Left ventricular function and mass after orthotopic heart transplantation: A comparison of cardiovascular magnetic resonance with echocardiography
Left ventricular function and mass after orthotopic heart transplantation: A comparison of cardiovascular magnetic resonance with echocardiography
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DOI：
10.1016/s1053-2498(00)00079-6
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发表时间：
2000-05-01
影响因子：
8.9
通讯作者：
Pennell, DJ
中科院分区：
文献类型：
--
作者：
Bellenger, NG;Marcus, NJ;Pennell, DJ
目的：比较m型超声心动图（echo）和快速屏气心血管磁共振（CMR）对原位心脏移植患者左心室功能和质量的评价。我们还试图在该患者群体中建立屏气CMR的可重复性。方法：对21例原位心脏移植患者的51组超声和CMR资料进行前瞻性分析。我们检查了该组屏气CMR在观察者内和观察者间的可重复性，并将其与已发表的数据进行了比较。我们将超声测量的左心室射血分数（EF）和质量与CMR数据进行比较。结果：CMR与超声的平均间隔时间为0 +/- 7天（平均+/- SD），每组CMR-超声数据采集间隔时间为5.1 +/- 4.1个月。心血管磁共振在该人群中显示出良好的再现性，EF的观察者内百分比变异性为2.2% +/- 2.4%，质量为3.2% +/- 2.7%，EF的观察者间百分比变异性为2.4% +/- 1.9%，质量为2.2% +/- 1.9%。无论使用何种公式（Bennett和Evans公式为-61.3至198 g，美国超声心动图学会（ASE）公式为-65.4至196.8 g， Devereux公式为-65.3至181 g， Teichholz公式为-95.2至64.6 g），回声和CMR之间的Bland-Altman一致极限在EF（-9.6%至15%）和质量方面都很宽。结论：快速获取CMR在移植心脏受者中是可重复的。我们发现回声的结果不太一致。技术的选择将取决于当地的资源以及临床结果的重要性。回声仍然很容易获得，并能快速评估体积、EF和质量。然而，CMR的良好再现性可能使其更适合于个人或研究人群的长期随访。
Objective: We compared the assessment of left ventricular function and mass by M-mode echocardiography (echo) with fast breath-hold cardiovascular magnetic resonance (CMR) in patients who received orthotopic heart transplantation. We also sought to establish the reproducibility of breath-hold CMR in this patient population.Method: We prospectively acquired 51 sets of echo and CMR data in 21 patients who had undergone orthotopic heart transplantation. We examined the intraobserver and interobserver reproducibility of breath-hold CMR in this group and compared it with published data. We compared the left ventricular ejection fraction (EF) and mass determined by echo with the CMR data.Results: The average time between CMR and echo was 0 +/- 7 days (mean +/- SD), the time between each set of CMR-echo data acquisition was 5.1 +/- 4.1 months. Cardiovascular magnetic resonance showed good reproducibility in this population, with intraobserver percentage variability of 2.2% +/- 2.4% for EF and 3.2% +/- 2.7% for mass, and interobserver percentage variability of 2.4% +/- 1.9% for EF and 2.2% +/- 1.9% for mass. The Bland-Altman limits of agreement between echo and CMR were wide for both EF (-9.6% to 15%) and mass, irrespective of the formula used (-61.3 to 198 g for the Bennett and Evans formula, -65.4 to 196.8 g for the American Society of Echocardiography (ASE) formula, -65.3 to 181 g for the Devereux formula, and -95.2 to 64.6 g for the Teichholz formula).Conclusion: Fast-acquisition CMR is reproducible in recipients of transplanted hearts. We found poor agreement with the results of echo. The choice of technique will depend on local resources as well as the clinical importance of the result. Echo remains readily available and gives rapid assessment of volumes, EF, and mass. However, the good reproducibility of CMR may make it a more suitable technique for long-term follow-up of an individual or of a study population.