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Liu X, Fan Y, Li S, Chen M, Li M, Hau WK, Zhang H, Xu L, Lee APW. Deep learning-based automated left ventricular ejection fraction assessment using 2-D echocardiography. Am J Physiol Heart Circ Physiol 2021; 321:H390-H399. [PMID: 34170197 DOI: 10.1152/ajpheart.00416.2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Deep learning (DL) has been applied for automatic left ventricle (LV) ejection fraction (EF) measurement, but the diagnostic performance was rarely evaluated for various phenotypes of heart disease. This study aims to evaluate a new DL algorithm for automated LVEF measurement using two-dimensional echocardiography (2DE) images collected from three centers. The impact of three ultrasound machines and three phenotypes of heart diseases on the automatic LVEF measurement was evaluated. Using 36890 frames of 2DE from 340 patients, we developed a DL algorithm based on U-Net (DPS-Net) and the biplane Simpson's method was applied for LVEF calculation. Results showed a high performance in LV segmentation and LVEF measurement across phenotypes and echo systems by using DPS-Net. Good performance was obtained for LV segmentation when DPS-Net was tested on the CAMUS data set (Dice coefficient of 0.932 and 0.928 for ED and ES). Better performance of LV segmentation in study-wise evaluation was observed by comparing the DPS-Net v2 to the EchoNet-dynamic algorithm (P = 0.008). DPS-Net was associated with high correlations and good agreements for the LVEF measurement. High diagnostic performance was obtained that the area under receiver operator characteristic curve was 0.974, 0.948, 0.968, and 0.972 for normal hearts and disease phenotypes including atrial fibrillation, hypertrophic cardiomyopathy, dilated cardiomyopathy, respectively. High performance was obtained by using DPS-Net in LV detection and LVEF measurement for heart failure with several phenotypes. High performance was observed in a large-scale dataset, suggesting that the DPS-Net was highly adaptive across different echocardiographic systems.NEW & NOTEWORTHY A new strategy of feature extraction and fusion could enhance the accuracy of automatic LVEF assessment based on multiview 2-D echocardiographic sequences. High diagnostic performance for the determination of heart failure was obtained by using DPS-Net in cases with different phenotypes of heart diseases. High performance for left ventricle segmentation was obtained by using DPS-Net, suggesting the potential for a wider range of application in the interpretation of 2DE images.
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Affiliation(s)
- Xin Liu
- Guangdong Academy Research on VR Industry, Foshan University, Guangdong, People's Republic of China
| | - Yiting Fan
- Department of Cardiology, Shanghai Chest Hospital, Shanghai JiaoTong University, Shanghai, People's Republic of China.,Laboratory of Cardiac Imaging and 3D Printing, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Shuang Li
- General Hospital of the Southern Theatre Command, PLA and Guangdong University of Technology, Guangdong, People's Republic of China
| | - Meixiang Chen
- General Hospital of the Southern Theatre Command, PLA and The First School of Clinical Medicine, Southern Medical University, Guangdong, People's Republic of China
| | - Ming Li
- Faculty of Medicine, Imperial College London, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - William Kongto Hau
- Division of Cardiology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Heye Zhang
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Lin Xu
- General Hospital of the Southern Theatre Command, PLA and The First School of Clinical Medicine, Southern Medical University, Guangdong, People's Republic of China
| | - Alex Pui-Wai Lee
- Laboratory of Cardiac Imaging and 3D Printing, Li Ka Shing Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China.,Division of Cardiology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, People's Republic of China
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Prognostic value of the left ventricular - left atrial volume ratio assessed using three-dimensional echocardiography with fully automated analytical software. J Cardiol 2021; 78:406-412. [PMID: 34088561 DOI: 10.1016/j.jjcc.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/11/2021] [Accepted: 04/24/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND we investigated the prognostic value of a new 3D echocardiography (3DE) parameter, the left ventricular-left atrial volume ratio (LVLAVR) in a diverse group of subjects. METHODS 3DE full-volume datasets were analyzed in 307 patients using fully automated LV and LA quantification software (Dynamic Heart Model, Philips Medical Systems, Andover, MA, USA), which generated LV and LA volume curves using artificial intelligence and 3D speckle tracking technology. We measured LVLAVR at LV end-diastole (edLVLAVR; LV end-diastolic volume / LA minimal volume), LVLAVR at LV end-systole (esLVLAVR: LV end-systolic volume / LA maximal volume), and their differences (ΔLVLAVR: edLVLAVR - esLVLAVR). No manual editing was performed on data of any patient. The primary endpoint was a major adverse cardiac event (MACE), including cardiac death, heart failure resulting in hospitalization, myocardial infarction, or ventricular tachyarrhythmia. RESULTS feasibility of LVLAVR measurements was 90%. During a median follow-up of 21 months, 43 patients developed a primary endpoint. Univariate Cox proportional hazard analysis revealed that edLVLAVR [hazard ratio (HR): 0.72, p < 0.01] and ΔLVLAVR (HR: 0.62, p < 0.01) were significantly associated with MACE. Median values of both edLVLAVR (4.59) and ΔLVLAVR (2.90) successfully stratified patients into high- and low-risk populations for future MACEs. ΔLVLAVR was still significantly associated with MACEs after adjusting for age, chronic kidney disease (CKD) and LV ejection fraction or after adjusting for age, CKD, and E/ε'. CONCLUSIONS LVLAVR provided incremental value over traditional LV systolic and diastolic function parameters to predict future adverse outcomes. The analysis was fully automated, thereby eliminating measurement variability.
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Boccalini S, Bons LR, van den Hoven AT, van den Bosch AE, Krestin GP, Roos-Hesselink J, Budde RPJ. Bicuspid aortic valve annulus: assessment of geometry and size changes during the cardiac cycle as measured with a standardized method to define the annular plane. Eur Radiol 2021; 31:8116-8129. [PMID: 33895857 PMCID: PMC8523432 DOI: 10.1007/s00330-021-07916-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/11/2021] [Accepted: 03/19/2021] [Indexed: 12/02/2022]
Abstract
Purpose Bicuspid aortic valve (BAV) is a complex malformation affecting not merely the aortic valve. However, little is known regarding the dynamic physiology of the aortic annulus in these patients and whether it is similar to tricuspid aortic valves (TAV). Determining the BAV annular plane is more challenging than for TAV. Our aim was to present a standardized methodology to determine BAV annulus and investigate its changes in shape and dimensions during the cardiac cycle. Methods BAV patients were prospectively included and underwent an ECG-gated cardiac CTA. The annulus plane was manually identified on reconstructions at 5% intervals of the cardiac cycle with a new standardized method for different BAV types. Based on semi-automatically defined contours, maximum and minimum diameter, area, area-derived diameter, perimeter, asymmetry ratio (AR), and relative area were calculated. Differences of dynamic annular parameters were assessed also per BAV type. Results Of the 55 patients included (38.4 ± 13.3 years; 58% males), 38 had BAV Sievers type 1, 10 type 0, and 7 type 2. The minimum diameter, perimeter, area, and area-derived diameter were significantly higher in systole than in diastole with a relative change of 13.7%, 4.8%, 13.7%, and 7.2% respectively (all p < 0.001). The AR was ≥ 1.1 in all phases, indicating an elliptic shape, with more pronounced flattening in diastole (p < 0.001). Different BAV types showed comparable dynamic changes. Conclusions BAV annulus undergo significant changes in shape during the cardiac cycle with a wider area in systole and a more elliptic conformation in diastole regardless of valve type. Key Points • A refined method for the identification of the annulus plane on CT scans of patients with bicuspid aortic valves, tailored for the specific anatomy of each valve type, is proposed. • The annulus of patients with bicuspid aortic valves undergoes significant changes during the cardiac cycle with a wider area and more circular shape in systole regardless of valve type. • As compared to previously published data, the bicuspid aortic valve annulus has physiological dynamics similar to that encountered in tricuspid valves but with overall larger dimensions. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-07916-8.
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Affiliation(s)
- Sara Boccalini
- Department of Radiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.
| | - Lidia R Bons
- Department of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Allard T van den Hoven
- Department of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Annemien E van den Bosch
- Department of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Gabriel P Krestin
- Department of Radiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Jolien Roos-Hesselink
- Department of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Ricardo P J Budde
- Department of Radiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands.,Department of Cardiology, Erasmus Medical Center, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands
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van den Hoven AT, Yilmazer S, Chelu RG, van Grootel RWJ, Minderhoud SCS, Bons LR, van Berendoncks AM, Duijnhouwer AL, Siebelink HMJ, van den Bosch AE, Budde RPJ, Roos-Hesselink JW, Hirsch A. Left ventricular global longitudinal strain in bicupsid aortic valve patients: head-to-head comparison between computed tomography, 4D flow cardiovascular magnetic resonance and speckle-tracking echocardiography. Int J Cardiovasc Imaging 2020; 36:1771-1780. [PMID: 32451876 PMCID: PMC7438282 DOI: 10.1007/s10554-020-01883-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 05/14/2020] [Indexed: 11/30/2022]
Abstract
Left ventricular global longitudinal strain (LVGLS) analysis is a sensitive measurement of myocardial deformation most often done using speckle-tracking transthoracic echocardiography (TTE). We propose a novel approach to measure LVGLS using feature-tracking software on the magnitude dataset of 4D flow cardiovascular magnetic resonance (CMR) and compare it to dynamic computed tomography (CT) and speckle tracking TTE derived measurements. In this prospective cohort study 59 consecutive adult patients with a bicuspid aortic valve (BAV) were included. The study protocol consisted of TTE, CT, and CMR on the same day. Image analysis was done using dedicated feature-tracking (4D flow CMR and CT) and speckle-tracking (TTE) software, on apical 2-, 3-, and 4-chamber long-axis multiplanar reconstructions (4D flow CMR and CT) or standard apical 2-, 3-, and 4-chamber acquisitions (TTE). CMR and CT GLS analysis was feasible in all patients. Good correlations were observed for GLS measured by CMR (− 21 ± 3%) and CT (− 20 ± 3%) versus TTE (− 20 ± 3%, Pearson’s r: 0.67 and 0.65, p < 0.001). CMR also correlated well with CT (Pearson’s r 0.62, p < 0.001). The inter-observer analysis showed moderate to good reproducibility of GLS measurement by CMR, CT and TTE (Pearsons’s r: 0.51, 0.77, 0.70 respectively; p < 0.05). Additionally, ejection fraction (EF), end-diastolic and end-systolic volume measurements (EDV and ESV) correlated well between all modalities (Pearson’s r > 0.61, p < 0.001). Feature-tracking GLS analysis is feasible using the magnitude images acquired with 4D flow CMR. GLS measurement by CMR correlates well with CT and speckle-tracking 2D TTE. GLS analysis on 4D flow CMR allows for an integrative approach, integrating flow and functional data in a single sequence. Not applicable, observational study.
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Affiliation(s)
- Allard T. van den Hoven
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Sultan Yilmazer
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Raluca G. Chelu
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Roderick W. J. van Grootel
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Savine C. S. Minderhoud
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Lidia R. Bons
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - An M. van Berendoncks
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Anthonie L. Duijnhouwer
- Department of Cardiology, Radboud University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hans-Marc J. Siebelink
- Department of Cardiology, Leiden University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annemien E. van den Bosch
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Ricardo P. J. Budde
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jolien W. Roos-Hesselink
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Alexander Hirsch
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Room Rg-419, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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DeVore GR, Klas B, Satou G, Sklansky M. Evaluation of Fetal Left Ventricular Size and Function Using Speckle-Tracking and the Simpson Rule. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1209-1221. [PMID: 30244474 DOI: 10.1002/jum.14799] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 07/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES This study was conducted to evaluate left ventricular (LV) size and function in healthy fetuses and to test a cohort of fetuses at risk for abnormal function using speckle-tracking software. METHODS Two hundred control fetuses were examined between 20 and 40 weeks' gestation. With the use of offline speckle-tracking software, the end-diastolic and end-systolic volumes were measured and the following computed: stroke volume (SV), SV per kilogram, cardiac output (CO), CO per kilogram, and ejection fraction. These were regressed against 7 independent variables related to the size, weight, and age of the fetuses. Five fetuses with risk factors for LV dysfunction were examined to sample the validity of the data from the control group. RESULTS The R2 values for measurements of the end-diastolic volume, SV, and CO correlated with the 7 independent variables of fetal size and age (0.7-0.78), whereas the SV/kg, CO/kg, and ejection fraction had lower R2 values (0.02-0.1). The measurements were normally distributed (Shapiro-Wilke > 0.5). The 5 fetuses at risk for abnormal LV function had measurements of LV size and function that were consistent with the expected pathologic condition. CONCLUSIONS Speckle tracking can provide a comprehensive evaluation of the size and function of the fetal LV.
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Affiliation(s)
- Greggory R DeVore
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Fetal Diagnostic Centers, Pasadena, Tarzana, and Lancaster, California, USA
| | | | - Gary Satou
- Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Mark Sklansky
- Division of Pediatric Cardiology, Department of Pediatrics, UCLA Mattel Children's Hospital, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Amadieu R, Hadeed K, Jaffro M, Karsenty C, Ratsimandresy M, Dulac Y, Acar P. Feasibility of New Transthoracic Three-Dimensional Echocardiographic Automated Software for Left Heart Chamber Quantification in Children. J Am Soc Echocardiogr 2019; 32:121-134.e1. [DOI: 10.1016/j.echo.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Indexed: 01/26/2023]
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Cai Q, Wang J, Li H, Li C, Wu X, Lu X. Measurement of Left Ventricular Volumes and Ejection Fraction in Patients with Regional Wall Motion Abnormalities Using an Automated 3D Quantification Algorithm. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2274-2282. [PMID: 30122311 DOI: 10.1016/j.ultrasmedbio.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 06/30/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
Accurate and rapid left ventricular (LV) ejection fraction (EF) measurement is crucial for patients with wall motion abnormalities (WMAs). Conventional 2D echocardiographic imaging has limitations. The recently developed software HeartModel (HM, Philips Healthcare, Andover, MA, USA) has shown promise in automated 3D quantification. However, the accuracy and detailed features of HM in measurements of LV volume and EF in patients with regional WMAs have not been carefully investigated. In the present study, echocardiographic imaging (EPIQ, X5-1, Philips Healthcare) was performed in 72 patients with WMAs. The LV end-diastolic volume (EDV), end-systolic volume (ESV) and EF were measured by HM in three modes: without editing and with global and regional endocardial border editing (Auto 3D-NE, Auto 3D-GE and Auto 3D-RE, respectively). The conventional 2D Simpson's biplane method and manual 3D quantification (QLAB-3DQA software, Philips Healthcare), as the standard method, were used for comparison. Among the three HM modalities, Auto 3D-RE exhibited the best correlation with manual 3D in assessing EDV, ESV and EF (r = 0.88, 0.93 and 0.91, respectively), although it took slightly longer (67.3 ± 13.0 s). Auto 3D-RE also exhibited a small degree of bias for the measurements (EDV: 11.7mL, ESV: 8.45mL, EF: -1.57%) and narrow limits of agreement. Heterogeneity of LV wall motion was defined to indicate the dispersion degree of WMAs. It associated with the difference in EF measurement between Auto 3D-RE and manual 3D (p = 0.014, hazard ratio = 5.19). In patients with WMAs, HM with regional contour editing enables accurate and efficient evaluation of LV volume and EF.
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Affiliation(s)
- Qizhe Cai
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China
| | - Jiangtao Wang
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China
| | - Hong Li
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China
| | - Cheng Li
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaopeng Wu
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China
| | - Xiuzhang Lu
- Department of Echocardiography, Heart Center, Beijing Chao Yang Hospital, Capital Medical University, Beijing, China.
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Bons LR, Duijnhouwer AL, Boccalini S, van den Hoven AT, van der Vlugt MJ, Chelu RG, McGhie JS, Kardys I, van den Bosch AE, Siebelink HMJ, Nieman K, Hirsch A, Broberg CS, Budde RPJ, Roos-Hesselink JW. Intermodality variation of aortic dimensions: How, where and when to measure the ascending aorta. Int J Cardiol 2018; 276:230-235. [PMID: 30213599 DOI: 10.1016/j.ijcard.2018.08.067] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/14/2018] [Accepted: 08/22/2018] [Indexed: 01/16/2023]
Abstract
BACKGROUND No established reference-standard technique is available for ascending aortic diameter measurements. The aim of this study was to determine agreement between modalities and techniques. METHODS In patients with aortic pathology transthoracic echocardiography, computed tomography angiography (CTA) and magnetic resonance angiography (MRA) were performed. Aortic diameters were measured at the sinus of Valsalva (SoV), sinotubular junction (STJ) and tubular ascending aorta (TAA) during mid-systole and end-diastole. In echocardiography both the inner edge-to-inner edge (I-I edge) and leading edge-to‑leading edge (L-L edge) methods were applied, and the length of the aortic annulus to the most cranial visible part of the ascending aorta was measured. In CTA and MRA the I-I method was used. RESULTS Fifty patients with bicuspid aortic valve (36 ± 13 years, 26% female) and 50 Turner patients (35 ± 13 years) were included. Comparison of all aortic measurements showed a mean difference of 5.4 ± 2.7 mm for the SoV, 5.1 ± 2.0 mm for the STJ and 4.8 ± 2.1 mm for the TAA. The maximum difference was 18 mm. The best agreement was found between echocardiography L-L edge and CTA during mid-systole. CTA and MRA showed good agreement. A mean difference of 1.5 ± 1.3 mm and 1.8 ± 1.5 mm was demonstrated at the level of the STJ and TAA comparing mid-systolic with end-diastolic diameters. The visible length of the aorta increased on average 5.3 ± 5.1 mmW during mid-systole. CONCLUSIONS MRA and CTA showed best agreement with L-L edge method by echocardiography. In individual patients large differences in ascending aortic diameter were demonstrated, warranting measurement standardization. The use of CTA or MRA is advised at least once.
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Affiliation(s)
- Lidia R Bons
- Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Sara Boccalini
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - Raluca G Chelu
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jackie S McGhie
- Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Isabella Kardys
- Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - Koen Nieman
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands; Departments of Cardiovascular medicine and Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - Alexander Hirsch
- Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Craig S Broberg
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA
| | - Ricardo P J Budde
- Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
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