Objective: To compare the left ventricular ejection fraction on echocardiograph, cardiac magnetic resonance imaging and single-photon emission computed tomography scan in heart failure patients. Study Design: This was a prospective cross-sectional study. Place and Duration of Study: Tertiary Cardiac Care Center of Rawalpindi, Pakistan, from Nov 2021 to Apr 2022. Methodology: This was a prospective cross-sectional study conducted from November 2021 to April 2022 at a tertiary cardiac care center of Rawalpindi. Thirty (n=30) heart failure patients of either gender with reduced ejection fraction were selected by consecutive sampling technique and were analyzed to quantify their left ventricular ejection fraction (LVEF) using Echo, CMR and SPECT scan. All three modalities were used to measure LVEF in these patients and were compared accordingly. Results: The LVEF measured by Cardiac Magnetic Resonance Imaging, Single Photon Emission Computed Tomography Scan and Echocardiography was in the range of 15% to 67%. The mean LVEF was 37.2±14.2 by CMR, 37.17±14.1 by SPECT and 38±12.3 by Echo. The mean LVEF determined by SPECT was slightly lower while that determined by Echocardiography was slightly higher. The measured p-value of LVEF by the three modalities, however, indicated statistically difference (p-value <0.05). Conclusion: Although the literature shows diversity in results of these modalities, CMR is considered the standard reference for assessment of LVEF when interpreted by an expert observer. We in our study found that all three modalities are complimentary to each other and can be used interchangeably depending upon the availability of the equipment and reporting expertise of the observers.

Objective: To evaluate the patterns of left ventricular hypertrophy (LVH) and late gadolinium enhancement (LGE) inhypertrophic cardiomyopathy. Study Design: Analytical cross-Sectional Study. Place and Duration of Study: Tertiary Cardiac Care Center, Rawalpindi Pakistan from 01 June 2020 to 30 Dec 2021. Methodology: This study was carried out at a tertiary cardiac care center retrospectively from 1 June 2020 to 31 December 2021. Patients having LV hypertrophy due to aortic stenosis, hypertension, athlete’s heart, and infiltrative disorders were excluded from study. Cases were included using nonprobability consecutive sampling. Sample size estimated by taking 0.2- 0.5 % (1 in 200-500) prevalence of hypertrophic cardiomyopathy using open epi sample size calculator was (n=38) taking 99.99% confidence interval. For the purpose of study all patients with confirmed HCM undergoing CMR during given period were included in study.Approval from the ethical review committee with IERB (IERB letter # 9/2/R&D/2022/179) was sought. CMR was performed using MRI 3 Tesla. Data analysis was done on SPSS version-26. Quantitative variables were expressed as Mean±SD. Qualitative variables were expressed as frequencies and percentages. ANOVA and student t-test (95% CI and 5% margin of error) was applied to compare the study variables. p-vale <0.05 was considered statistically significant. Results: Majority 77(86.7%) of patients were males. Most common pattern of involvement for LV hypertrophy was asymmetrical septal hypertrophy in 47 (52.8%) followed by apical HCM in 29(32.6%). LVOT obstruction was observed in 30(33.7%) of patients. Mean maximum LV wall thickness was 22mm±5.47. Conclusion: Our study shows association, between the extent of Late Gadolinium Enhancement and LV wall thickness, myocardial mass index in HCM patients.