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Greutmann M, Tobler D, Engel R, Heg D, Mueller C, Frenk A, Gabriel H, Rutz T, Buechel RR, Willhelm M, Trachsel L, Freese M, Ruperti-Repilado FJ, Valsangiacomo Buechel E, Beitzke D, Haaf P, Wustmann K, Schwitz F, Possner M, Schwitter J, Bouchardy J, Schwerzmann M. Effect of phosphodiesterase-5 inhibition on SystEmic Right VEntricular size and function. A multicentre, double-blind, randomized, placebo-controlled trial: SERVE. Eur J Heart Fail 2023; 25:1105-1114. [PMID: 37264734 DOI: 10.1002/ejhf.2924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/11/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023] Open
Abstract
AIMS In adults with congenital heart disease and systemic right ventricles, progressive right ventricular systolic dysfunction is common and is associated with adverse outcomes. Our aim was to assess the impact of the phosphodiesterase-5-inhibitor tadalafil on right ventricular systolic function. METHODS AND RESULTS This was a double-blind, randomized, placebo-controlled, multicentre superiority trial (NCT03049540) involving 100 adults with systemic right ventricles (33 women, mean age: 40.7 ± 10.7 years), comparing tadalafil 20 mg once daily versus placebo (1:1 ratio). The primary endpoint was the change in right ventricular end-systolic volume after 3 years of therapy. Secondary endpoints were changes in right ventricular ejection fraction, exercise capacity and N-terminal pro-B-type natriuretic peptide concentration. Primary endpoint assessment by intention to treat analysis at 3 years of follow-up was possible in 83 patients (42 patients in the tadalafil group and 41 patients in the placebo group). No significant changes over time in right ventricular end-systolic volumes were observed in the tadalafil and the placebo group, and no significant differences between treatment groups (3.4 ml, 95% confidence interval -4.3 to 11.0, p = 0.39). No significant changes over time were observed for the pre-specified secondary endpoints for the entire study population, without differences between the tadalafil and the placebo group. CONCLUSIONS In this trial in adults with systemic right ventricles, right ventricular systolic function, exercise capacity and neuro-hormonal activation remained stable over a 3-year follow-up period. No significant treatment effect of tadalafil was observed. Further research is needed to find effective treatment for improvement of ventricular function in adults with systemic right ventricles.
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Affiliation(s)
- Matthias Greutmann
- University Heart Center, Department of cardiology, University of Zurich, Zürich, Switzerland
| | - Daniel Tobler
- Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Reto Engel
- Department of Cardiology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Dik Heg
- CTU Bern, University of Bern, Bern, Switzerland
| | - Christian Mueller
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
| | - André Frenk
- Department of Cardiology, Center for Congenital Heart Disease, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Harald Gabriel
- Department of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Tobias Rutz
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Cardiac MR Center of the University Hospital Lausanne and CMR Corelab (swissCVIcorelab, CHUV), Lausanne, Switzerland
| | - Ronny R Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Matthias Willhelm
- University Clinic of Cardiology, Preventive Cardiology and Sports Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Lukas Trachsel
- University Clinic of Cardiology, Preventive Cardiology and Sports Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Michael Freese
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland
| | | | | | - Dietrich Beitzke
- Department of Biomedical Imaging and Image-Guided Therapy, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Philip Haaf
- Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Kerstin Wustmann
- Cardiac MR Center of the University Hospital Lausanne and CMR Corelab (swissCVIcorelab, CHUV), Lausanne, Switzerland
| | - Fabienne Schwitz
- Department of Cardiology, Center for Congenital Heart Disease, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Mathias Possner
- University Heart Center, Department of cardiology, University of Zurich, Zürich, Switzerland
| | - Juerg Schwitter
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Cardiac MR Center of the University Hospital Lausanne and CMR Corelab (swissCVIcorelab, CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, Lausanne University (UniL), Lausanne, Switzerland
| | - Judith Bouchardy
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Division of Cardiology, Hôpitaux Universitaires de Genève (HUG), Genève, Switzerland
| | - Markus Schwerzmann
- Department of Cardiology, Center for Congenital Heart Disease, Bern University Hospital, University of Bern, Bern, Switzerland
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
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Greutmann M, Ruperti J, Schwitz F, Haag N, Santos Lopes B, Meier L, Babic D, Valsangiacomo Buechel E, Kellenberger C, Bonassin F, Attenhofer Jost C, Schwerzmann M, Wustmann K, Tobler D. High Variability of Right Ventricular Volumes and Function in Adults with Severe Pulmonary Regurgitation Late After Tetralogy of Fallot Repair. Am J Cardiol 2022; 166:88-96. [PMID: 34949470 DOI: 10.1016/j.amjcard.2021.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 01/20/2023]
Abstract
Our aim was to assess changes of right ventricular end-diastolic volumes (RVEDVi) and right ventricular ejection fraction (RVEF) in asymptomatic adults with repaired tetralogy of Fallot, with native right ventricular outflow tract and severe pulmonary regurgitation by serial cardiac magnetic resonance imaging (CMR). The study included 23 asymptomatic adults who underwent ≥3 CMR studies (total of 88 CMR studies). We compared changes in RVEDVi and RVEF between first and last study (median follow-up: 8.8 years, interquartile range: 6.3 to 13.1 years) and between all study pairs. Variability of measurements between study pairs (65 consecutive and 139 nonconsecutive CMR study pairs) were assessed using Bland-Altman analysis and intraclass correlation coefficients. On average, there were no significant changes of RVEDVi or RVEF over the study period (change in RVEDVi: +0.4 ± 17.8 ml/m2, change in RVEF: -1.0 ± 5.5%). Assessment of variability of measurements between study pairs demonstrated no systematic change in RVEDVi and RVEF between study pairs with limits of agreement within the range of previously published studies (RVEDVi -29.1 to +27.2 ml/m2; RVEF -11.5% to 10.2%). High intraclass correlation coefficients for RVEDVi (0.943, 95% CI 0.906 to 0.965, p <0.001) and RVEF (0.815, 95% CI 0.697 to 0.887, p <0.0001) indicate high reliability of reported measurements. In conclusion, in asymptomatic adults with repaired tetralogy of Fallot with native right ventricular outflow tracts and severe pulmonary regurgitation, CMR measurements of RV volumes and RVEF remain stable during follow-up with variability between CMR studies in individual patients, as expected for interobserver and interstudy variability. Measurements derived from a single CMR study or changes occurring between 2 CMR studies should be used with caution for clinical decision-making.
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Affiliation(s)
- Matthias Greutmann
- Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Javier Ruperti
- Center for congenital heart disease, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Fabienne Schwitz
- Center for congenital heart disease, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Nora Haag
- Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bruno Santos Lopes
- Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lukas Meier
- Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daniela Babic
- Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Christian Kellenberger
- Department of Diagnostic Imaging, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Francesca Bonassin
- Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Christine Attenhofer Jost
- Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Markus Schwerzmann
- Center for congenital heart disease, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Kerstin Wustmann
- Center for congenital heart disease, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Daniel Tobler
- Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland
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Budts W, Miller O, Babu-Narayan SV, Li W, Valsangiacomo Buechel E, Frigiola A, van den Bosch A, Bonello B, Mertens L, Hussain T, Parish V, Habib G, Edvardsen T, Geva T, Roos-Hesselink JW, Hanseus K, Dos Subira L, Baumgartner H, Gatzoulis M, Di Salvo G. Imaging the adult with simple shunt lesions: position paper from the EACVI and the ESC WG on ACHD. Endorsed by AEPC (Association for European Paediatric and Congenital Cardiology). Eur Heart J Cardiovasc Imaging 2021; 22:e58-e70. [PMID: 33338215 DOI: 10.1093/ehjci/jeaa314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 01/08/2023] Open
Abstract
In 2018, the position paper 'Imaging the adult with congenital heart disease: a multimodality imaging approach' was published. The paper highlights, in the first part, the different imaging modalities applied in adult congenital heart disease patients. In the second part, these modalities are discussed more detailed for moderate to complex anatomical defects. Because of the length of the paper, simple lesions were not touched on. However, imaging modalities to use for simple shunt lesions are still poorly known. One is looking for structured recommendations on which they can rely when dealing with an (undiscovered) shunt lesion. This information is lacking for the initial diagnostic process, during repair and at follow-up. Therefore, this paper will focus on atrial septal defect, ventricular septal defect, and persistent arterial duct. Pre-, intra-, and post-procedural imaging techniques will be systematically discussed. This position paper will offer algorithms that might help at a glance. The document is prepared for general cardiologists, trainees, medical students, imagers/technicians to select the most appropriate imaging modality and to detect the requested information for each specific lesion. It might serve as reference to which researchers could refer when setting up a (imaging) study.
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Affiliation(s)
- Werner Budts
- Department Cardiovascular Sciences (KU Leuven), Congenital and Structural Cardiology (CSC UZ Leuven), Herestraat 49, B-3000 Leuven, Belgium
| | - Owen Miller
- Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - Sonya V Babu-Narayan
- Department of Adult Congenital Heart Disease, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK
| | - Wei Li
- Department of Adult Congenital Heart Disease, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK
| | | | - Alessandra Frigiola
- Department of Adult Congenital Heart Disease, Guy's and St Thomas' Hospital and School of Biomedical Engineering and Imaging Sciences, Kings College, London, UK
| | | | - Beatrice Bonello
- Department of Pediatric Cardiology, Great Ormond Street Hospital, London, UK
| | - Luc Mertens
- Division of Cardiology, Labatt Family Heart Centre, Hospital for Sick Children and University of Toronto, SickKids, Ontario, Canada
| | - Tarique Hussain
- Department of Paediatrics, University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - Victoria Parish
- Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK
| | - Gilbert Habib
- Cardiology Department, APHM, La Timone Hospital, Boulevard Jean Moulin, Marseille, France
| | - Thor Edvardsen
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Tal Geva
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Laura Dos Subira
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Helmut Baumgartner
- Department of Cardiology III-Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Cardiology, Muenster, Germany
| | - Michael Gatzoulis
- Department of Adult Congenital Heart Disease, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK
| | - Giovanni Di Salvo
- Department of Adult Congenital Heart Disease, National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, London, UK
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Granegger M, Thamsen B, Hubmann EJ, Choi Y, Beck D, Valsangiacomo Buechel E, Voutat M, Schweiger M, Meboldt M, Hübler M. A long-term mechanical cavopulmonary support device for patients with Fontan circulation. Med Eng Phys 2019; 70:9-18. [DOI: 10.1016/j.medengphy.2019.06.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/15/2019] [Accepted: 06/19/2019] [Indexed: 12/28/2022]
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Dougoud S, Valsangiacomo Buechel E, Kellenberger CJ, Mayer KA. A large right ventricular mass in a 42-year-old female marathon runner. Eur Heart J 2016; 38:216. [DOI: 10.1093/eurheartj/ehw400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Indexed: 11/13/2022] Open
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Werner H, Latal B, Valsangiacomo Buechel E, Beck I, Landolt MA. Health-related quality of life after open-heart surgery. J Pediatr 2014; 164:254-8.e1. [PMID: 24268635 DOI: 10.1016/j.jpeds.2013.10.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 08/13/2013] [Accepted: 10/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To determine health-related quality of life (HRQoL) in 1-year-old infants with congenital heart disease (CHD), to follow-up with these children at age 4 years, and to examine predictors of HRQoL. STUDY DESIGN Parents of 144 infants who had undergone cardiopulmonary bypass surgery for CHD before age 6 months were prospectively included in this cohort study. Parents completed a standardized questionnaire on child HRQoL at 1 year and 4 years of age; medical data were extracted from the patients' hospital records. RESULTS Parents reported a significant reduction of the children's physical functioning compared with healthy controls at age 1 year. At age 4 years, children with CHD had poorer cognitive functioning but better social functioning compared with healthy controls. Lower HRQoL at age 4 years was not significantly predicted by univentricular or biventricular CHD but was predicted by the presence of an underlying genetic defect, tube feeding at 1 year, and lower HRQoL at 1 year. CONCLUSION This study shows that HRQoL of infants and preschool-age children with CHD is impaired in physical and cognitive dimensions. Children with lower overall HRQoL at age 1 year, an underlying genetic defect, and tube feeding need to be monitored carefully to provide appropriate and timely interventions.
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Affiliation(s)
- Helene Werner
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Beatrice Latal
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Emanuela Valsangiacomo Buechel
- Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland; Department of Cardiology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Ingrid Beck
- Child Development Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland; Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland
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Leonardi B, Chinali M, Secinaro A, Buechel EV, Silvestri V, Albanese SB, Carotti A, Pongiglione G. The impact of age on right ventricular morphology and function late after repair of Tetralogy of Fallot: a cardiac magnetic resonance study. J Cardiovasc Magn Reson 2014. [PMCID: PMC4042227 DOI: 10.1186/1532-429x-16-s1-p125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Werner H, Latal B, Valsangiacomo Buechel E, Beck I, Landolt MA. The impact of an infant's severe congenital heart disease on the family: a prospective cohort study. CONGENIT HEART DIS 2013; 9:203-10. [PMID: 23870136 DOI: 10.1111/chd.12123] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this article is to investigate the impact of a child's severe congenital heart disease on the family and to prospectively examine the influence of disease specific and psychosocial factors on the family. DESIGN A prospective cohort study. PATIENTS Parents of 104 infants who had undergone cardiopulmonary bypass surgery before the age of 12 months for congenital heart disease were included. INTERVENTIONS None. OUTCOME MEASURES Parents completed the generic Impact on Family scale and a social support questionnaire; a large number of medical data were extracted from the patients' hospital records. RESULTS Parents most frequently reported that they were thinking about not having more children and living on a "roller coaster." No difference was found in the total Impact on Family scale score between fathers and mothers. The presence of a genetic disorder in the child and lower levels of perceived social support was significantly associated with a greater impact on the family. CONCLUSIONS The impact of an infant's congenital heart disease on the family is determined both by child's medical condition and family's psychosocial factors. Families with poorer social support network may have the greatest need for professional interventions, especially if their child has an underlying genetic disorder.
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Affiliation(s)
- Helene Werner
- Department of Psychosomatics and Psychiatry, University Children's Hospital, Zurich, Switzerland
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Stähli BE, Gebhard C, Biaggi P, Klaassen S, Valsangiacomo Buechel E, Attenhofer Jost CH, Jenni R, Tanner FC, Greutmann M. Left ventricular non-compaction: prevalence in congenital heart disease. Int J Cardiol 2012; 167:2477-81. [PMID: 22704867 DOI: 10.1016/j.ijcard.2012.05.095] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 05/05/2012] [Accepted: 05/27/2012] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Left ventricular non-compaction cardiomyopathy (LVNC) is a rare cardiomyopathy, originally described as an isolated disease without other structural cardiac abnormalities. The aim of this study was to explore the prevalence of LVNC among adults with different types of congenital heart disease. METHODS From our databases we identified adults with congenital heart disease who fulfilled diagnostic criteria for LVNC. We report frequencies of associated congenital cardiac defects and the prevalence of LVNC among patients with different congenital heart defects. RESULTS From a total of 202 patients with LVNC, 24 patients (12%; mean age 32 ± 11 years, 19 males) had additional congenital cardiac defects. Associated defects were left ventricular outflow tract abnormalities in 11 patients (46%), including 7 uni- or bicuspid aortic valves; two aortic coarctations; one diffuse aortic hypoplasia and one subaortic stenosis, Ebstein anomaly in 6 patients (25%), tetralogy of Fallot in two (8%), and double outlet right ventricle in one patient (4%). In our cohort, the prevalence of LVNC was highest among patients with Ebstein anomaly (6/40, 15%), followed by aortic coarctation (2/60, 3%), tetralogy of Fallot (3/129, 2%) and uni- or bicuspid aortic valves (7/963, 1%). CONCLUSION In adults, various forms of congenital heart disease are associated with LVNC, particularly stenotic lesions of the left ventricular outflow tract, Ebstein anomaly, and tetralogy of Fallot. In the future, studying these patients in more depth may provide a better understanding of the interplay between genetic and hemodynamic factors that lead to the phenotype of LVNC.
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Affiliation(s)
- Barbara E Stähli
- Cardiology, Cardiovascular Center, University Hospital Zürich, Zürich, Switzerland
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Affiliation(s)
- Daniel Quandt
- Division of Paediatric Cardiology, University Children's Hospital, Steinwiesstrasse 75, Zurich, Switzerland
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Sheehan FH, Kilner PJ, Sahn DJ, Vick GW, Stout KK, Ge S, Helbing WA, Lewin M, Shurman AJ, Buechel EV, Litt HI, Waiss MP. Accuracy of knowledge-based reconstruction for measurement of right ventricular volume and function in patients with tetralogy of Fallot. Am J Cardiol 2010; 105:993-9. [PMID: 20346319 DOI: 10.1016/j.amjcard.2009.11.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2009] [Revised: 11/16/2009] [Accepted: 11/16/2009] [Indexed: 10/19/2022]
Abstract
We tested the accuracy and reproducibility of knowledge-based reconstruction (KBR) for measuring right ventricular (RV) volume and function. KBR enables rapid assessment of the right ventricle from sparse user input by referencing a database. KBR generates a 3-dimensional surface to fit points that the user enters at anatomic landmarks. We measured the RV volume using KBR from magnetic resonance images in 20 patients with repaired tetralogy of Fallot at end-diastole and end-systole. We entered points in the long- and short-axis and/or oblique views. The true volume was computed by manually tracing the RV borders for 3-dimensional reconstruction using the piecewise smooth subdivision surface method. The reference database included 54 patients with tetralogy of Fallot patients. The KBR values agreed closely with the true values for the end-diastolic volume (r = 0.993), end-systolic volume (r = 0.992), and ejection fraction (EF; r = 0.930). KBR slightly overestimated the end-diastolic volume (4 +/- 10 ml, p = NS), end-systolic volume (1 +/- 9 ml, p = NS), and EF (4 +/- 3%, p = NS). No bias in the error was found by Bland-Altman analysis (p = NS for end-diastolic and end-systolic volume and EF). The KBR volumes had approached the true volumes (235 +/- 93 vs 243 +/- 93, p = 0.012, r = 0.978 for end-diastolic and end-systolic volumes combined) already after the first run and the entry of 19 +/- 3 points. In conclusion, KBR provided accurate measurement of the RV volume and EF with minimal user input. KBR is a clinically feasible alternative to full manual tracing of the heart borders from imaging data.
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Sahn DJ, Waiss MP, Kilner P, Helbing W, Litt H, Stout K, Buechel EV, Shurman A. ACCURACY OF RIGHT VENTRICULAR VOLUME AND FUNCTION ANALYSIS IN PATIENTS WITH SYSTEMIC RIGHT VENTRICLES USING KNOWLEDGE BASED RECONSTRUCTION. J Am Coll Cardiol 2010. [DOI: 10.1016/s0735-1097(10)60389-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Buechel EV, Kaiser T, Jackson C, Schmitz A, Kellenberger CJ. Normal right- and left ventricular volumes and myocardial mass in children measured by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2009; 11:19. [PMID: 19545393 PMCID: PMC2718870 DOI: 10.1186/1532-429x-11-19] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 06/21/2009] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Quantification of ventricular volume by steady state free precession (SSFP) cardiovascular magnetic resonance is accurate and reproducible. Normal values exist for adults, but are lacking for children.We sought to establish normal values for left and right ventricular volumes, mass and function in healthy children by using SSFP. METHODS AND RESULTS Fifty children (27 females, 23 males) without cardiovascular disease were evaluated. Median age was 11 years (range 7 months - 18 years), weight 35 kg (range 7-77 kg), height 146 cm (range 66-181 cm). Thirty-six examinations were performed with breath holding, 14 in freely breathing sedated children.Ventricular volumes and mass were measured in the end systolic and end diastolic phase on SSFP cine images acquired in a short axis plane as a stack of 12 contiguous slices covering full length of both ventricles. Regression analysis showed an exponential relationship between body surface area (BSA) and ventricular volumes and mass (normal value = a*BSAb). Normative curves for males and females are presented in relation to BSA for the end-diastolic volume, end-systolic volume and mass of both ventricles. Intra- and interobserver variability of the measurements was within the limits of 2% and 7% respectively, except for right ventricular mass (10%). CONCLUSION The exponential equation for calculation of normal values for each ventricular parameter and graphical display of normative curves for data acquired in healthy children by SSFP cardiovascular magnetic resonance are provided.
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Affiliation(s)
| | - Thomas Kaiser
- Division of Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland
| | - Clare Jackson
- Division of Pediatric Cardiology, University Children's Hospital, Zurich, Switzerland
| | - Achim Schmitz
- Division of Anesthesiology, University Children's Hospital, Zurich, Switzerland
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Mueller F, Knirsch W, Harpes P, Prêtre R, Valsangiacomo Buechel E, Kretschmar O. Long-term follow-up of acute changes in coronary artery diameter caused by Kawasaki disease: risk factors for development of stenotic lesions. Clin Res Cardiol 2009; 98:501-7. [DOI: 10.1007/s00392-009-0032-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Accepted: 05/20/2009] [Indexed: 11/28/2022]
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