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Left atrial structure and functional quantitation using cardiovascular magnetic resonance and multimodality tissue tracking: validation and reproducibility assessment.

Zareian M, Ciuffo L, Habibi M, Opdahl A, Chamera EH, Wu CO, Bluemke DA, Lima JA, Venkatesh BA - J Cardiovasc Magn Reson (2015)

Bottom Line: LA total, active and passive ejection fractions were calculated.Pearson's correlation and Bland-Altman analysis were used to compare the measurements.In a second sample of 25 subjects (age: 65.7 ± 7.1, 72% males) inter study, intra and inter reader reliability analysis was performed.

View Article: PubMed Central - PubMed

Affiliation: MR 110, Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA. mytra_z@hotmail.com.

ABSTRACT

Background: Left atrium (LA) strain, volume and function are important markers of cardiovascular disease and myocardial impairment. We aimed to assess the accuracy of LA biplane volume and function measured by Multimodality Tissue Tracking (MTT). Also we assessed the inter-study reproducibility for cardiovascular magnetic resonance (CMR) derived LA volume and function parameters.

Methods: Thirty subjects (mean age: 71.3 ± 8.7, 87% male) including twenty subjects with cardiovascular events and ten healthy subjects, with CMR were evaluated in the Multi-Ethnic Study of Atherosclerosis (MESA). LA volumes were computed by the modified biplane method from 2- and 4-chamber projections and the Simpson's method from short-axis slices using both methods - manual and semi-automated delineation using MTT. LA total, active and passive ejection fractions were calculated. Pearson's correlation and Bland-Altman analysis were used to compare the measurements. In a second sample of 25 subjects (age: 65.7 ± 7.1, 72% males) inter study, intra and inter reader reliability analysis was performed. The intra-class correlation coefficient (ICC) was evaluated.

Results: Left atrial MTT structural and functional parameters were not different from manual delineation, yet image analysis was only half as time consuming on average with MTT. Maximal volume MTT was not different between the Simpson's and Biplane methods, functional parameters, however were different. MTT allowed us to measure multiple LA parameters with good-excellent (ICC; 0.88- 0.98, p < 0.001) intra-and inter reader reproducibility and fair-good (ICC; 0.44-0.82, p < 0.05-0.001) inter study reproducibility.

Conclusions: MTT derived LA biplane volume and function is accurate and reproducible and is suited for use in longitudinal studies.

No MeSH data available.


Related in: MedlinePlus

Biplane method. Manual delineation requires manual drawing of the endocardial contours in (1) end-diastolic, (2) end-systolic and (3) pre-atrial kick phase, separately for 2 (a) and 4 (b) chamber projections. Corresponding contours using Multimodality Tissue Tracking software are shown at end-diastole (c) and endsystole (d). The contours were drawn at left-ventricular end-systole (the point of largest LA enlargement) and were propagated by the software throughout the cardiac cycle
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Fig3: Biplane method. Manual delineation requires manual drawing of the endocardial contours in (1) end-diastolic, (2) end-systolic and (3) pre-atrial kick phase, separately for 2 (a) and 4 (b) chamber projections. Corresponding contours using Multimodality Tissue Tracking software are shown at end-diastole (c) and endsystole (d). The contours were drawn at left-ventricular end-systole (the point of largest LA enlargement) and were propagated by the software throughout the cardiac cycle

Mentions: All the above parameters were obtained from strain, strain rate and volume curves from MTT (Fig. 3). LA performs three different functions during the cardiac cycle: 1) acts as a reservoir during LV systole; 2) acts as a conduit in early LV diastole; 3) acts as an active pump during late LV diastole [1]. Taking this information in consideration, we performed the measurement of pre-atrial contraction volume at the point where the rate of change of atrial volume was closest to zero, at this point the atria acts as a conduit, thus, only minor changes in volumes can be visualized in the LA, representing the transition between atrial conduit phase and atrial contraction phase (Fig. 3) [14]. Left atrial ejection fraction (LAEF %) was calculated as: (Vmax-Vmin)/Vmax × 100; Left atrial passive ejection fraction (LAPEF %): (Vmax-VpreA)/Vmax × 100 and Left atrial active ejection fraction (LAAEF %): (VpreA-Vmin)/VpreA × 100.Fig. 3


Left atrial structure and functional quantitation using cardiovascular magnetic resonance and multimodality tissue tracking: validation and reproducibility assessment.

Zareian M, Ciuffo L, Habibi M, Opdahl A, Chamera EH, Wu CO, Bluemke DA, Lima JA, Venkatesh BA - J Cardiovasc Magn Reson (2015)

Biplane method. Manual delineation requires manual drawing of the endocardial contours in (1) end-diastolic, (2) end-systolic and (3) pre-atrial kick phase, separately for 2 (a) and 4 (b) chamber projections. Corresponding contours using Multimodality Tissue Tracking software are shown at end-diastole (c) and endsystole (d). The contours were drawn at left-ventricular end-systole (the point of largest LA enlargement) and were propagated by the software throughout the cardiac cycle
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4487838&req=5

Fig3: Biplane method. Manual delineation requires manual drawing of the endocardial contours in (1) end-diastolic, (2) end-systolic and (3) pre-atrial kick phase, separately for 2 (a) and 4 (b) chamber projections. Corresponding contours using Multimodality Tissue Tracking software are shown at end-diastole (c) and endsystole (d). The contours were drawn at left-ventricular end-systole (the point of largest LA enlargement) and were propagated by the software throughout the cardiac cycle
Mentions: All the above parameters were obtained from strain, strain rate and volume curves from MTT (Fig. 3). LA performs three different functions during the cardiac cycle: 1) acts as a reservoir during LV systole; 2) acts as a conduit in early LV diastole; 3) acts as an active pump during late LV diastole [1]. Taking this information in consideration, we performed the measurement of pre-atrial contraction volume at the point where the rate of change of atrial volume was closest to zero, at this point the atria acts as a conduit, thus, only minor changes in volumes can be visualized in the LA, representing the transition between atrial conduit phase and atrial contraction phase (Fig. 3) [14]. Left atrial ejection fraction (LAEF %) was calculated as: (Vmax-Vmin)/Vmax × 100; Left atrial passive ejection fraction (LAPEF %): (Vmax-VpreA)/Vmax × 100 and Left atrial active ejection fraction (LAAEF %): (VpreA-Vmin)/VpreA × 100.Fig. 3

Bottom Line: LA total, active and passive ejection fractions were calculated.Pearson's correlation and Bland-Altman analysis were used to compare the measurements.In a second sample of 25 subjects (age: 65.7 ± 7.1, 72% males) inter study, intra and inter reader reliability analysis was performed.

View Article: PubMed Central - PubMed

Affiliation: MR 110, Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA. mytra_z@hotmail.com.

ABSTRACT

Background: Left atrium (LA) strain, volume and function are important markers of cardiovascular disease and myocardial impairment. We aimed to assess the accuracy of LA biplane volume and function measured by Multimodality Tissue Tracking (MTT). Also we assessed the inter-study reproducibility for cardiovascular magnetic resonance (CMR) derived LA volume and function parameters.

Methods: Thirty subjects (mean age: 71.3 ± 8.7, 87% male) including twenty subjects with cardiovascular events and ten healthy subjects, with CMR were evaluated in the Multi-Ethnic Study of Atherosclerosis (MESA). LA volumes were computed by the modified biplane method from 2- and 4-chamber projections and the Simpson's method from short-axis slices using both methods - manual and semi-automated delineation using MTT. LA total, active and passive ejection fractions were calculated. Pearson's correlation and Bland-Altman analysis were used to compare the measurements. In a second sample of 25 subjects (age: 65.7 ± 7.1, 72% males) inter study, intra and inter reader reliability analysis was performed. The intra-class correlation coefficient (ICC) was evaluated.

Results: Left atrial MTT structural and functional parameters were not different from manual delineation, yet image analysis was only half as time consuming on average with MTT. Maximal volume MTT was not different between the Simpson's and Biplane methods, functional parameters, however were different. MTT allowed us to measure multiple LA parameters with good-excellent (ICC; 0.88- 0.98, p < 0.001) intra-and inter reader reproducibility and fair-good (ICC; 0.44-0.82, p < 0.05-0.001) inter study reproducibility.

Conclusions: MTT derived LA biplane volume and function is accurate and reproducible and is suited for use in longitudinal studies.

No MeSH data available.


Related in: MedlinePlus