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Reproducibility of Cardiac Magnetic Resonance Imaging (CMRI)-Derived Right Ventricular Parameters in Repaired Tetralogy of Fallot (ToF).
Heart Lung Circ. 2018 Mar; 27(3):381-385.HL

Abstract

BACKGROUND

Quantification of right ventricular (RV) volumes is challenging owing to variable reproducibility and is especially so in congenital heart disease. Cardiac magnetic resonance (CMR) has the ability to more comprehensively survey the entire right ventricle and is currently considered the gold standard.

AIMS

We aimed to determine the inter-observer reproducibility of CMR-derived RV volumes generated by two independent and experienced (SCMR Level III) observers in Tetralogy of Fallot (ToF) patients with varying degrees of RV dilatation.

METHODS

We performed a retrospective analysis of 120 consecutive patients with repaired ToF who underwent CMR. Two blinded observers calculated RV volumes in each oblique short axis slice independently. Bland-Altman analysis and inter-observer correlation coefficients (ICC) were assessed.

RESULTS

The coefficients of variation for RV parameters were: 2.9%, 8% and 3.4% for right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV) and right ventricular ejection fraction (RVEF) respectively. For RVEDV the interobserver correlation was 0.992 demonstrating excellent volumetric correlation between observers. The mean difference between the observers for right ventricular end diastolic volume index (RVEDVi) was 2.5ml/m2 (95% limits of agreement -7.3 to 12.2ml/m2). For patients with mild-moderate RV dilatation (RVEDVi <150ml/m2) the mean difference of RVEDVi was 1.8ml/m2 (95% limits of agreement -5.7 to 9.3ml/m2). For patients with severe RV dilatation (RVEDVi≥150ml/m2) the mean difference was -3.4ml/m2 (95% limits of agreement -8.6 to 15.4ml/m2).

CONCLUSIONS

In patients with repaired ToF and variable degrees of RV dilatation, CMR assessment of RV volumes and function has high inter-observer reproducibility. This allows for optimal timing of pulmonary valve replacement, based on progression of RV dilatation over time.

Authors+Show Affiliations

Paediatrics, The Heart Centre for Children, The Children's Hospital at Westmead and Cardiac MRI, Cardiovascular Magnetic Resonance, Sydney, NSW, Australia. Electronic address: ganeshimay@gmail.com.Cardiovascular Magnetic Resonance, Sydney, NSW, Australia.Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.Paediatric Cardiology, The Heart Centre for Children, The Children's Hospital at Westmead and The University of Sydney, Sydney, NSW, Australia.Cardiology and Cardiac MR, Royal Prince Alfred Hospital, The Heart Centre for Children, The Children's Hospital at Westmead and Cardiovascular Magnetic Resonance, Sydney, NSW, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28662918

Citation

Gnanappa, Ganesh Kumar, et al. "Reproducibility of Cardiac Magnetic Resonance Imaging (CMRI)-Derived Right Ventricular Parameters in Repaired Tetralogy of Fallot (ToF)." Heart, Lung & Circulation, vol. 27, no. 3, 2018, pp. 381-385.
Gnanappa GK, Rashid I, Celermajer D, et al. Reproducibility of Cardiac Magnetic Resonance Imaging (CMRI)-Derived Right Ventricular Parameters in Repaired Tetralogy of Fallot (ToF). Heart Lung Circ. 2018;27(3):381-385.
Gnanappa, G. K., Rashid, I., Celermajer, D., Ayer, J., & Puranik, R. (2018). Reproducibility of Cardiac Magnetic Resonance Imaging (CMRI)-Derived Right Ventricular Parameters in Repaired Tetralogy of Fallot (ToF). Heart, Lung & Circulation, 27(3), 381-385. https://doi.org/10.1016/j.hlc.2017.04.017
Gnanappa GK, et al. Reproducibility of Cardiac Magnetic Resonance Imaging (CMRI)-Derived Right Ventricular Parameters in Repaired Tetralogy of Fallot (ToF). Heart Lung Circ. 2018;27(3):381-385. PubMed PMID: 28662918.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reproducibility of Cardiac Magnetic Resonance Imaging (CMRI)-Derived Right Ventricular Parameters in Repaired Tetralogy of Fallot (ToF). AU - Gnanappa,Ganesh Kumar, AU - Rashid,Imran, AU - Celermajer,David, AU - Ayer,Julian, AU - Puranik,Rajesh, Y1 - 2017/06/03/ PY - 2016/10/30/received PY - 2017/03/22/revised PY - 2017/04/28/accepted PY - 2017/7/1/pubmed PY - 2018/7/24/medline PY - 2017/7/1/entrez KW - Cardiovascular magnetic resonance KW - Inter-observer reproducibility KW - Repaired Tetralogy of Fallot KW - Right ventricle SP - 381 EP - 385 JF - Heart, lung & circulation JO - Heart Lung Circ VL - 27 IS - 3 N2 - BACKGROUND: Quantification of right ventricular (RV) volumes is challenging owing to variable reproducibility and is especially so in congenital heart disease. Cardiac magnetic resonance (CMR) has the ability to more comprehensively survey the entire right ventricle and is currently considered the gold standard. AIMS: We aimed to determine the inter-observer reproducibility of CMR-derived RV volumes generated by two independent and experienced (SCMR Level III) observers in Tetralogy of Fallot (ToF) patients with varying degrees of RV dilatation. METHODS: We performed a retrospective analysis of 120 consecutive patients with repaired ToF who underwent CMR. Two blinded observers calculated RV volumes in each oblique short axis slice independently. Bland-Altman analysis and inter-observer correlation coefficients (ICC) were assessed. RESULTS: The coefficients of variation for RV parameters were: 2.9%, 8% and 3.4% for right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV) and right ventricular ejection fraction (RVEF) respectively. For RVEDV the interobserver correlation was 0.992 demonstrating excellent volumetric correlation between observers. The mean difference between the observers for right ventricular end diastolic volume index (RVEDVi) was 2.5ml/m2 (95% limits of agreement -7.3 to 12.2ml/m2). For patients with mild-moderate RV dilatation (RVEDVi <150ml/m2) the mean difference of RVEDVi was 1.8ml/m2 (95% limits of agreement -5.7 to 9.3ml/m2). For patients with severe RV dilatation (RVEDVi≥150ml/m2) the mean difference was -3.4ml/m2 (95% limits of agreement -8.6 to 15.4ml/m2). CONCLUSIONS: In patients with repaired ToF and variable degrees of RV dilatation, CMR assessment of RV volumes and function has high inter-observer reproducibility. This allows for optimal timing of pulmonary valve replacement, based on progression of RV dilatation over time. SN - 1444-2892 UR - https://www.unboundmedicine.com/medline/citation/28662918/Reproducibility_of_Cardiac_Magnetic_Resonance_Imaging__CMRI__Derived_Right_Ventricular_Parameters_in_Repaired_Tetralogy_of_Fallot__ToF__ DB - PRIME DP - Unbound Medicine ER -