Bellenger N G, Marcus N J, Davies C, Yacoub M, Banner N R, Pennell D J
Cardiovascular MR Unit, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College, London, United Kingdom.
J Heart Lung Transplant. 2000 May;19(5):444-52. doi: 10.1016/s1053-2498(00)00079-6.
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.
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.
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).
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.
我们比较了在接受原位心脏移植的患者中，通过M型超声心动图（超声）和屏气心血管磁共振成像（CMR）对左心室功能和质量的评估。我们还试图确定屏气CMR在该患者群体中的可重复性。
我们前瞻性地获取了21例接受原位心脏移植患者的51组超声和CMR数据。我们检查了该组中屏气CMR的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比较。我们将超声测定的左心室射血分数（EF）和质量与CMR数据进行了比较。
CMR和超声之间的平均时间间隔为0±7天（平均值±标准差），每组CMR-超声数据采集之间的时间间隔为5.1±4.1个月。心血管磁共振成像在该群体中显示出良好的可重复性，观察者内EF的百分比变异性为2.2%±2.4%，质量为3.2%±2.7%，观察者间EF的百分比变异性为2.4%±1.9%，质量为2.2%±1.9%。超声和CMR之间的布兰德-奥特曼一致性界限对于EF（-9.6%至15%）和质量都很宽，无论使用何种公式（贝内特和埃文斯公式为-61.3至198克，美国超声心动图学会（ASE）公式为-65.4至196.8克，德弗罗公式为-65.3至181克，泰希霍尔兹公式为-95.2至64.6克）。
快速采集的CMR在心脏移植受者中具有可重复性。我们发现与超声结果的一致性较差。技术的选择将取决于当地资源以及结果的临床重要性。超声仍然容易获得，并能快速评估容积、EF和质量。然而，CMR良好的可重复性可能使其成为个体或研究群体长期随访更合适的技术。
