BACKGROUND: Assessment of graft function after cardiac transplantation is essential for patient management and clinical research. Previous studies have found that the left ventricular (LV) ejection fraction (EF) by echocardiography (echo), radionuclide ventriculography (RNV), and cardiovascular magnetic resonance (CMR) is discrepant in patients with heart failure. METHOD: Twelve patients underwent LV EF assessment by echo, angiography (angio), RNV, and CMR one year following heart transplantation. The scans were analyzed independently in blinded fashion. RESULTS: The mean EF was 63 +/- 6% by RNV, 66 +/- 6% by CMR, 70 +/- 12% by angio, and 74 +/- 4% by echo. Significant differences were found between CMR and echo (p < 0.001), RNV and echo (p < 0.001), and RNV and angio (p < 0.05). The correlation between the techniques was poor (r = 0.3-0.6), and the scatter plots also suggested considerable variations between techniques. This was confirmed by the wide Bland-Altman limits of agreement (ranging from 22 to 45%). These were particularly wide for comparisons with angiography (43-45%). CONCLUSION: The EF measurement by echo, angio, RNV, and CMR are not interchangeable in patients following heart transplantation. The CMR and RNV provided the best agreement in EF and appear preferable for research studies. Echocardiography systematically overestimated LV EF and showed poor agreement with other techniques. Angiography overestimated LV function, and its routine use did not add to information gained from noninvasive studies.
BACKGROUND: Assessment of graft function after cardiac transplantation is essential for patient management and clinical research. Previous studies have found that the left ventricular (LV) ejection fraction (EF) by echocardiography (echo), radionuclide ventriculography (RNV), and cardiovascular magnetic resonance (CMR) is discrepant in patients with heart failure. METHOD: Twelve patients underwent LV EF assessment by echo, angiography (angio), RNV, and CMR one year following heart transplantation. The scans were analyzed independently in blinded fashion. RESULTS: The mean EF was 63 +/- 6% by RNV, 66 +/- 6% by CMR, 70 +/- 12% by angio, and 74 +/- 4% by echo. Significant differences were found between CMR and echo (p < 0.001), RNV and echo (p < 0.001), and RNV and angio (p < 0.05). The correlation between the techniques was poor (r = 0.3-0.6), and the scatter plots also suggested considerable variations between techniques. This was confirmed by the wide Bland-Altman limits of agreement (ranging from 22 to 45%). These were particularly wide for comparisons with angiography (43-45%). CONCLUSION: The EF measurement by echo, angio, RNV, and CMR are not interchangeable in patients following heart transplantation. The CMR and RNV provided the best agreement in EF and appear preferable for research studies. Echocardiography systematically overestimated LV EF and showed poor agreement with other techniques. Angiography overestimated LV function, and its routine use did not add to information gained from noninvasive studies.
Authors: Kai Nassenstein; Holger Eberle; Stefan Maderwald; Christoph J Jensen; Christina Heilmaier; Thomas Schlosser; Oliver Bruder Journal: Eur Radiol Date: 2010-06-09 Impact factor: 5.315
Authors: Kai Nassenstein; Stephan Orzada; Lars Haering; Andreas Czylwik; Michael Zenge; Holger Eberle; Thomas Schlosser; Oliver Bruder; Edgar Müller; Mark E Ladd; Stefan Maderwald Journal: Eur Radiol Date: 2011-09-24 Impact factor: 5.315
Authors: Christopher Lane; Paul Dorian; Nina Ghosh; Maria Radina; Suzan O'Donnell; Kevin Thorpe; Iqwal Mangat; Victoria Korley; Arnold Pinter Journal: Can J Cardiol Date: 2010-03 Impact factor: 5.223
Authors: Renee Margossian; Marcy L Schwartz; Ashwin Prakash; Lisa Wruck; Steven D Colan; Andrew M Atz; Timothy J Bradley; Mark A Fogel; Lynne M Hurwitz; Edward Marcus; Andrew J Powell; Beth F Printz; Michael D Puchalski; Jack Rychik; Girish Shirali; Richard Williams; Shi-Joon Yoo; Tal Geva Journal: Am J Cardiol Date: 2009-06-06 Impact factor: 2.778
Authors: Kai Lin; Jeremy D Collins; Donald M Lloyd-Jones; Marie-Pierre Jolly; Debiao Li; Michael Markl; James C Carr Journal: Acad Radiol Date: 2015-12-31 Impact factor: 3.173
Authors: Craig R Butler; Richard Thompson; Mark Haykowsky; Mustafa Toma; Ian Paterson Journal: J Cardiovasc Magn Reson Date: 2009-03-12 Impact factor: 5.364
Authors: Philip J Kilner; Tal Geva; Harald Kaemmerer; Pedro T Trindade; Juerg Schwitter; Gary D Webb Journal: Eur Heart J Date: 2010-01-11 Impact factor: 29.983