Document Detail

Cardiac MRI: a new gold standard for ventricular volume quantification during high-intensity exercise.
MedLine Citation:
PMID:  23258478     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Accurate measures are critical when attempting to distinguish normal from pathological changes in cardiac function during exercise, yet imaging modalities have seldom been assessed against invasive exercise standards. We sought to validate a novel method of biventricular volume quantification by cardiac MRI (CMR) during maximal exercise.
METHODS AND RESULTS: CMR was performed on 34 subjects during exercise and free-breathing with the use of an ungated real-time (RT-ungated) CMR sequence. ECG and respiratory movements were retrospectively synchronized, enabling compensation for cardiac cycle and respiratory phase. Feasibility of RT-ungated imaging was compared with standard exercise CMR imaging with ECG gating (gated); accuracy of RT-ungated CMR was assessed against an invasive standard (direct Fick); and reproducibility was determined after a second bout of maximal exercise. Ventricular volumes were analyzed more frequently during high-intensity exercise with RT-ungated compared with gated CMR (100% versus 47%; P<0.0001) and with better interobserver variability for RT-ungated (coefficient of variation=1.9% and 2.0% for left and right ventricular stroke volumes, respectively) than gated (coefficient of variation=15.2% and 13.6%; P<0.01). Cardiac output determined by RT-ungated CMR proved accurate against the direct Fick method with excellent agreement (intraclass correlation coefficient, R=0.96), which was highly reproducible during a second bout of maximal exercise (R=0.98).
CONCLUSIONS: When RT-ungated CMR is combined with post hoc analysis incorporating compensation for respiratory motion, highly reproducible and accurate biventricular volumes can be measured during maximal exercise.
Andre La Gerche; Guido Claessen; Alexander Van de Bruaene; Nele Pattyn; Johan Van Cleemput; Marc Gewillig; Jan Bogaert; Steven Dymarkowski; Piet Claus; Hein Heidbuchel
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2012-12-17
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  6     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-20     Completed Date:  2013-05-09     Revised Date:  2013-07-08    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  329-38     Citation Subset:  IM    
Department of Cardiovascular Medicine, University Hospital of Leuven, Leuven, Belgium.
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MeSH Terms
Analysis of Variance
Arrhythmias, Cardiac / diagnosis*,  pathology,  physiopathology
Cardiac-Gated Imaging Techniques / standards*
Exercise Test / standards*
Feasibility Studies
Heart Failure / diagnosis*,  pathology,  physiopathology
Heart Rate
Heart Ventricles / pathology,  physiopathology*
Magnetic Resonance Imaging, Cine / standards*
Middle Aged
Observer Variation
Predictive Value of Tests
Reference Standards
Reproducibility of Results
Stroke Volume*
Time Factors
Ventricular Function, Left*
Ventricular Function, Right*
Young Adult
Comment In:
Circ Cardiovasc Imaging. 2013 May 1;6(3):e20   [PMID:  23696591 ]
Circ Cardiovasc Imaging. 2013 May 1;6(3):e19   [PMID:  23696590 ]

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