Cardiac MRI: a new gold standard for ventricular volume quantification during high-intensity exercise

Accurate measures are critical when attempting to distinguish normal from pathological changes in cardiac function during exercise, yet imaging modalities have seldom been assessed against invasive exercise standards. We sought to validate a novel method of biventricular volume quantification by car...

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Vydáno v:Circulation. Cardiovascular imaging Ročník 6; číslo 2; s. 329
Hlavní autoři: La Gerche, Andre, Claessen, Guido, Van de Bruaene, Alexander, Pattyn, Nele, Van Cleemput, Johan, Gewillig, Marc, Bogaert, Jan, Dymarkowski, Steven, Claus, Piet, Heidbuchel, Hein
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.03.2013
Témata:
Adolescent
Adult
Analysis of Variance
Arrhythmias, Cardiac - diagnosis
Arrhythmias, Cardiac - pathology
Arrhythmias, Cardiac - physiopathology
Cardiac-Gated Imaging Techniques - standards
Child
Electrocardiography
Exercise Test - standards
Feasibility Studies
Heart Failure - diagnosis
Heart Failure - pathology
Heart Failure - physiopathology
Heart Rate
Heart Ventricles - pathology
Heart Ventricles - physiopathology
Humans
Magnetic Resonance Imaging, Cine - standards
Middle Aged
Observer Variation
Predictive Value of Tests
Reference Standards
Reproducibility of Results
Respiration
Stroke Volume
Time Factors
Ventricular Function, Left
Ventricular Function, Right
Young Adult
ISSN:1942-0080, 1942-0080
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Shrnutí:Accurate measures are critical when attempting to distinguish normal from pathological changes in cardiac function during exercise, yet imaging modalities have seldom been assessed against invasive exercise standards. We sought to validate a novel method of biventricular volume quantification by cardiac MRI (CMR) during maximal exercise. CMR was performed on 34 subjects during exercise and free-breathing with the use of an ungated real-time (RT-ungated) CMR sequence. ECG and respiratory movements were retrospectively synchronized, enabling compensation for cardiac cycle and respiratory phase. Feasibility of RT-ungated imaging was compared with standard exercise CMR imaging with ECG gating (gated); accuracy of RT-ungated CMR was assessed against an invasive standard (direct Fick); and reproducibility was determined after a second bout of maximal exercise. Ventricular volumes were analyzed more frequently during high-intensity exercise with RT-ungated compared with gated CMR (100% versus 47%; P<0.0001) and with better interobserver variability for RT-ungated (coefficient of variation=1.9% and 2.0% for left and right ventricular stroke volumes, respectively) than gated (coefficient of variation=15.2% and 13.6%; P<0.01). Cardiac output determined by RT-ungated CMR proved accurate against the direct Fick method with excellent agreement (intraclass correlation coefficient, R=0.96), which was highly reproducible during a second bout of maximal exercise (R=0.98). When RT-ungated CMR is combined with post hoc analysis incorporating compensation for respiratory motion, highly reproducible and accurate biventricular volumes can be measured during maximal exercise.
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ISSN:1942-0080
1942-0080
DOI:10.1161/CIRCIMAGING.112.980037