Comparison of echocardiographic (US) volumetry with cardiac magnetic resonance (CMR) imaging in transfusion dependent thalassemia major (TM).
Comparison of echocardiographic (US) volumetry with cardiac magnetic resonance (CMR) imaging in transfusion dependent thalassemia major (TM).
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DOI：
10.1186/1476-7120-5-24
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发表时间：
2007-07-14
影响因子：
1.9
通讯作者：
Aessopos, Athanassios
中科院分区：
文献类型：
--
作者：
Giakoumis, Anastasios;Berdoukas, Vasilis;Aessopos, Athanassios
背景：尽管重型地中海贫血（TM）患者的生存率有所提高，但最常见的死亡原因是心脏病。定期心脏随访是必要的，以确定和扭转病理。心脏磁共振（CMR）和超声心动图（US）同时应用于TM患者，以进行心脏评估和持续监测。为了评估两种方法的准确性和可靠性，对共同特征进行比较将是有用的，特别关注常规US应用。TM的特殊属性提供了一个很好的机会，心脏成像研究，具有普遍的通用applications.METHODS：135 TM患者进行了美国（Teichholz的M-模式公式-快速访问的手段，测量体积和射血分数）和CMR容量测定。结果：CMR与US的容积测量值被低估，尤其是舒张末期容积（p < 0.001）。收缩末期容积显示边界双尾概率（p约0.05）。射血分数的相关性可接受（r = 0.60），无统计学显著差异（p = 0.37），Bland Altman图范围较窄（25.8%）。超声短轴缩短率与CMR射血分数有较好的相关性（r = 0.58）。在不存在心壁运动异常的情况下，US Teichholz的M模式容积测量公式虽然与高分辨率CMR技术相比不太复杂，但提供了足够的射血分数估计用于常规使用，特别是当监测心脏功能随时间的总体变化时，并且易于执行。
BACKGROUND: Despite advances in survival in patients with thalassemia major (TM) the most common cause of death is cardiac disease. Regular cardiac follow-up is imperative in order to identify and reverse pathology. Cardiac Magnetic Resonance (CMR) and Echocardiography (US) are applied in parallel to TM patients for cardiac evaluation and ongoing monitoring. A comparison between mutual features would be useful in order to assess the accuracy and reliability of the two methods, with a particular focus on routine US application. TM's special attributes offer an excellent opportunity for cardiac imaging research that has universal general purpose applications.METHODS: 135 TM patients underwent US (Teichholz's M-mode formula - rapidly accessible means of measuring volumes and ejection fraction) and CMR volumetry. Paired-samples t-test, Passing & Badlock regression and Bland & Altman plot were used while comparing the common parameters between the CMR and the US.RESULTS: We found that the US volumes were underestimated, especially the end-diastolic volume (p < 0.001). The end-systolic volume showed a borderline two-tailed probability (p approximately 0.05). The correlation for the ejection fraction was acceptable (r = 0.60) without a statistically significant difference (p = 0.37) and the Bland Altman plot range was narrow (25.8%). There was a satisfactory correlation of the US' shortening fraction with CMR's ejection fraction (r = 0.58).CONCLUSION: In cases where cardiac wall movement abnormalities are absent, the US Teichholz's M-mode formula for volume measurements, though less sophisticated in comparison to the high resolution CMR technique, offers an adequate ejection fraction estimation for routine use, especially when monitoring gross alterations in cardiac function over time, and is easy to perform.