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LVEF by 16 segments WMS.(15%-40%-65%)
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LVEF by WMS for Non cardiologist echocardiographers
2D and 16 segments Bull ‘s eye wall motion score to asses systolic function may appear outdated in the current era of strain and 3D for the cardiologist. However for the majority of non cardiologist using echocardiography (emergency physician, intensivist , anesthesiologist, cardiac surgeon…) the simplicity and accuracy of the 2D 16 segment LVEF- WMS is attracting (ref :1-2). In our recent paper we have shown that a new segmental LVEF score ( Normal segment =4%, hypokinetic segment =2.5% , akinetic segment = 1% , dyskinetic or aneurismal segment = 0%) accurately estimates LVEF avoiding the use of regression equation or conversion table .
Dyskinesia and Aneurysm
Regarding dyskinetic (D) an aneurysmal (AN) segment , the last ASE guidelines (Lang et al. 2015) recommend to score 4 for dyskinesia (systolic bulging of the LV wall) but do not assign a specific score for aneurysm ( systolic and diastolic bulging of the LV wall). We believe that AN is a pathologic entity that is more severe than D as it leads to more scar arrhythmia, thrombus formation and is detrimental to LVEF. Because of it negative effect on LVEF , we still use D and AN in our evaluation of WMS. In our recent paper ( ref: 3) we had only 4 patients with D and 7 patients with AN. In order to better evaluate our score of 0% for D and AN , we further analysed the score of 92 patients with D (n=35) or AN (n=57) using our new segmental LVEF score and compared it to the classic WMS (which was previously validated against nuclear medicine (40 patients with D and 42 patients with AN) ( ref: 4). This analysis suggests that a negative score of -1% for D and -2% for AN segments results in a more accurate estimation of LVEF .
R. Lebeau md Cardiologist HSCM Ref .: 1- Lebeau R, Potter B, Sas G, Moustafa S, Di Lorenzo M, Soulière V, Beaulieu Y, Sauvé C, Amyot R, Serri K,. Performance of a simplified wall motion score index method for non-cardiologists to assess left ventricular ejection fraction. ISRN Emergency Medecine. 2012:1-5
2- Lebeau R, Sas G, El-Rayes M, Serban A, Moustafa S, Essadiqi B, Di Lorenzo M, Soulière V, Beaulieu Y, Sauvé C, Amyot R, Serri K. Left ventricular ejection fraction assessment by non-cardiologists from transverse views using a simplified wall motion score index. Echo Res Pract. 2015:2(1):1-8.
3- Lebeau R, Serri K, Di Lorenzo M, Sauvé C, Lê V H V, Soulière V, El-Rayes M, Pagé M, Zaïani C, Garot J, Poulin F,. Assessment of LVEF using a new 16-segment wall motion score in echocardiography. Echo Res Pract. 2018:5(2):63-9. (supplemental data fig 1A)
4- Lebeau R, Di Lorenzo M, Amyot R, Veilleux M, Lemieux R, Sauvé C. A new tool for estimating left ventricular ejection fraction derived from wall motion score index. Canadian Journal of Cardiology 2003 19 397-404.
R. Lebeau md Cardiologist HSCM Ref .: 1- Lebeau R, Potter B, Sas G, Moustafa S, Di Lorenzo M, Soulière V, Beaulieu Y, Sauvé C, Amyot R, Serri K,. Performance of a simplified wall motion score index method for non-cardiologists to assess left ventricular ejection fraction. ISRN Emergency Medecine. 2012:1-5
2- Lebeau R, Sas G, El-Rayes M, Serban A, Moustafa S, Essadiqi B, Di Lorenzo M, Soulière V, Beaulieu Y, Sauvé C, Amyot R, Serri K. Left ventricular ejection fraction assessment by non-cardiologists from transverse views using a simplified wall motion score index. Echo Res Pract. 2015:2(1):1-8.
3- Lebeau R, Serri K, Di Lorenzo M, Sauvé C, Lê V H V, Soulière V, El-Rayes M, Pagé M, Zaïani C, Garot J, Poulin F,. Assessment of LVEF using a new 16-segment wall motion score in echocardiography. Echo Res Pract. 2018:5(2):63-9. (supplemental data fig 1A)
4- Lebeau R, Di Lorenzo M, Amyot R, Veilleux M, Lemieux R, Sauvé C. A new tool for estimating left ventricular ejection fraction derived from wall motion score index. Canadian Journal of Cardiology 2003 19 397-404.
N.B.: 65%-40%-15%, D=-15, AN=-30
If you use the 17 segment Bull-eye model , simply do not include the segment 17 in your calculation¨¨
According to our article in Archives of Cardiovascular Disease (1) our new method 16 LVEF score (4%-2.5%-1%) can be use in cardiac MRI
1- Ref.: ¨¨ Assessment of LVEF using the WMSI in cardiac resonance imaging¨¨ Archives of Cardiovascular Diseases 2012,105,91-98
Lebeau R, Serri K, Morice MC, Hovasse T , Unterseeh T , Piechaud JF and Garot J.
If you use the 17 segment Bull-eye model , simply do not include the segment 17 in your calculation¨¨
According to our article in Archives of Cardiovascular Disease (1) our new method 16 LVEF score (4%-2.5%-1%) can be use in cardiac MRI
1- Ref.: ¨¨ Assessment of LVEF using the WMSI in cardiac resonance imaging¨¨ Archives of Cardiovascular Diseases 2012,105,91-98
Lebeau R, Serri K, Morice MC, Hovasse T , Unterseeh T , Piechaud JF and Garot J.
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