LVEF nuclear medicine or echosonogram? Which is more reliable?

[Dr_Omar]

I had a nuclear medicine perfusion test and it showd my LVEF to be 46% but my echocardiogram showd it to be 60%.  A the test time I was on 240 mg diltiazem and 40 mg Lisinopril daily.  I do have a history of bad hypertension.  I do suffer from occasional PVC and PAC's.  Any opinion? Thanks.

[hugaw00zel]

A MUGA and a nuclear medicine stress test (perfusion) are both done by nuclear medicine technologists, but they are different tests.  The MUGA stands for multi-gated acquisition; whereas the stress test measures the uptake of the radiotracer of your heart muscle both during rest and stress, then compares the two.  I do not know what an echocardiogram does in comparison, but the main point of a stress test is for located blood flow to your heart muscle (and will give you an ejection fraction of your left ventricle), but the MUGA scan gives a more accurate left ventricular ejection fraction because the radioisotope is in your actual blood stream, not your heart muscle.

[Dr_Omar]

Thanks for the response.  I have a cardiologist telling me the echogram is more reliable and that nuclear is mainly to show perfusion.  I am still not sure.  Any MD out there to express an opinion tie breaker??

[trvvn5]

I would go with the MUGA.  An echo generally only shows anatomy.  Its does show fluid movement, but I don't think that its as reliable as the MUGA.  MUGA scans actually calculate the amount of radiotracer that is being pushed out of the left ventricle.  Highly sensitive cameras and computers calculate the origin of a radioactive emission that is traveling through the bloodstream.  So the computer is actually calculating where the fluid is as opposed to the echo that is imaging the fluid from outside the body.  So my suggestion would be that the MUGA is the more accurate of the two.