Bellenger N G, Francis J M, Davies C L, Coats A J, Pennell D J
National Heart and Lung Institute, CMR Unit, Royal Brompton Hospital, London, United Kingdom.
J Cardiovasc Magn Reson. 2000;2(1):15-22. doi: 10.3109/10976640009148669.
Our objective was to establish a cardiovascular magnetic resonance (CMR) cardiac function clinic to provide an assessment of cardiac volume, mass, and function in patients with heart failure on the same day as their cardiology outpatient clinic appointment. Sixty-four patients attended the CMR function clinic. The reproducibility, patient acceptability, and time efficiency of the CMR clinic were assessed and compared with radionuclide ventriculography (RNV) and echocardiography (echo). Reports were available in the cardiology outpatient clinic within 2 hr of the CMR appointment time. The reproducibility of volumes, ejection fraction, and mass in this heart failure population was good and comparable with CMR studies in the normal population. CMR was more acceptable to the patients than both RNV and echo (p < 0.05). The total time for CMR was less than that of RNV (42 +/- 4 and 61 +/- 4 min, respectively; p < 0.001) but more than that of echo (echo, 23 +/- 2 min; p < 0.001). Comparison of ejection fractions revealed a correlation between CMR and RNV of 0.7, but Bland-Altman limits of agreement were wide (-10.5% to 18.9%). For CMR versus echo, the correlation was 0.6, and the limits of agreement were wider (-29.9% to 23.3%). The correlation between RNV and echo was 0.2 with wider limits of agreement (-29.8% to 24. 9%). In conclusion, CMR can provide a rapid, reproducible, and patient acceptable assessment of cardiac function in heart failure patients, whereas other methods appear to have a wider variance. The high reproducibility of CMR lends itself to the follow-up of clinical progression and the effect of treatment in patients with heart failure.
我们的目标是设立一家心血管磁共振(CMR)心功能诊所,以便在心力衰竭患者进行心脏病门诊预约的同一天,对其心脏容积、质量和功能进行评估。64名患者前往CMR功能诊所就诊。对CMR诊所的可重复性、患者接受度和时间效率进行了评估,并与放射性核素心室造影(RNV)和超声心动图(超声)进行了比较。在CMR预约时间后的2小时内,心脏病门诊即可获取报告。在该心力衰竭人群中,容积、射血分数和质量的可重复性良好,与正常人群的CMR研究结果相当。与RNV和超声相比,患者对CMR的接受度更高(p < 0.05)。CMR的总用时比RNV少(分别为42±4分钟和61±4分钟;p < 0.001),但比超声多(超声为23±2分钟;p < 0.001)。射血分数比较显示,CMR与RNV的相关性为0.7,但布兰德-奥特曼一致性界限较宽(-10.5%至18.9%)。对于CMR与超声,相关性为0.6,一致性界限更宽(-29.9%至23.3%)。RNV与超声的相关性为0.2,一致性界限更宽(-29.8%至24.9%)。总之,CMR可为心力衰竭患者提供快速、可重复且患者可接受的心脏功能评估,而其他方法的差异似乎更大。CMR的高可重复性有助于对心力衰竭患者的临床进展和治疗效果进行随访。