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Yin G, Cui C, An J, Zhao K, Yang K, Li S, Yang X, Wang J, Dong Z, Yu S, He J, Chen X, Lu M, Zhao S. Assessment of Left Ventricular Systolic Function by Cardiovascular Magnetic Resonance Compressed Sensing Real-Time Cine Imaging Combined With Area-Length Method in Normal Sinus Rhythm and Atrial Fibrillation. Front Cardiovasc Med 2022; 9:896816. [PMID: 35711346 PMCID: PMC9197321 DOI: 10.3389/fcvm.2022.896816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/03/2022] [Indexed: 11/30/2022] Open
Abstract
Background The most-commonly used multi-slice Simpson's method employed with routine two-dimensional segmented cine images makes it difficult to evaluate left ventricular (LV) volume and function due to endocardial border blurring and beat-to-beat variation during atrial fibrillation (AF) status. Objectives To assess the feasibility of compressed sensing real-time (CSRT) cine imaging combined with an area-length method for quantification of LV systolic function in normal sinus rhythm (NSR) and AF. Methods The CSRT cine sequence and routine segmented balanced Steady-State-Free-Precession cine sequence were performed in 71 patients with NSR (n = 36) or AF (n = 35). Image quality and edge sharpness for both sequences were assessed. The LV functional measurements in patients with NSR included end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), cardiac output (CO), cardiac index (CI), and LV mass (LVM); all were assessed using segmented cine with Simpson's rule in short axis (SegSA_Simpson, as a reference standard) and area-length (AL) method in the two chamber (Seg2CH_AL) or four chamber (Seg4CH_AL) and CSRT cine with AL method in the two chamber (CSRT2CH_AL) or four chamber (CSRT4CH_AL). Finally, the mean, maximum, and minimum values of each LV functional parameter [EDV/ESV/SV/EF/CO/CI/LVM/heart rate (HR)] from 4~5 consecutive heartbeats were measured using CSRT2CH_AL in patients with AF. Results In patients with NSR, measurements of EDV (p > 0.05), ESV (p > 0.05), SV (p > 0.05), EF (p > 0.05), and LVM (p > 0.05) assessed with CSRT2CH_AL did not differ significantly from those obtained with SegSA_Simpson. In patients with AF, CSRT image quality score (p < 0.001) and edge sharpness (p < 0.001) both were significantly higher than those obtained from segmented cine. The CSRT2CH_AL provided significantly different results among mean, maximum, and minimum values of each LV parameter from 4~5 consecutive heartbeats (all p < 0.001) with strong inter- and intra-observer agreement in AF. Conclusions The CSRT cine sequence combined with two chamber area-length analysis accurately assessed LV systolic function in NSR. This approach is expected to permit the assessment of multiple parameters in consecutive heartbeats with good inter- and intra-observer reproducibility for beat-to-beat analysis of LV function in AF.
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Affiliation(s)
- Gang Yin
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Chen Cui
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Jing An
- Siemens Shenzhen Magnetic Resonance Ltd., Siemens MRI Center, Shenzhen, China
| | - Kankan Zhao
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, SZ University Town, Shenzhen, China
| | - Kai Yang
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Shuang Li
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Xinling Yang
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Jiaxin Wang
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Zhixiang Dong
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Shiqin Yu
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Jian He
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Xiuyu Chen
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Minjie Lu
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
| | - Shihua Zhao
- MR Center, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, Beijing, China
- *Correspondence: Shihua Zhao
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Fumagalli I, Vitullo P, Vergara C, Fedele M, Corno AF, Ippolito S, Scrofani R, Quarteroni A. Image-Based Computational Hemodynamics Analysis of Systolic Obstruction in Hypertrophic Cardiomyopathy. Front Physiol 2022; 12:787082. [PMID: 35069249 PMCID: PMC8773089 DOI: 10.3389/fphys.2021.787082] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/13/2021] [Indexed: 12/01/2022] Open
Abstract
Hypertrophic Cardiomyopathy (HCM) is a pathological condition characterized by an abnormal thickening of the myocardium. When affecting the medio-basal portion of the septum, it is named Hypertrophic Obstructive Cardiomyopathy (HOCM) because it induces a flow obstruction in the left ventricular outflow tract. In any type of HCM, the myocardial function can become compromised, possibly resulting in cardiac death. In this study, we investigated with computational analysis the hemodynamics of patients with different types of HCM. The aim was quantifying the effects of this pathology on the intraventricular blood flow and pressure gradients, and providing information potentially useful to guide the indication and the modality of the surgical treatment (septal myectomy). We employed an image-based computational approach, integrating fluid dynamics simulations with geometric and functional data, reconstructed from standard cardiac cine-MRI acquisitions. We showed that with our approach we can better understand the patho-physiological behavior of intraventricular blood flow dynamics due to the abnormal morphological and functional aspect of the left ventricle. The main results of our investigation are: (a) a detailed patient-specific analysis of the blood velocity, pressure and stress distribution associated to HCM; (b) a computation-based classification of patients affected by HCM that can complement the current clinical guidelines for the diagnosis and treatment of HOCM.
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Affiliation(s)
- Ivan Fumagalli
- MOX, Dipartimento di Matematica, Politecnico di Milano, Milan, Italy
| | - Piermario Vitullo
- MOX, Dipartimento di Matematica, Politecnico di Milano, Milan, Italy
| | - Christian Vergara
- LaBS, Dipartimento di Chimica, Materiali e Ingegneria Chimica “Giulio Natta”, Politecnico di Milano, Milan, Italy
| | - Marco Fedele
- MOX, Dipartimento di Matematica, Politecnico di Milano, Milan, Italy
| | - Antonio F. Corno
- Children’s Heart Institute, Hermann Children’s Hospital, McGovern Medical School, University of Texas Health, Houston, TX, United States
| | | | | | - Alfio Quarteroni
- MOX, Dipartimento di Matematica, Politecnico di Milano, Milan, Italy
- Institute of Mathematics, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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Colunga AL, Kim KG, Woodall NP, Dardas TF, Gennari JH, Olufsen MS, Carlson BE. Deep phenotyping of cardiac function in heart transplant patients using cardiovascular system models. J Physiol 2020; 598:3203-3222. [PMID: 32372434 DOI: 10.1113/jp279393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/01/2020] [Indexed: 01/10/2023] Open
Abstract
KEY POINTS Right heart catheterization data from clinical records of heart transplant patients are used to identify patient-specific models of the cardiovascular system. These patient-specific cardiovascular models represent a snapshot of cardiovascular function at a given post-transplant recovery time point. This approach is used to describe cardiac function in 10 heart transplant patients, five of which had multiple right heart catheterizations allowing an assessment of cardiac function over time. These patient-specific models are used to predict cardiovascular function in the form of right and left ventricular pressure-volume loops and ventricular power, an important metric in the clinical assessment of cardiac function. Outcomes for the longitudinally tracked patients show that our approach was able to identify the one patient from the group of five that exhibited post-transplant cardiovascular complications. ABSTRACT Heart transplant patients are followed with periodic right heart catheterizations (RHCs) to identify post-transplant complications and guide treatment. Post-transplant positive outcomes are associated with a steady reduction of right ventricular and pulmonary arterial pressures, toward normal levels of right-side pressure (about 20 mmHg) measured by RHC. This study shows that more information about patient progression is obtained by combining standard RHC measures with mechanistic computational cardiovascular system models. The purpose of this study is twofold: to understand how cardiovascular system models can be used to represent a patient's cardiovascular state, and to use these models to track post-transplant recovery and outcome. To obtain reliable parameter estimates comparable within and across datasets, we use sensitivity analysis, parameter subset selection, and optimization to determine patient-specific mechanistic parameters that can be reliably extracted from the RHC data. Patient-specific models are identified for 10 patients from their first post-transplant RHC, and longitudinal analysis is carried out for five patients. Results of the sensitivity analysis and subset selection show that we can reliably estimate seven non-measurable quantities; namely, ventricular diastolic relaxation, systemic resistance, pulmonary venous elastance, pulmonary resistance, pulmonary arterial elastance, pulmonary valve resistance and systemic arterial elastance. Changes in parameters and predicted cardiovascular function post-transplant are used to evaluate the cardiovascular state during recovery of five patients. Of these five patients, only one showed inconsistent trends during recovery in ventricular pressure-volume relationships and power output. At the four-year post-transplant time point this patient exhibited biventricular failure along with graft dysfunction while the remaining four exhibited no cardiovascular complications.
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Affiliation(s)
- Amanda L Colunga
- North Carolina State University, Raleigh, North Carolina, United States
| | - Karam G Kim
- University of Washington, Seattle, Washington, United States
| | - N Payton Woodall
- North Carolina State University, Raleigh, North Carolina, United States
| | - Todd F Dardas
- University of Washington, Seattle, Washington, United States
| | - John H Gennari
- University of Washington, Seattle, Washington, United States
| | - Mette S Olufsen
- North Carolina State University, Raleigh, North Carolina, United States
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Hahn RT, Meduri CU, Davidson CJ, Lim S, Nazif TM, Ricciardi MJ, Rajagopal V, Ailawadi G, Vannan MA, Thomas JD, Fowler D, Rich S, Martin R, Ong G, Groothuis A, Kodali S. Early Feasibility Study of a Transcatheter Tricuspid Valve Annuloplasty. J Am Coll Cardiol 2017; 69:1795-1806. [DOI: 10.1016/j.jacc.2017.01.054] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 11/30/2022]
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Drees R, Johnson RA, Stepien RL, Munoz Del Rio A, Saunders JH, François CJ. QUANTITATIVE PLANAR AND VOLUMETRIC CARDIAC MEASUREMENTS USING 64 MDCT AND 3T MRI VS. STANDARD 2D AND M-MODE ECHOCARDIOGRAPHY: DOES ANESTHETIC PROTOCOL MATTER? Vet Radiol Ultrasound 2015; 56:638-57. [PMID: 26082285 PMCID: PMC5006684 DOI: 10.1111/vru.12269] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 04/28/2015] [Indexed: 12/17/2022] Open
Abstract
Cross-sectional imaging of the heart utilizing computed tomography and magnetic resonance imaging (MRI) has been shown to be superior for the evaluation of cardiac morphology and systolic function in humans compared to echocardiography. The purpose of this prospective study was to test the effects of two different anesthetic protocols on cardiac measurements in 10 healthy beagle dogs using 64-multidetector row computed tomographic angiography (64-MDCTA), 3T magnetic resonance (MRI) and standard awake echocardiography. Both anesthetic protocols used propofol for induction and isoflourane for anesthetic maintenance. In addition, protocol A used midazolam/fentanyl and protocol B used dexmedetomedine as premedication and constant rate infusion during the procedure. Significant elevations in systolic and mean blood pressure were present when using protocol B. There was overall good agreement between the variables of cardiac size and systolic function generated from the MDCTA and MRI exams and no significant difference was found when comparing the variables acquired using either anesthetic protocol within each modality. Systolic function variables generated using 64-MDCTA and 3T MRI were only able to predict the left ventricular end diastolic volume as measured during awake echocardiogram when using protocol B and 64-MDCTA. For all other systolic function variables, prediction of awake echocardiographic results was not possible (P = 1). Planar variables acquired using MDCTA or MRI did not allow prediction of the corresponding measurements generated using echocardiography in the awake patients (P = 1). Future studies are needed to validate this approach in a more varied population and clinically affected dogs.
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Affiliation(s)
| | | | | | | | - Jimmy H Saunders
- Faculty of Veterinary Medicine, UGent, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Christopher J François
- Department of Radiology, School of Medicine and Public Health, UW-Madison, 600 Highland Avenue, Madison, WI, 53792
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Technical assessment of whole body angiography and cardiac function within a single MRI examination. Clin Radiol 2015; 70:595-603. [PMID: 25791202 PMCID: PMC4728185 DOI: 10.1016/j.crad.2015.02.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 01/21/2015] [Accepted: 02/04/2015] [Indexed: 11/24/2022]
Abstract
AIM To evaluate a combined protocol for simultaneous cardiac MRI (CMR) and contrast-enhanced (CE) whole-body MR angiography (WB-MRA) techniques within a single examination. MATERIALS AND METHODS Asymptomatic volunteers (n = 48) with low-moderate risk of cardiovascular disease (CVD) were recruited. The protocol was divided into four sections: (1) CMR of left ventricle (LV) structure and function; (2) CE-MRA of the head, neck, and thorax followed by the distal lower limbs; (3) CMR LV "late gadolinium enhancement" assessment; and (4) CE-MRA of the abdomen and pelvis followed by the proximal lower limbs. Multiple observers undertook the image analysis. RESULTS For CMR, the mean ejection fraction (EF) was 67.3 ± 4.8% and mean left ventricular mass (LVM) was 100.3 ± 22.8 g. The intra-observer repeatability for EF ranged from 2.1-4.7% and from 9-12 g for LVM. Interobserver repeatability was 8.1% for EF and 19.1 g for LVM. No LV delayed myocardial enhancement was observed. For WB-MRA, some degree of luminal narrowing or stenosis was seen at 3.6% of the vessel segments (involving n = 29 of 48 volunteers) and interobserver radiological opinion was consistent in 96.7% of 1488 vessel segments assessed. CONCLUSION Combined assessment of WB-MRA and CMR can be undertaken within a single examination on a clinical MRI system. The associated analysis techniques are repeatable and may be suitable for larger-scale cardiovascular MRI studies.
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Sieslack AK, Dziallas P, Nolte I, Wefstaedt P, Hungerbühler SO. Quantification of right ventricular volume in dogs: a comparative study between three-dimensional echocardiography and computed tomography with the reference method magnetic resonance imaging. BMC Vet Res 2014; 10:242. [PMID: 25306140 PMCID: PMC4209227 DOI: 10.1186/s12917-014-0242-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 09/24/2014] [Indexed: 01/09/2023] Open
Abstract
Background Right ventricular (RV) volume and function are important diagnostic and prognostic factors in dogs with primary or secondary right-sided heart failure. The complex shape of the right ventricle and its retrosternal position make the quantification of its volume difficult. For that reason, only few studies exist, which deal with the determination of RV volume parameters. In human medicine cardiac magnetic resonance imaging (CMRI) is considered to be the reference technique for RV volumetric measurement (Nat Rev Cardiol 7(10):551-563, 2010), but cardiac computed tomography (CCT) and three-dimensional echocardiography (3DE) are other non-invasive methods feasible for RV volume quantification. The purpose of this study was the comparison of 3DE and CCT with CMRI, the gold standard for RV volumetric quantification. Results 3DE showed significant lower and CCT significant higher right ventricular volumes than CMRI. Both techniques showed very good correlations (R > 0.8) with CMRI for the volumetric parameters end-diastolic volume (EDV) and end-systolic volume (ESV). Ejection fraction (EF) and stroke volume (SV) were not different when considering CCT and CMRI, whereas 3DE showed a significant higher EF and lower SV than CMRI. The 3DE values showed excellent intra-observer variability (<3%) and still acceptable inter-observer variability (<13%). Conclusion CCT provides an accurate image quality of the right ventricle with comparable results to the reference method CMRI. CCT overestimates the RV volumes; therefore, it is not an interchangeable method, having the disadvantage as well of needing general anaesthesia. 3DE underestimated the RV-Volumes, which could be explained by the worse image resolution. The excellent correlation between the methods indicates a close relationship between 3DE and CMRI although not directly comparable. 3DE is a promising technique for RV volumetric quantification, but further studies in awake dogs and dogs with heart disease are necessary to evaluate its usefulness in veterinary cardiology.
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Sieslack AK, Dziallas P, Nolte I, Wefstaedt P. Comparative assessment of left ventricular function variables determined via cardiac computed tomography and cardiac magnetic resonance imaging in dogs. Am J Vet Res 2013; 74:990-8. [DOI: 10.2460/ajvr.74.7.990] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Huang XS, Gu CX, Yang JF, Wei H, Li JX, Zhou QW. Off-pump anteroapical aneurysm plication following left ventricular postinfarction aneurysm: effect on cardiac function, clinical status and survival. Can J Surg 2013; 56:119-27. [PMID: 23351499 DOI: 10.1503/cjs.022111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In patients with coronary disease and aneurysm, ventricular reconstruction with revascularization is a surgical option. Details of patient selection and optimal surgical technique are still debated. We report our results with off-pump aneurysm plication after ventricular aneurysm with relative wall thinning. METHODS We retrospectively reviewed the records of 248 patients who had an operation for postinfarction left ventricular aneurysm. Reconstruction was accomplished by off-pump anteroapical aneurysm plication. The following variables were recorded: preoperative clinical, angiographic and echocardiographic findings and operative procedures. Outcomes were early mortality, long-term survival and poor 5-year result, defined as the need for transplantation or repeated hospitalization for congestive heart failure. Risk factors were pinpointed using the t test and survival curves. Independent risk factors were identified using Cox regression methods. RESULTS Hospital mortality was low (2.0%). Mean follow-up was 5.8 (standard deviation [SD] 3.8) years. Actuarial survival at 1 and 5 years was 94% and 84%. Among the 232 survivors, 200 were in functional class I or II, and the average increase in ejection fraction was 14.0% (SD 3.1%). As determined by multivariable analysis, factors predicting poor outcome were advanced age, ejection fraction less than 0.35, conicity index less than 1, end-systolic volume index greater than 80 mL/m2, advanced New York Heart Association functional class and congestive heart failure. CONCLUSION Using wall thinning as a criterion for patient selection, the technique of off-pump anteroapical aneurysm plication can be performed with low operative mortality and provides good symptomatic relief and long-term survival.
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Affiliation(s)
- Xin-sheng Huang
- The Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China
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Miller CA, Jordan P, Borg A, Argyle R, Clark D, Pearce K, Schmitt M. Quantification of left ventricular indices from SSFP cine imaging: Impact of real-world variability in analysis methodology and utility of geometric modeling. J Magn Reson Imaging 2012; 37:1213-22. [DOI: 10.1002/jmri.23892] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 09/17/2012] [Indexed: 11/08/2022] Open
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Jeevanantham V, Chughtai H, Little WC, Morgan T, Kitzman DW, Hamilton CA, Hundley WG. Aging reduces left atrial performance during adrenergic stress in middle aged and older patients. Cardiol J 2012; 19:45-52. [PMID: 22298167 DOI: 10.5603/cj.2012.0008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND During adrenergic stress, the influence of age on left atrial (LA) function is unknown. We hypothesized that aging decreases LA total emptying fraction (LAEF) during maximal adrenergic stress. The aim of the study was to determine the influence of aging on LA function during adrenergic stress in middle aged and older patients. METHODS We enrolled 167 middle aged and elderly participants, and measured LA and left ventricular (LV) volumes using a multi-slice three-dimensional cine white blood cardiovascular magnetic resonance (CMR) technique before and during intravenous dobutamine infused to achieve 80% of the maximum heart rate response for age. Paired sample t-test was used to detect differences in LA and LV volumes between baseline and peak dose stage of dobutamine stress CMR, and multivariable linear regression was used to identify predictors of LA function. RESULTS Participants averaged 68 ± 8 years in age, 53% were men, 25% exhibited coronary artery disease, 35% had diabetes, 9% had a remote history of atrial fibrillation, 90% had hypertension, and 11% had inducible LV wall motion abnormalities indicative of ischemia during dobutamine CMR. Increasing age correlated with LA volumes (maximal and minimal) and inversely correlated with LAEF at rest and after peak adrenergic stress. Age was an independent predictor of LAEF during adrenergic stress, even after accounting for gender, LV volumes, and other co-morbidities including inducible ischemia. CONCLUSIONS Age is associated with a decrease in LA function during adrenergic stress even after adjusting for co-morbidities associated with cardiovascular disease and LV function.
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Affiliation(s)
- Vinodh Jeevanantham
- Department of Internal Medicine (Cardiology Section), Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1045, USA
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Maffei E, Messalli G, Martini C, Nieman K, Catalano O, Rossi A, Seitun S, Guaricci AI, Tedeschi C, Mollet NR, Cademartiri F. Left and right ventricle assessment with Cardiac CT: validation study vs. Cardiac MR. Eur Radiol 2012; 22:1041-9. [PMID: 22270140 PMCID: PMC3321142 DOI: 10.1007/s00330-011-2345-6] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 10/05/2011] [Accepted: 10/08/2011] [Indexed: 12/03/2022]
Abstract
Objectives To compare Magnetic Resonance (MR) and Computed Tomography (CT) for the assessment of left (LV) and right (RV) ventricular functional parameters. Methods Seventy nine patients underwent both Cardiac CT and Cardiac MR. Images were acquired using short axis (SAX) reconstructions for CT and 2D cine b-SSFP (balanced-steady state free precession) SAX sequence for MR, and evaluated using dedicated software. Results CT and MR images showed good agreement: LV EF (Ejection Fraction) (52 ± 14% for CT vs. 52 ± 14% for MR; r = 0.73; p > 0.05); RV EF (47 ± 12% for CT vs. 47 ± 12% for MR; r = 0.74; p > 0.05); LV EDV (End Diastolic Volume) (74 ± 21 ml/m² for CT vs. 76 ± 25 ml/m² for MR; r = 0.59; p > 0.05); RV EDV (84 ± 25 ml/m² for CT vs. 80 ± 23 ml/m² for MR; r = 0.58; p > 0.05); LV ESV (End Systolic Volume)(37 ± 19 ml/m² for CT vs. 38 ± 23 ml/m² for MR; r = 0.76; p > 0.05); RV ESV (46 ± 21 ml/m² for CT vs. 43 ± 18 ml/m² for MR; r = 0.70; p > 0.05). Intra- and inter-observer variability were good, and the performance of CT was maintained for different EF subgroups. Conclusions Cardiac CT provides accurate and reproducible LV and RV volume parameters compared with MR, and can be considered as a reliable alternative for patients who are not suitable to undergo MR. Key Points • Cardiac-CT is able to provide Left and Right Ventricular function. • Cardiac-CT is accurate as MR for LV and RV volume assessment. • Cardiac-CT can provide accurate evaluation of coronary arteries and LV and RV function. Electronic supplementary material The online version of this article (doi:10.1007/s00330-011-2345-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Erica Maffei
- Cardiovascular Radiology Unit, Giovanni XXIII Hospital, 31050, Monastier di Treviso, Italy
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Śpiewak M, Biernacka EK, Małek ŁA, Miśko J, Kowalski M, Miłosz B, Petryka J, Żabicka M, Rużyłło W. Quantitative assessment of pulmonary regurgitation in patients with and without right ventricular tract obstruction. Eur J Radiol 2011; 80:e164-8. [DOI: 10.1016/j.ejrad.2010.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 07/07/2010] [Accepted: 07/09/2010] [Indexed: 10/19/2022]
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Hof IE, Velthuis BK, Van Driel VJ, Wittkampf FH, Hauer RN, Loh P. Left atrial volume and function assessment by magnetic resonance imaging. J Cardiovasc Electrophysiol 2011; 21:1247-50. [PMID: 20487121 DOI: 10.1111/j.1540-8167.2010.01805.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Left Atrial Volume and Function Assessment. INTRODUCTION In patients with atrial fibrillation undergoing catheter ablation, magnetic resonance imaging (MRI) can determine left atrial (LA) volume and function before and after ablation. The most accurate, but time consuming, method to determine LA volume is the multiple slice method (MSM), which involves manual tracing of LA area on each slice. The area length method (ALM) offers a simplified, but unvalidated, alternative for LA volume assessment by MRI. The aim of this study was to compare LA volume and function assessment by ALM with MSM. METHODS AND RESULTS MRI was performed before and after catheter ablation in 40 patients with atrial fibrillation (30 male, mean age 57 years). All patients had sinus rhythm during imaging. In total, 72 MRI scans were available. LA end-diastolic and end-systolic volumes (EDV, respectively ESV) were measured by both methods. LA function was determined by calculating LA ejection fraction (EF = (EDV-ESV)/EDV). Measured by ALM, mean LA EDV and ESV were significantly lower than using MSM (102 mL and 49 mL vs 111 mL and 65 mL, respectively, P < 0.001) with a larger difference in mean ESV than EDV (16 mL vs 9 mL). This resulted in an overestimation of LA EF by ALM with a mean of 11% (54% by ALM and 42% by MSM, P < 0.001). ALM correlated well with MSM for LA EDV and ESV (r = 0.77, respectively 0.85), and showed no significant difference in intraobserver and interobserver variability. CONCLUSION ALM significantly underestimates LA volumes and overestimates LA function, but correlates well with the more accurate MSM.
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Affiliation(s)
- Irene E Hof
- Department of Cardiology Department of Radiology, University Medical Center, Utrecht, The Netherlands
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15
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Comparison of epicardial adipose tissue (EAT) thickness and anthropometric measurements in metabolic syndrome (MS) cases above and under the age of 65. Arch Gerontol Geriatr 2011; 52:e79-84. [DOI: 10.1016/j.archger.2010.06.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 05/20/2010] [Accepted: 05/22/2010] [Indexed: 11/21/2022]
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Geva T. Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Magn Reson 2011; 13:9. [PMID: 21251297 PMCID: PMC3036629 DOI: 10.1186/1532-429x-13-9] [Citation(s) in RCA: 382] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 01/20/2011] [Indexed: 11/10/2022] Open
Abstract
Surgical management of tetralogy of Fallot (TOF) results in anatomic and functional abnormalities in the majority of patients. Although right ventricular volume load due to severe pulmonary regurgitation can be tolerated for many years, there is now evidence that the compensatory mechanisms of the right ventricular myocardium ultimately fail and that if the volume load is not eliminated or reduced by pulmonary valve replacement the dysfunction might be irreversible. Cardiovascular magnetic resonance (CMR) has evolved during the last 2 decades as the reference standard imaging modality to assess the anatomic and functional sequelae in patients with repaired TOF. This article reviews the pathophysiology of chronic right ventricular volume load after TOF repair and the risks and benefits of pulmonary valve replacement. The CMR techniques used to comprehensively evaluate the patient with repaired TOF are reviewed and the role of CMR in supporting clinical decisions regarding pulmonary valve replacement is discussed.
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Affiliation(s)
- Tal Geva
- Department of Cardiology, Children's Hospital Boston, Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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Ozgun M, Kirchhof P, Bunck AC, Heindel W, Eckardt L, Maintz D. MRI of right atrial function after catheter ablation of atrial flutter. Acad Radiol 2010; 17:856-61. [PMID: 20471870 DOI: 10.1016/j.acra.2010.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2010] [Revised: 03/15/2010] [Accepted: 03/17/2010] [Indexed: 10/19/2022]
Abstract
RATIONALE AND OBJECTIVES Catheter ablation of the cavotricuspid isthmus (CTI) is an effective treatment of right atrial flutter. The objective of this study was to evaluate the changes in CTI length and right atrial (RA) function after radiofrequency ablation of isthmus-dependent atrial flutter (isthmus ablation). MATERIALS AND METHODS Magnetic resonance imaging was obtained in 14 patients (2 female, mean age 59 +/- 9) before and after isthmus ablation (mean delay 80 +/- 175 days) using steady-state free precession cine magnetic resonance imaging in right anterior oblique view orientation. Right atrial function (maximum/minimum right atrial volumes, stroke volume, ejection fraction) and maximum/minimum length of the CTI were measured. RESULTS After isthmus ablation, maximum RA volume decreased by 13% (P = .02) and minimum RA volume by 22% (P = .01), whereas stroke volume and ejection fraction did not increase significantly (P = .4 and .2, respectively). After ablation, the maximum length of the CTI showed a significant decrease of 19% (P < .001) and the minimum length a decrease of 24% (P < .001). A linear correlation between change in CTI length and number of energy applications during ablation could not be observed (r = .605, P = .22 for minimum length; r = .384, P = .18 for maximum length). After eliminating the outliers in the number of energy applications, a significant correlation between energy applications and change in CTI systolic length was found (r = .808, P = .008). CONCLUSION Magnetic resonance imaging to visualize right atrial size and function in right anterior oblique orientation was successfully performed and easy to evaluate for volumetric analysis and determination of CTI length. Scarring of the CTI with the use of catheter ablation leads to a significant and linear decrease in its length and to a subsequent reduction of right atrial volumes, whereas functional parameters such as stroke volume/ejection fraction did not change significantly.
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Siddiqi L, Prakken NH, Velthuis BK, Cramer MJ, Oey PL, Boer P, Bots ML, Blankestijn PJ. Sympathetic activity in chronic kidney disease patients is related to left ventricular mass despite antihypertensive treatment. Nephrol Dial Transplant 2010; 25:3272-7. [DOI: 10.1093/ndt/gfq175] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Functional parameters of the left ventricle: comparison of cardiac MRI and cardiac CT in a large population. Radiol Med 2010; 115:702-13. [PMID: 20177984 DOI: 10.1007/s11547-010-0525-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 07/07/2009] [Indexed: 10/19/2022]
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