Squeri Angelo, Censi Stefano, Reverberi Claudio, Gaibazzi Nicola, Baldelli Marco, Binno Simone Maurizio, Properzi Enrico, Bosi Stefano
UO Cardiologia, Maria Cecilia Hospital-GVM Care and Research, Cotignola, RA, Italy.
Dipartimento Cardio-Nefro-Polmonare, Azienda Ospedaliero Universitaria di Parma, Parma, Italy.
J Echocardiogr. 2017 Mar;15(1):18-26. doi: 10.1007/s12574-016-0315-3. Epub 2016 Sep 2.
Accurate quantification of left ventricular (LV) volumes [end-diastolic volume (EDV) and end-systolic volume (ESV)] and ejection fraction (EF) is of critical importance. The development of real-time three-dimensional echocardiography (RT3DE) has shown better correlation than two-dimensional (2D) echocardiography with magnetic resonance imaging (MRI) measurements. The aim of our study was to assess the accuracy of RT3DE and 64-slice computed tomography (CT) in the evaluation of LV volumes and function using MRI as the reference standard in a real-world population with various types of heart disease with different chamber geometry.
The study population consisted of 66 patients referred for cardiac MRI for various pathologies. All patients underwent cardiac MRI, and RT3DE and 64 slices CT were then performed on a subsequent day. The study population was then divided into 5 clinical groups depending on the underlying heart disease.
RT3DE volumes correlated well with MRI values (R values: 0.90 for EDV and 0.94 for ESV). RT3DE measurements of EF correlated well with MRI values (R = 0.86). RT3DE measurements resulted in slightly underestimated values of both EDV and ESV, as reflected by biases of -9.18 and -4.50 mL, respectively. Comparison of RT3DE and MRI in various types of cardiomyopathies showed no statistical difference between different LV geometrical patterns.
These results confirm that RT3DE has good accuracy in everyday clinical practice and can be of clinical utility in all types of cardiomyopathy independently of LV geometric pattern, LV diameter or wall thickness, taking into account a slight underestimation of LV volumes and EF compared to MRI.
准确量化左心室(LV)容积[舒张末期容积(EDV)和收缩末期容积(ESV)]以及射血分数(EF)至关重要。实时三维超声心动图(RT3DE)的发展显示,与二维(2D)超声心动图相比,其与磁共振成像(MRI)测量的相关性更好。我们研究的目的是,在以MRI作为参考标准的现实世界中患有各种类型心脏病且心室几何形状不同的人群中,评估RT3DE和64层计算机断层扫描(CT)在评估LV容积和功能方面的准确性。
研究人群包括66例因各种病理情况接受心脏MRI检查的患者。所有患者均接受了心脏MRI检查,随后第二天进行了RT3DE和64层CT检查。然后根据潜在的心脏病将研究人群分为5个临床组。
RT3DE容积与MRI值相关性良好(R值:EDV为0.90,ESV为0.94)。RT3DE测量的EF与MRI值相关性良好(R = 0.86)。RT3DE测量结果导致EDV和ESV值均略有低估,分别表现为偏差-9.18和-4.50 mL。RT3DE与MRI在各种类型心肌病中的比较显示,不同LV几何模式之间无统计学差异。
这些结果证实,RT3DE在日常临床实践中具有良好的准确性,并且在所有类型的心肌病中均具有临床实用性,与LV几何模式、LV直径或壁厚无关,不过与MRI相比,LV容积和EF会略有低估。