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心房颤动期间心输出量的无创测量:心脏磁共振成像与惰性气体再呼吸法的比较

Non-invasive measurement of cardiac output during atrial fibrillation: comparison between cardiac magnetic resonance imaging and inert gas rebreathing.

作者信息

Saur J, Trinkmann F, Doesch C, Weissmann J, Hamm K, Schoenberg S O, Borggrefe M, Haghi D, Kaden J J

机构信息

First Department of Medicine (Cardiology, Angiology, Pneumology and Intensive Care), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.

出版信息

Cardiology. 2010;115(3):212-6. doi: 10.1159/000288712. Epub 2010 Feb 27.

Abstract

OBJECTIVES

Atrial fibrillation (AF) is one of the most frequent heart rhythm disorders. It potentially influences cardiac function and its measurement. Cardiac magnetic resonance imaging (CMR) has become the new gold standard for non-invasive assessment of cardiac output (CO). A novel inert gas rebreathing (IGR) device based on the Fick Principle also proved promising in patients in sinus rhythm (SR). The aim of our study was to compare the agreement of non-invasive CO measurements between CMR and IGR in AF patients.

METHODS

A total of 68 patients, 34 with AF and 34 pair-matched controls in SR, were included.

RESULTS

Bland-Altman analysis showed good agreement between both methods, with an average deviation of 0.2 +/-1.2 l/min in the AF group versus 0.3 +/-1.0 l/min in the SR group (p = 0.77). IGR demonstrated good agreement for CO between 2.0 and 5.4 l/min. However, in hyperdynamic circulatory conditions (CO >5.5 l/min), the increasing disagreement of IGR and CMR measurements reached statistical significance.

CONCLUSIONS

Non-invasive CO measurements using CMR and IGR are feasible in patients suffering from AF. Good agreement was found between the two methods in an unselected cohort. Hyperdynamic circulatory conditions can lead to significant measurement differences which, however, do not affect the reproducibility of IGR.

摘要

目的

心房颤动(AF)是最常见的心律失常之一。它可能会影响心脏功能及其测量。心脏磁共振成像(CMR)已成为无创评估心输出量(CO)的新金标准。一种基于菲克原理的新型惰性气体再呼吸(IGR)装置在窦性心律(SR)患者中也显示出前景。我们研究的目的是比较AF患者中CMR和IGR无创测量CO的一致性。

方法

共纳入68例患者,其中34例为AF患者,34例为SR的配对对照。

结果

布兰德-奥特曼分析显示两种方法之间具有良好的一致性,AF组的平均偏差为0.2±1.2升/分钟,而SR组为0.3±1.0升/分钟(p = 0.77)。IGR显示在2.0至5.4升/分钟之间CO具有良好的一致性。然而,在高动力循环状态下(CO>5.5升/分钟),IGR和CMR测量之间日益增加的不一致达到统计学意义。

结论

使用CMR和IGR进行无创CO测量在AF患者中是可行的。在一个未选择的队列中发现两种方法之间具有良好的一致性。高动力循环状态可导致显著的测量差异,然而,这并不影响IGR的可重复性。

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