Assessment of Left Ventricular Ejection Fraction Calculation on Long-axis Views From Cardiac Magnetic Resonance Imaging in Patients With Acute Myocardial Infarction

Huttin, Olivier; Petit, Marie-Anaïs; Bozec, Erwan; Eschalier, Romain; Juillière, Yves; Moulin, F.; Lemoine, Simon; Selton-Suty, Christine; Sadoul, Nicolas; Mandry, Damien; Beaumont, Marine; Felblinger, Jacques; Girerd, Nicolas; Marie, Pierre-Yves

doi:10.1097/md.0000000000001856

Cited by 23 publications

(20 citation statements)

References 16 publications

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“…First, in our patients and volunteers, global cardiac and systolic functional parameters like EDV, ESV, EF, and MM exhibited significant statistical differences between the two approaches, while the absolute differences where rather minor and the ICC was high to very high. These findings are similar to other CMR studies comparing the assessment of LV function using SAX and LAX datasets, and it should be reconsidered whether a statistically significant difference is actually clinically relevant [17,35]. Second, we only included a relatively small number of subjects.…”

Section: Discussionsupporting

confidence: 79%

Diagnosis of Left Ventricular Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging: Comparison of Volume-Time Curves Derived from Long- and Short-Axis Cine Steady-State Free Precession Datasets

Schaafs

Wyschkon

Elgeti

et al. 2020

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Purpose To evaluate the diagnostic performance of diastolic function parameters derived from long-axis (LAX) planimetry compared with short-axis (SAX) volumetry in cardiac magnetic resonance imaging. Materials and Methods Cine steady-state free precession (SSFP) datasets of 15 healthy participants (8 young and 7 middle aged) and 25 patients with echocardiographically proven diastolic dysfunction (9 mild, 9 moderate, and 7 severe) were retrospectively included. Volume-time curves for assessing left ventricular (LV) function were obtained by manually contouring the LV endocardial borders in SAX and LAX datasets. The time needed for contouring was recorded for each dataset. The following LV parameters were determined: end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), myocardial mass (MM), time to peak filling rate (TPFR), normalized peak filling rate (nPFR), and the ratio of early to late peak filling rate (E/A ratio). A Wilcoxon signed-rank test was used to compare subgroups based on age and severity of diastolic dysfunction for statistical differences. Intraclass correlation coefficients were used to assess intermethod and interobserver reliability. Results Accuracy for the diagnosis of diastolic dysfunction was highest for E/A (mild diastolic dysfunction) and nPFR (any stage of diastolic dysfunction) derived from LAX datasets (E/A: area under the curve (AUC) = 0.97, sensitivity of 68 % and specificity of 100 %; nPFR: AUC = 0.84, sensitivity of 84 % and specificity of 80 %). Diastolic parameters showed a moderate to good intraclass correlation between both methods. The mean differences in EDV, ESV, EF, and MM were 5.3 ml, 1.9 ml, 3.5 %, and 11 g, respectively (each p < 0.001). Significantly less time was needed to derive volume-time curves from LAX images (median 14:45 min, interquartile range 14:15–15:53 min versus median 29:25 min, interquartile range 28:12–32:22 min; p = 0.001). The interobserver reliability was generally good to excellent. Conclusion Diastolic function parameters derived from left ventricular LAX planimetry have high diagnostic performance and can be obtained in significantly less time compared with SAX volumetry. These findings may pave the way for routine use of LAX planimetry in the clinical diagnosis of diastolic dysfunction. Key points: Citation Format

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Section: Discussionsupporting

confidence: 79%

Diagnosis of Left Ventricular Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging: Comparison of Volume-Time Curves Derived from Long- and Short-Axis Cine Steady-State Free Precession Datasets

Schaafs

Wyschkon

Elgeti

et al. 2020

Rofo

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“…The study population was extracted from the single-center “REMI” (relation between aldosterone and cardiac REmodeling after Myocardial Infarction) cohort in which serial CMR and biomarker measurements were performed after reperfused acute MI [14, 15]. The study protocol, in compliance with the Declaration of Helsinki, was approved by the local Ethics Committee (CPP agreement n° 2009-A00537-50) and was registered on the ClinicalTrials.gov site (NCT01109225).…”

Section: Methodsmentioning

confidence: 99%

Cardiac remodeling following reperfused acute myocardial infarction is linked to the concomitant evolution of vascular function as assessed by cardiovascular magnetic resonance

Huttin

Mandry

Eschalier

et al. 2016

Journal of Cardiovascular Magnetic Resonance

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BackgroundLeft ventricular (LV) remodeling following acute myocardial infarction (MI) is difficult to predict at an individual level although a possible interfering role of vascular function has yet to be considered to date. This study aimed to determine the extent to which this LV remodeling is influenced by the concomitant evolution of vascular function and LV loading conditions, as assessed by phase-contrast Cardiovascular Magnetic Resonance (CMR) of the ascending aorta.MethodsCMR was performed in 121 patients, 2–4 days after reperfusion of a first ST-segment elevation myocardial infarction and 6 months thereafter. LV remodeling was: (i) assessed by the 6-month increase in end-diastolic volume (EDV) and/or ejection fraction (EF) and (ii) correlated with the indexed aortic stroke volume (mL.m−2), determined by a CMR phase-contrast sequence, along with derived functional vascular parameters (total peripheral vascular resistance (TPVR), total arterial compliance index, effective arterial elastance).ResultsAt 6 months, most patients were under angiotensin enzyme converting inhibitors (86%) and beta-blockers (84%) and, on average, all functional vascular parameters were improved whereas blood pressure levels were not. An increase in EDV only (EDV+/EF-) was documented in 17% of patients at 6 months, in EF only (EDV-/EF+) in 31%, in both EDV and EF (EDV+/EF+) in 12% and neither EDV nor EF (EDV-/EF-) in 40%. The increase in EF was mainly and independently linked to a concomitant decline in TPVR (6-month change in mmHg.min.m2.L−1, EDV-/EF-: +1 ± 8, EDV+/EF-: +3 ± 9, EDV-/EF+: -7 ± 6, EDV+/EF+: -15 ± 20, p < 0.001) while the absence of any EF improvement was associated with high persisting rates of abnormally high TPVR at 6 months (EDV-/EF-: 31%, EDV+/EF-: 38%, EDV-/EF+: 5%, EDV+/EF+: 13%, p = 0.007). By contrast, the 6–month increase in EDV was mainly dependent on cardiac as opposed to vascular parameters and particularly on the presence of microvascular obstruction at baseline (EDV-/EF-: 37%, EDV+/EF-: 76%, EDV-/EF+: 38%, EDV+/EF+: 73%, p = 0.003).ConclusionLV remodeling following reperfused MI is strongly influenced by the variable decrease in systemic vascular resistance under standard care vasodilating medication. The CMR monitoring of vascular resistance may help to tailor these medications for improving vascular resistance and consequently, LV ejection fraction.Trial registration NCT01109225 on ClinicalTrials.gov site (April, 2010).

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“…Different T1 mapping methods and parameter sets result in different ranges of T1 and ECV values for normal myocardium and blood [8, 10, 11]. Although previous studies have examined the impact of slice position in measuring other cardiac parameters in CMR imaging (such as left ventricular mass, volume and ejection fraction) [12–14], very limited data are available today comparing T1 [15] and ECV measurements from short and long axis acquisitions [16, 17]. Despite this, current recommendations on T1 and ECV mapping in patients with global/diffuse cardiac disease [18] suggest adding a long axis map to aid analysis.…”

Section: Introductionmentioning

confidence: 99%

Comparison of short axis and long axis acquisitions of T1 and extracellular volume mapping using MOLLI and SASHA in patients with myocardial infarction and healthy volunteers

et al. 2019

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Background Although previous studies have examined the impact of slice position in volumetric measurements in Cardiovascular Magnetic Resonance (CMR) imaging, very limited data are available today comparing T1 and Extra-Cellular Volume (ECV) measurements from short and long axis acquisitions. The purpose of this study was to investigate the impact of slice position and orientation on T1 and ECV measurements using the MOdified Look-Locker Inversion recovery (MOLLI) and Saturation recovery single-shot acquisition (SASHA) sequence in patients with myocardial infarction and in healthy volunteers. Methods Eight (8) healthy volunteers with no medical history and eight (8) patients with myocardial infarction were included in this study. MOLLI and SASHA were utilized and short-axis and long-axis images were acquired. T1 and ECV measurements were performed by drawing same size regions of interest on the myocardium as well in the blood pool at the intersections of the short axis and long axis images. Results In healthy volunteers, there were no statistically significant differences in native T1 and ECV values between short axis and long axis acquisitions using MOLLI (two-chamber, three-chamber and four-chamber) and SASHA (three-chamber). In patients, there were no statistically significant differences in native T1 and ECV values between short axis and 3-chamber long axis acquisitions in both remote and affected myocardium using MOLLI and SASHA. Conclusions Long axis measurements of myocardial T1 and ECV using MOLLI and SASHA exhibit good agreement with the corresponding short axis measurements allowing for fast and reliable myocardial tissue characterization in cases where shortening of the overall imaging acquisition is required.

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Assessment of Left Ventricular Ejection Fraction Calculation on Long-axis Views From Cardiac Magnetic Resonance Imaging in Patients With Acute Myocardial Infarction

Abstract: Supplemental Digital Content is available in the text

Cited by 23 publications

References 16 publications

Diagnosis of Left Ventricular Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging: Comparison of Volume-Time Curves Derived from Long- and Short-Axis Cine Steady-State Free Precession Datasets

Diagnosis of Left Ventricular Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging: Comparison of Volume-Time Curves Derived from Long- and Short-Axis Cine Steady-State Free Precession Datasets

Cardiac remodeling following reperfused acute myocardial infarction is linked to the concomitant evolution of vascular function as assessed by cardiovascular magnetic resonance

Comparison of short axis and long axis acquisitions of T1 and extracellular volume mapping using MOLLI and SASHA in patients with myocardial infarction and healthy volunteers

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