Studies were eligible for inclusion if they measured the LVEF using multi-slice CT (64 slices or more) and compared this with the reference standard: MRI, TTE, or both. Included studies had to report the mean and standard deviation for the LVEF, as measured by multi-slice CT and the reference standard. Included studies had to perform multi-slice CT according to standard procedures, which required patients to be in sinus rhythm, without any arrhythmias, able to hold their breath for 10 to 12 seconds during scanning, and to have no allergy to contrast media and no renal dysfunction. Studies of patients not fulfilling these criteria were excluded.
In studies comparing multi-slice CT with MRI, the mean age of participants was 57.5 years (SD 12) and 77% were male. In studies comparing multi-slice CT with TTE, the mean age of participants was 58 years (SD 12.5) and 67% were male. The indications for imaging varied, including: known or suspected coronary artery disease; previous or suspected ischaemic heart disease; previous heart transplant; acute myocardial infarction; mitral regurgitation; aortic regurgitation; aortic stenosis; and cardiomyopathy. Most of the included studies used 64-slice CT and one third used dual-source CT.
Three reviewers independently assessed studies for inclusion and any disagreements were resolved by discussion.