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缺血性心力衰竭患者心脏磁共振和二维超声心动图左心室测量的统计学一致性。

Statistical agreement of left ventricle measurements using cardiac magnetic resonance and 2D echocardiography in ischemic heart failure.

机构信息

Department of Radiology and Nuclear Medicine, Medical University of Silesia, Katowice, Poland.

出版信息

Med Sci Monit. 2012 Mar;18(3):MT19-25. doi: 10.12659/msm.882507.

Abstract

BACKGROUND

The aim of this study was to compare cardiac magnetic resonance imaging (CMR) with 2-dimensional echocardiography (2D echo) in the assessment of left ventricle (LV) function parameters and mass in patients with ischemic heart disease and severely depressed LV function. Although 2D echo is commonly used to assess LV indices, CMR is the state-of-the-art technique. Agreement between these 2 methods in these patients has not been well established.

MATERIAL/METHODS: LV indexed end systolic and diastolic volumes (EDVi and ESVi), indexed mass (LVMi) and ejection fraction (EF) were assessed in 67 patients (12 women), using 2D echo and CMR.

RESULTS

According to statistical analysis (Bland-Altman), 2D echo underestimated LV EDV and ESV and overestimated EF and LVMi compared to CMR. The highest correlation between 2D echo and CMR was found for EDVi (R2=0.73, p<0.0001) and ESVi (R2=0.69, p<0.0001) and the lowest for EF (R2=0.21, p=0.001) and LVMi (R2=0.20, p=0.002). The maximal differences between 2D echo and CMR were found for highest mesurements of LV volumes and mass, and for lowest EF values.

CONCLUSIONS

There is moderate to strong correlation between CMR and 2D echo in the assessment of LV function parameters and mass in patients with ischemic heart failure. Between-method agreement depends on the degree of LV dysfunction. The results of assessment of the severely damaged LV obtained by the use of 2D echo should be interpreted with caution.

摘要

背景

本研究旨在比较心脏磁共振成像(CMR)与二维超声心动图(2D 回声)在评估缺血性心脏病和严重左心室(LV)功能障碍患者的 LV 功能参数和质量方面的作用。虽然 2D 回声常用于评估 LV 指数,但 CMR 是最先进的技术。这两种方法在这些患者中的一致性尚未得到很好的确定。

材料/方法:使用 2D 回声和 CMR 评估 67 例患者(12 例女性)的 LV 指数收缩末期和舒张末期容积(EDVi 和 ESVi)、指数质量(LVMi)和射血分数(EF)。

结果

根据统计分析(Bland-Altman),与 CMR 相比,2D 回声低估了 LV EDV 和 ESV,高估了 EF 和 LVMi。2D 回声与 CMR 相关性最高的是 EDVi(R2=0.73,p<0.0001)和 ESVi(R2=0.69,p<0.0001),相关性最低的是 EF(R2=0.21,p=0.001)和 LVMi(R2=0.20,p=0.002)。2D 回声与 CMR 之间的最大差异见于 LV 容积和质量的最高测量值,以及 EF 值最低的情况。

结论

CMR 和 2D 回声在评估缺血性心力衰竭患者的 LV 功能参数和质量方面具有中等至强相关性。方法间的一致性取决于 LV 功能障碍的程度。使用 2D 回声评估严重受损的 LV 时,应谨慎解释结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a6b/3560747/1bf2f877e3be/medscimonit-18-3-MT19-g001.jpg

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