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Elmadi J, Satish Kumar L, Pugalenthi LS, Ahmad M, Reddy S, Barkhane Z. Cardiovascular Magnetic Resonance Imaging: A Prospective Modality in the Diagnosis and Prognostication of Heart Failure. Cureus 2022; 14:e23840. [PMID: 35530891 PMCID: PMC9072284 DOI: 10.7759/cureus.23840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/13/2022] Open
Abstract
Heart failure (HF) is a clinical syndrome resulting from structural cardiac remodeling and altered function that impairs tissue perfusion. This article aimed to highlight the current diagnostic and prognostic value of cardiac magnetic resonance (CMR) in the management of HF and prospective future applications. Reviewed are the physics associated with CMR, its use in ischemic and non-ischemic causes of HF, and its role in quantifying left ventricular ejection fraction. It also emphasized that CMR allows for noninvasive morphologic and functional assessment, tissue characterization, blood flow, and perfusion evaluation in patients with suspected or diagnosed HF. CMR has become a crucial instrument for the diagnosis, prognosis, and therapy planning in patients with HF and cardiomyopathy due to its accuracy in quantifying cardiac volumes and ejection fraction (considered the gold standard) as well as native and post-contrast myocardial tissue characterization.
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Samtani R, Bienstock S, Lai AC, Liao S, Baber U, Croft L, Stern E, Beerkens F, Ting P, Goldman ME. Assessment and validation of a novel fast fully automated artificial intelligence left ventricular ejection fraction quantification software. Echocardiography 2022; 39:473-482. [PMID: 35178746 DOI: 10.1111/echo.15318] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/11/2022] [Accepted: 01/27/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Quantification of left ventricular ejection fraction (LVEF) by transthoracic echocardiography (TTE) is operator-dependent, time-consuming, and error-prone. LVivoEF by DIA is a new artificial intelligence (AI) software, which displays the tracking of endocardial borders and rapidly quantifies LVEF. We sought to assess the accuracy of LVivoEF compared to cardiac magnetic resonance imaging (cMRI) as the reference standard and to compare LVivoEF to the standard-of-care physician-measured LVEF (MD-EF) including studies with ultrasound enhancing agents (UEAs). METHODS In 273 consecutive patients, we compared MD-EF and AI-derived LVEF to cMRI. AI-derived LVEF was obtained from a non-UEA four-chamber view without manual correction. Thirty-one patients were excluded: 25 had interval interventions or incomplete TTE or cMRI studies and six had uninterpretable non-UEA apical views. RESULTS In the 242 subjects, the correlation between AI and cMRI was r = .890, similar to MD-EF and cMRI with r = .891 (p = 0.48). Of the 126 studies performed with UEAs, the correlation of AI using the unenhanced four-chamber view was r = .89, similar to MD-EF with r = .90. In the 116 unenhanced studies, AI correlation was r = .87, similar to MD-EF with r = .84. From Bland-Altman analysis, LVivoEF underreported the LVEF with a bias of 3.63 ± 7.40% EF points compared to cMRI while MD-EF to cMRI had a bias of .33 ± 7.52% (p = 0.80). CONCLUSIONS Compared to cMRI, LVivoEF can accurately quantify LVEF from a standard apical four-chamber view without manual correction. Thus, LVivoEF has the ability to improve and expedite LVEF quantification.
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Affiliation(s)
- Rajeev Samtani
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Solomon Bienstock
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Ashton C Lai
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Steve Liao
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Usman Baber
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Lori Croft
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Eric Stern
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Frans Beerkens
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Peter Ting
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Martin E Goldman
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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Manole S, Budurea C, Pop S, Iliescu AM, Ciortea CA, Iancu SD, Popa L, Coman M, Szabó L, Coman V, Bálint Z. Correlation between Volumes Determined by Echocardiography and Cardiac MRI in Controls and Atrial Fibrillation Patients. Life (Basel) 2021; 11:life11121362. [PMID: 34947893 PMCID: PMC8707690 DOI: 10.3390/life11121362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/04/2021] [Accepted: 12/05/2021] [Indexed: 11/21/2022] Open
Abstract
Aims: We aimed to compare cardiac volumes measured with echocardiography (echo) and cardiac magnetic resonance imaging (MRI) in a mixed cohort of healthy controls (controls) and patients with atrial fibrillation (AF). Materials and methods: In total, 123 subjects were included in our study; 99 full datasets were analyzed. All the participants underwent clinical evaluation, EKG, echo, and cardiac MRI acquisition. Participants with full clinical data were grouped into 63 AF patients and 36 controls for calculation of left atrial volume (LA Vol) and 51 AF patients and 30 controls for calculation of left ventricular end-diastolic volume (LV EDV), end-systolic volume (ESV), and LV ejection fraction (LV EF). Results: No significant differences in LA Vol were observed (p > 0.05) when measured by either echo or MRI. However, echo provided significantly lower values for left ventricular volume (p < 0.0001). The echo LA Vol of all the subjects correlated well with that measured by MRI (Spearmen correlation coefficient r = 0.83, p < 0.0001). When comparing the two methods, significant positive correlations of EDV (all subjects: r = 0.55; Controls: r = 0.71; and AF patients: r = 0.51) and ESV (all subjects: r = 0.62; Controls: r = 0.47; and AF patients: r = 0.66) were found, with a negative bias for values determined using echo. For a subgroup of participants with ventricular volumes smaller than 49.50 mL, this bias was missing, thus in this case echocardiography could be used as an alternative for MRI. Conclusion: Good correlation and reduced bias were observed for LA Vol and EF determined by echo as compared to cardiac MRI in a mixed cohort of patients with AF and healthy volunteers. For the determination of volume values below 49.50 mL, an excellent correlation was observed between values obtained using echo and MRI, with comparatively reduced bias for the volumes determined by echo. Therefore, in certain cases, echocardiography could be used as a less expensive, less time-consuming, and contraindication free alternative to MRI for cardiac volume determination.
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Affiliation(s)
- Simona Manole
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Claudia Budurea
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
| | - Sorin Pop
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
| | - Alin M. Iliescu
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
| | - Cristiana A. Ciortea
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Stefania D. Iancu
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
- Faculty of Physics, Babeș-Bolyai University, 400084 Cluj-Napoca, Romania
| | - Loredana Popa
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Mihaela Coman
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
| | - László Szabó
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
- Faculty of Physics, Babeș-Bolyai University, 400084 Cluj-Napoca, Romania
| | - Vasile Coman
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, 400372 Cluj-Napoca, Romania
| | - Zoltán Bálint
- IMOGEN Research Institute, County Clinical Emergency Hospital, 400006 Cluj-Napoca, Romania; (S.M.); (C.B.); (S.P.); (A.M.I.); (C.A.C.); (S.D.I.); (L.P.); (M.C.); (L.S.); (V.C.)
- Faculty of Physics, Babeș-Bolyai University, 400084 Cluj-Napoca, Romania
- Correspondence: ; Tel.: +40-264-405-300; Fax: +40-264-591-906
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