Wenzel Jan-Per, Albrecht Jan-Niklas, Toprak Betül, Petersen Elina, Nikorowitsch Julius, Cavus Ersin, Jahnke Charlotte, Riedl Katharina Alina, Adam Gerhard, Twerenbold Raphael, Blankenberg Stefan, Kirchhof Paulus, Lund Gunnar, Tahir Enver, Müllerleile Kai, Radunski Ulf K
Clinic for Rhythmology, University Hospital Schleswig-Holstein (UKSH), Lübeck, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Clin Res Cardiol. 2025 May 12. doi: 10.1007/s00392-025-02660-1.
Comparing transthoracic echocardiography (TTE) and cardiac magnetic resonance imaging (CMR) is crucial for cardiac assessment. This study aims to clarify their comparability in a large population sample.
CMR and two- (2D) and three-dimensional (3D) TTE were used to quantify left and right heart dimensions in participants of the Hamburg City Health Study. Intertechnique agreement was evaluated using Bland-Altman analyses, Pearson correlation coefficients, and Cohen's Kappa.
Data from 2126 participants (median age 67 [IQR: 59-72] years, 897 (42.2%) female) were analyzed. Left ventricular (LV) diastolic volumes were similar (CMR: 117.0 [96.2, 138.0] ml, 2D-TTE: 111.8 [93.6, 134.3] ml, r = 0.7, p < 0.001), while systolic volumes were lower with CMR (CMR: 36.0 [26.9, 46.0] ml, 2D-TTE: 46.7 [37.9, 57.5] ml, r = 0.67, p < 0.001). CMR LV ejection fraction (LVEF) was 10% higher than 2D-TTE (CMR = 69.0 [64.0, 74.0]%, 2D-TTE = 58.3 [55.5, 61.7]%, p < 0.001; r = 0.40, p < 0.001). Left atrial volumes correlated moderately with low bias (CMR: 53.0 [40.0, 68.0] ml, 2D-TTE: 51.6 [41.5, 64.0] ml, r = 0.63, p < 0.001). LV mass showed good correlation but was higher using 2D-TTE (r = 0.74, p < 0.001). Right ventricular (RV) volumes showed the largest differences, with CMR demonstrating lower interobserver variability (ICC = 0.97 vs. 0.61 for 2D-TTE) and markedly larger volumes (RVEDV mean bias = 74.8 ml, r = 0.50, p < 0.001).
In a large general population, CMR quantifies cardiac function and dimensions more reliably than TTE. Both modalities provide significantly different absolute values, limiting intertechnique transferability.
Retrospectively registered at ClinicalTrial.gov, registration number: NCT03934957, registration date: 04/01/2019, https://clinicaltrials.gov/study/NCT03934957 .
比较经胸超声心动图（TTE）和心脏磁共振成像（CMR）对于心脏评估至关重要。本研究旨在阐明它们在大样本人群中的可比性。
在汉堡市健康研究的参与者中，使用CMR以及二维（2D）和三维（3D）TTE来量化左右心腔尺寸。采用布兰德-奥特曼分析、皮尔逊相关系数和科恩卡方检验来评估不同技术间的一致性。
分析了2126名参与者的数据（年龄中位数67岁[四分位间距：59 - 72岁]，897名（42.2%）为女性）。左心室（LV）舒张末期容积相似（CMR：117.0[96.2, 138.0]ml，2D-TTE：111.8[93.6, 134.3]ml，r = 0.7，p < 0.001），而CMR测得的收缩末期容积较低（CMR：36.0[26.9, 46.0]ml，2D-TTE：46.7[37.9, 57.5]ml，r = 0.67，p < 0.001）。CMR测得的左心室射血分数（LVEF）比2D-TTE高10%（CMR = 69.0[64.0, 74.0]%，2D-TTE = 58.3[55.5, 61.7]%，p < 0.001；r = 0.40，p < 0.001）。左心房容积具有中等程度的相关性且偏差较小（CMR：53.0[40.0, 68.0]ml，2D-TTE：51.6[41.5, 64.0]ml，r = 0.63，p < 0.001）。左心室质量显示出良好的相关性，但2D-TTE测得的值更高（r = 0.74，p < 0.001）。右心室（RV）容积差异最大，CMR显示观察者间变异性较低（组内相关系数ICC = 0.97，而2D-TTE为0.61）且容积明显更大（右心室舒张末期容积平均偏差 = 74.8 ml，r = 0.50，p < 0.001）。
在一大群普通人群中，CMR比TTE更可靠地量化心脏功能和尺寸。两种检查方式提供的绝对值差异显著，限制了不同技术间的可转移性。
在ClinicalTrial.gov上进行回顾性注册，注册号：NCT03934957，注册日期：2019年1月4日，https://clinicaltrials.gov/study/NCT03934957 。
