Tricuspid flow and regurgitation in congenital heart disease and pulmonary hypertension: comparison of 4D flow cardiovascular magnetic resonance and echocardiography
Tricuspid flow and regurgitation in congenital heart disease and pulmonary hypertension: comparison of 4D flow cardiovascular magnetic resonance and echocardiography
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DOI：
10.1186/s12968-017-0426-7
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发表时间：
2018-01-15
影响因子：
6.4
通讯作者：
Leiner, Tim
中科院分区：
文献类型：
--
作者：
Driessen, Mieke M. P.;Schings, Marjolijn A.;Leiner, Tim
背景：三尖瓣（TV）反流（TR）是肺动脉高压和右侧先天性心脏病的常见并发症，与发病率和死亡率增加相关。通过超声心动图和传统心血管磁共振 (CMR) 对 TR 严重程度的估计尚未得到很好的验证，并且具有很高的变异性。 4D 速度编码 (4D-flow) CMR 用于测量右心室 (RV) 几何结构复杂且 TR 程度不同的患者的三尖瓣血流。本研究的目的是：1) 通过比较 4D 流 CMR 导出的 TV 有效流量与 2D 流导出的穿过肺动脉瓣 (PV) 的有效流量，评估 4D 流 CMR 的准确性； 2) 评估 TV 4D-flow CMR 再现性，以及 3) 将 4D-flow CMR 的 TR 等级与超声心动图的 TR 等级进行比较。 方法：通过 4D-flow CMR 和超声心动图对 21 名健康受试者（41.2 +/- 10.5 岁，女性 7 名（33%））进行 TR 评估。 67 名右心室压力负荷患者（42.7 +/- 17.0 岁，女性 32 名（48%））。 CMR 协议包括电视上的 4D 流 CMR 测量、PV 上的 2D 流测量和传统的平面测量。根据国际建议对超声心动图图像进行 TR 分级。使用 Bland-Altman 分析和组内相关系数 (ICC) 来评估相关性和一致性。结果：通过 4D 流 CMR 测量的 TV 有效流量与 2D 流 CMR 测量的 PV 有效流量显示出良好的相关性和一致性，ICC = 0.899（p
Background: Tricuspid valve (TV) regurgitation (TR) is a common complication of pulmonary hypertension and right-sided congenital heart disease, associated with increased morbidity and mortality. Estimation of TR severity by echocardiography and conventional cardiovasvular magnetic resonance (CMR) is not well validated and has high variability. 4D velocity-encoded (4D-flow) CMR was used to measure tricuspid flow in patients with complex right ventricular (RV) geometry and varying degrees of TR. The aims of the present study were: 1) to assess accuracy of 4D-flow CMR across the TV by comparing 4D-flow CMR derived TV effective flow to 2D-flow derived effective flow across the pulmonary valve (PV); 2) to assess TV 4D-flow CMR reproducibility, and 3) to compare TR grade by 4D-flow CMR to TR grade by echocardiography.Methods: TR was assessed by both 4D-flow CMR and echocardiography in 21 healthy subjects (41.2 +/- 10.5 yrs., female 7 (33%)) and. 67 RV pressure-load patients (42.7 +/- 17.0 yrs., female 32 (48%)). The CMR protocol included 4D-flow CMR measurement across the TV, 2D-flow measurement across the PV and conventional planimetric measurements. TR grading on echocardiographic images was performed based on the international recommendations. Bland-Altman analysis and intra-class correlation coefficients (ICC) were used to asses correlations and agreement.Results: TV effective flow measured by 4D-flow CMR showed good correlation and agreement with PV effective flow measured, by 2D-flow CMR with ICC = 0.899 (p