMR doesn’t depend on patient’s habitus. Thus, high-quality imaging can be achieved in most patients. In all orientations, all chambers and wall segments including those of the right ventricle, can be visualized with high reproducibility. Therefore, analysis of regional and global myocardial function can be performed using CMR with highest possible accuracy. Using myocardial tagging, even small wall motion abnormalities can be detected. Additionally, Dobutamine stress CMR offers ischemia evaluation, with the same examination protocol known from stress echocardiography. 4)
Cardiac Molecular Imaging
When using ECG-gated acquisition techniques in myocardial perfusion scintigraphy both SPECT and PET techniques allow global and regional function analysis. This is a well established diagnostic measure.
Cardiac CT offers high temporal and spatial resolution, thereby being able to provide important functional cardiac information. Volumetric analysis by CT compares to magnetic resonance in accuracy and allows the calculation of left ventricular functional parameters like end-diastole volumes and ejection fraction. Also regional wall motion abnormalities in acute and chronic settings can be diagnosed with good diagnostic accuracy. 5) syngo Circulation is the only scientifically evaluated postprocessing software in the market to meet those clinical needs.