Grothues F, Wolfram O, Fantoni C, Boenigk H, Götte A, Tempelmann C, Klein H U, Auricchio A
Department of Cardiology, Otto-von-Guericke-University Leipziger Strasse 44, D-39120 Magdeburg, Germany.
Europace. 2006 Jan;8(1):37-41. doi: 10.1093/europace/euj016.
The CARTO electrophysiological mapping system has demonstrated accurate results for end-diastolic ventricular volumes in casts and animals. However, in humans, a comparison with cardiac magnetic resonance (CMR), the non-invasive gold standard for volumetric analysis, has not yet been performed.
A total of 34 (29 male) heart failure patients (NYHA class III/IV) underwent an electrophysiological mapping procedure with the CARTO system in the left ventricle (LV) (n = 34) and right ventricle (RV) (n = 12) and CMR for RV and LV end-diastolic volume (RVEDV and LVEDV) measurements another day. Mean LVEDV was comparable between CMR and CARTO (328 +/- 95 and 320 +/- 92 mL, respectively; P = NS), whereas RV volumes measured by CARTO were larger (CMR 140 +/- 48 vs. CARTO 176 +/- 47 mL; P < 0.01). Overall, we found a good correlation between CMR and CARTO measurements for both chambers; however, the Bland-Altman analysis showed a non-interchangeability of these methods. Measurement differences were independent of chamber size, but significantly affected by the number of acquired mapping points.
Although CMR and CARTO showed a good correlation in the measurement of RVEDV and LVEDV in a group of heart failure patients, the clinical interchangeability of the two methods may be questioned.
CARTO电生理标测系统已在铸型和动物实验中显示出对舒张末期心室容积的准确测量结果。然而,在人类中,尚未与心脏磁共振成像(CMR)这一体积分析的无创金标准进行比较。
共有34例(29例男性)心力衰竭患者(纽约心脏协会心功能III/IV级)在一天内接受了CARTO系统在左心室(LV)(n = 34)和右心室(RV)(n = 12)的电生理标测程序,并在另一天接受了CMR检查以测量RV和LV的舒张末期容积(RVEDV和LVEDV)。CMR和CARTO测量的平均LVEDV具有可比性(分别为328±95和320±92 mL;P =无显著性差异),而CARTO测量的RV容积更大(CMR为140±48 vs. CARTO为176±47 mL;P < 0.01)。总体而言,我们发现两个腔室的CMR和CARTO测量值之间具有良好的相关性;然而,Bland-Altman分析显示这些方法不可互换。测量差异与腔室大小无关,但受采集的标测点数量的显著影响。
尽管CMR和CARTO在一组心力衰竭患者的RVEDV和LVEDV测量中显示出良好的相关性,但这两种方法在临床上的互换性可能受到质疑。