| Left ventricular papillary muscles and trabeculae are significant determinants of cardiac MRI volumetric measurements: effects on clinical standards in patients with advanced systolic dysfunction. | |
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MedLine Citation:
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PMID: 17698216 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Left ventricular (LV) mass and ejection fraction are of diagnostic and therapeutic importance in patients with systolic dysfunction. Cardiac MRI (CMR) has been proposed as a standard for these indices. Prior studies have variably included papillary muscles and trabeculae in either intracavitary or myocardial volumes. Quantitative effects and clinical implications of this methodological difference in patients with systolic dysfunction are unknown. METHODS: Fifty consecutive patients with known systolic dysfunction (EF<40%) underwent CMR. LV volumes were determined using previously established methods: Method 1 included papillary muscles and trabeculae in cavity volume, method 2 included these in myocardial volume. Both methods were used for each patient with tracings superimposed to isolate papillary/trabecular volume and insure consistency of other endocardial contours. Readers applied methods in random order blinded to clinical findings and results of the other method. RESULTS: LV mass differed substantially by method (p<0.001) with absolute difference of 16.6%. Ejection fraction differed by 3 points (p<0.001) with absolute differences of > or =5 points in 16% of patients. Mean differences in LV mass and ejection fraction were produced by consistent methodological differences on a per-patient basis. Methodology used produced differences in patients meeting established criteria for LV hypertrophy (28% vs. 60%, p<0.001) and ICD implantation (64% vs. 48%, p<0.01). CONCLUSIONS: LV mass and ejection fraction differ significantly between commonly employed CMR methods. Alternative inclusion of papillary muscles and trabeculae in either cavity or myocardial volumes produces significant differences in clinical and therapeutic indices that can affect management of patients with advanced systolic dysfunction. |
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Authors:
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Jonathan W Weinsaft; Matthew D Cham; Matthew Janik; James K Min; Claudia I Henschke; David F Yankelevitz; Richard B Devereux |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-08-14 |
Journal Detail:
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Title: International journal of cardiology Volume: 126 ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-16 Completed Date: 2008-07-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 359-65 Citation Subset: IM |
Affiliation:
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Greenberg Division of Cardiology, Department of Medicine, New York Presbyterian Hospital - Weill Cornell Medical Center, New York, NY 10021, USA. jww2001@med.cornell.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Volume Cohort Studies Female Heart Failure, Systolic / etiology, physiopathology* Heart Ventricles / pathology Humans Hypertrophy, Left Ventricular / complications, diagnosis Image Processing, Computer-Assisted* Magnetic Resonance Imaging, Cine* Male Middle Aged Papillary Muscles / pathology* Probability Prognosis Reference Values Sensitivity and Specificity Severity of Illness Index Stroke Volume Ventricular Dysfunction, Left / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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