The use of dedicated long-axis views focused on the left atrium improves the accuracy of left atrial volumes and emptying fraction measured by cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Stefano Figliozzi¹  Camilla Torlasco²  Denisa Muraru³  Luigi P. Badano³  Gianfranco Parati³  Diana R. Florescu⁴  Lara Tondi⁵  Antonia Camporeale⁵  Massimo Lombardi⁵  Silvia Pica⁵  Giandomenico Disabato⁶ 

[1] Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy;Department of Cardiology, Istituto Auxologico Italiano IRCCS, Milan, Italy;Department of Cardiology, Istituto Auxologico Italiano IRCCS, Milan, Italy;Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy;Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy;Department of Cardiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania;Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy;Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy;University of Pavia, Pavia, Italy;

关键词: Left atrial volume;    Left atrial emptying fraction;    Left atrial strain;    Cardiac magnetic resonance;    Accuracy;   

DOI  :  10.1186/s12968-022-00905-w

 received in 2022-05-23, accepted in 2022-11-29,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe use of apical views focused on the left atrium (LA) has improved the accuracy of LA volume evaluation by two-dimensional (2D) echocardiography. However, routine cardiovascular magnetic resonance (CMR) evaluation of LA volumes still uses standard 2- and 4-chamber cine images focused on the left ventricle (LV). To investigate the potential of LA-focused CMR cine images, we compared LA maximuml (LAVmax) and minimum (LAVmin) volumes, and emptying fraction (LAEF), calculated on both standard and LA-focused long-axis cine images, with LA volumes and LAEF obtained by short-axis cine stacks covering the LA. LA strain was also calculated and compared between standard and LA-focused images.MethodsLA volumes and LAEF were obtained from 108 consecutive patients by applying the biplane area-length algorithm to both standard and LA-focused 2- and 4-chamber cine images. Manual segmentation of a short-axis cine stack covering the LA was used as the reference method. In addition, LA strain reservoir (εs), conduit (εe) and booster pump (εa) were calculated using CMR feature-tracking.ResultsCompared to the reference method, the standard approach significantly underestimated LA volumes (LAVmax: bias − 13 ml; LOA =  + 11, − 37 ml; LAVmax i: bias − 7 ml/m2; LOA =  + 7, − 21 ml/m2; LAVmin; bias − 10 ml, LOA: + 9, − 28 ml; LAVmin i: bias − 5 ml/m2, LOA: + 5, − 16 ml/m2), and overestimated LA-EF (bias 5%, LOA: + 23, − 14%). Conversely, LA volumes (LAVmax: bias 0 ml; LOA: + 10, − 10 ml; LAVmax i: bias 0 ml/m2; LOA: + 5, − 6 ml/m2; LAVmin: bias − 2 ml; LOA: + 7, − 10 ml; LAVmin i: bias − 1 ml/m2; LOA: + 3, − 5 ml/m2) and LAEF (bias 2%, LOA: + 11, − 7%) by LA-focused cine images were similar to those measured using the reference method. LA volumes by LA-focused images were obtained faster than using the reference method (1.2 vs 4.5 min, p < 0.001). LA strain (εs: bias 7%, LOA = 25, − 11%; εe: bias 4%, LOA = 15, − 8%; εa: bias 3%, LOA = 14, − 8%) was significantly higher in standard vs. LA-focused images (p < 0.001).ConclusionLA volumes and LAEF measured using dedicated LA-focused long-axis cine images are more accurate than using standard LV-focused cine images. Moreover, LA strain is significantly lower in LA-focused vs. standard images.

【 授权许可】

CC BY   
© The Author(s) 2023

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