Secchi Francesco, Petrini Marcello, Di Leo Giovanni, Bandera Francesco, Castelvecchio Serenella, Guazzi Marco, Menicanti Lorenzo, Sardanelli Francesco
Unità di Radiologia, IRCCS Policlinico San Donato, Piazza E. Malan, 20097, San Donato Milanese, Milano, Italy,
Int J Cardiovasc Imaging. 2015 Apr;31(4):813-20. doi: 10.1007/s10554-015-0599-9. Epub 2015 Jan 28.
To evaluate biventricular pump function after surgical ventricle restoration (SVR) using cardiac magnetic resonance (CMR). We retrospectively studied 39 patients who performed 1.5-T CMR before/after SVR acquiring short-axis ECG-gated cine sequences. End-diastolic, end-systolic, and stroke volume indexed to body surface area (EDVI, ESVI, and SVI), ejection fraction (EF), and their modification after SVR (∆) were obtained for right ventricle (RV) and left ventricle (LV). Wilcoxon signed rank test and Spearman correlation coefficient were used; EF reproducibility was estimated. Median LVEF increased from 24% [interquartile range (IQR) 19-31%] before SVR to 34% (IQR 29-43%) after SVR (P < 0.001). Median RVEF remained unchanged from 58% (IQR 48-66%) before SVR to 57% (IR 46-64%) after SVR (P = 0.743). The correlation between LVEF and RVEF was not significant before SVR (r = 0.182; P = 0.266) but significant after SVR (r = 0.445; P = 0.005). The ∆RVEF was positively correlated with ∆LVEF (r = 0.558; P < 0.001). ∆RVSVI was positively correlated with ∆LVSVI (r = 0.502; P = 0.001). LVEF reproducibility before SVR was 97% for both intra- and inter-reader reproducibility; RVEF reproducibility was 96 and 93%, respectively. SVR improved LV function without apparent impact on RV function. After SVR the two ventricles showed a functional recoupling. Reproducibility of CMR EF was excellent for both ventricles.
使用心脏磁共振成像（CMR）评估手术性心室修复（SVR）后的双心室泵功能。我们回顾性研究了39例在SVR前后进行1.5-T CMR检查并采集短轴心电图门控电影序列的患者。获取右心室（RV）和左心室（LV）的舒张末期、收缩末期及每搏量指数（EDVI、ESVI和SVI）、射血分数（EF）及其在SVR后的变化（∆）。采用Wilcoxon符号秩检验和Spearman相关系数；评估EF的可重复性。左心室射血分数（LVEF）中位数从SVR前的24%[四分位数间距（IQR）19 - 31%]提高到SVR后的34%（IQR 29 - 43%）（P < 0.001）。右心室射血分数（RVEF）中位数在SVR前为58%（IQR 48 - 66%），SVR后为57%（IQR 46 - 64%），保持不变（P = 0.743）。SVR前LVEF与RVEF之间的相关性不显著（r = 0.182；P = 0.266），但SVR后显著（r = 0.445；P = 0.005）。∆RVEF与∆LVEF呈正相关（r = 0.558；P < 0.001）。∆RVSVI与∆LVSVI呈正相关（r = 0.502；P = 0.001）。SVR前LVEF在阅片者内和阅片者间的可重复性均为97%；RVEF的可重复性分别为96%和93%。SVR改善了左心室功能，而对右心室功能无明显影响。SVR后两个心室显示出功能再耦合。CMR EF对两个心室的可重复性都非常好。
