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Rodrigues JCL, Rooms B, Hyde K, Rohan S, Nightingale AK, Paton J, Manghat N, Bucciarelli-Ducci C, Hamilton M, Zhang H, MacIver DH. The corrected left ventricular ejection fraction: a potential new measure of ventricular function. Int J Cardiovasc Imaging 2021; 37:1987-1997. [PMID: 33616783 DOI: 10.1007/s10554-021-02193-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 02/12/2021] [Indexed: 12/28/2022]
Abstract
Left ventricular ejection fraction (LVEF) has a limited role in predicting outlook in heart diseases including heart failure. We quantified the independent geometric factors that determine LVEF using cardiac MRI and sought to provide an improved measure of ventricular function by adjusting for such independent variables. A mathematical model was used to analyse the independent effects of structural variables and myocardial shortening on LVEF. These results informed analysis of cardiac MRI data from 183 patients (53 idiopathic dilated cardiomyopathy (DCM), 36 amyloidosis, 55 hypertensives and 39 healthy controls). Left ventricular volumes, LVEF, wall thickness, internal dimensions and longitudinal and midwall fractional shortening were measured. The modelling demonstrated LVEF increased in a curvilinear manner with increasing mFS and longitudinal shortening and wall thickness but decreased with increasing internal diameter. Controls in the clinical cohort had a mean LVEF 64 ± 7%, hypertensives 66 ± 8%, amyloid 49 ± 16% and DCM 30 ± 11%. The mean end-diastolic wall thickness in controls was 8 ± 1 mm, DCM 8 ± 1 mm, hypertensives 11 ± 3 mm and amyloid 14 ± 3 mm, P < 0.0001). LVEF correlated with absolute wall thickening relative to ventricular size (R2 = 0.766). A regression equation was derived from raw MRI data (R2 = 0.856) and used to 'correct' LVEF (EFc) by adjusting the wall thickness and ventricular size to the mean of the control group. Improved quantification of the effects of geometric changes and strain significantly enhances understanding the myocardial mechanics. The EFc resulted in reclassification of a 'ventricular function' in some individuals and may provide an improved measure of myocardial performance especially in thick-walled, low-volume ventricles.
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Affiliation(s)
- Jonathan Carl Luis Rodrigues
- NIHR Bristol Cardiovascular Biomedical Research Centre, Cardiac Magnetic Resonance Department, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.,Department of Radiology, Royal United Hospital Bath NHS Foundation Trust, Bath, UK
| | - Benjamin Rooms
- Medical School, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Katie Hyde
- Medical School, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Stephen Rohan
- Medical School, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Angus K Nightingale
- CardioNomics Research Group, Clinical Research and Imaging Centre, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Julian Paton
- CardioNomics Research Group, Clinical Research and Imaging Centre, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.,Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Nathan Manghat
- Department of Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Chiara Bucciarelli-Ducci
- NIHR Bristol Cardiovascular Biomedical Research Centre, Cardiac Magnetic Resonance Department, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Mark Hamilton
- Department of Radiology, Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Henggui Zhang
- Biological Physics Group, School of Physics and Astronomy, University of Manchester, Manchester, UK
| | - David H MacIver
- Biological Physics Group, School of Physics and Astronomy, University of Manchester, Manchester, UK. .,Department of Cardiology, Musgrove Park Hospital, Taunton, TA1 5DA, UK.
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Rodrigues JCL, Amadu AM, Ghosh Dastidar A, Harries I, Burchell AE, Ratcliffe LEK, Hart EC, Hamilton MCK, Paton JFR, Nightingale AK, Manghat NE. Noctural dipping status and left ventricular hypertrophy: A cardiac magnetic resonance imaging study. J Clin Hypertens (Greenwich) 2018. [DOI: 10.1111/jch.13235] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Jonathan C. L. Rodrigues
- NIHR Bristol Cardiovascular Biomedical Research Unit; Cardiac Magnetic Resonance Department; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
- School of Physiology, Pharmacology, and Neurosciences; Biomedical Sciences; University of Bristol; Bristol UK
- CardioNomics Research Group; Clinical Research Imaging Centre Bristol; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
| | - Antonio Matteo Amadu
- NIHR Bristol Cardiovascular Biomedical Research Unit; Cardiac Magnetic Resonance Department; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
- Department of Surgical, Microsurgical, and Medical Sciences; Institute of Radiological Sciences; University of Sassari; Sassari Italy
| | - Amardeep Ghosh Dastidar
- NIHR Bristol Cardiovascular Biomedical Research Unit; Cardiac Magnetic Resonance Department; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
- Department of Cardiology; Bristol Royal Infirmary; University Hospitals; Bristol NHS Foundation Trust; Bristol UK
| | - Iwan Harries
- NIHR Bristol Cardiovascular Biomedical Research Unit; Cardiac Magnetic Resonance Department; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
- Department of Cardiology; Bristol Royal Infirmary; University Hospitals; Bristol NHS Foundation Trust; Bristol UK
| | - Amy E. Burchell
- CardioNomics Research Group; Clinical Research Imaging Centre Bristol; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
- Department of Cardiology; Bristol Royal Infirmary; University Hospitals; Bristol NHS Foundation Trust; Bristol UK
| | - Laura E. K. Ratcliffe
- CardioNomics Research Group; Clinical Research Imaging Centre Bristol; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
| | - Emma C. Hart
- School of Physiology, Pharmacology, and Neurosciences; Biomedical Sciences; University of Bristol; Bristol UK
- CardioNomics Research Group; Clinical Research Imaging Centre Bristol; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
| | - Mark C. K. Hamilton
- Department of Clinical Radiology, Bristol Royal Infirmary; University Hospitals Bristol NHS Foundation Trust; Bristol UK
| | - Julian F. R. Paton
- School of Physiology, Pharmacology, and Neurosciences; Biomedical Sciences; University of Bristol; Bristol UK
- CardioNomics Research Group; Clinical Research Imaging Centre Bristol; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
| | - Angus K. Nightingale
- CardioNomics Research Group; Clinical Research Imaging Centre Bristol; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
- Department of Cardiology; Bristol Royal Infirmary; University Hospitals; Bristol NHS Foundation Trust; Bristol UK
| | - Nathan E. Manghat
- NIHR Bristol Cardiovascular Biomedical Research Unit; Cardiac Magnetic Resonance Department; Bristol Heart Institute; University Hospitals Bristol NHS Foundation Trust; Bristol UK
- Department of Clinical Radiology, Bristol Royal Infirmary; University Hospitals Bristol NHS Foundation Trust; Bristol UK
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