Cardiovascular MR dobutamine stress in adult tetralogy of Fallot: disparity between CMR volumetry and flow for cardiovascular function.
Publication year
2011Source
Journal of Magnetic Resonance Imaging, 33, 6, (2011), pp. 1341-50ISSN
Annotation
01 juni 2011
Publication type
Article / Letter to editor

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Organization
Radiology
Journal title
Journal of Magnetic Resonance Imaging
Volume
vol. 33
Issue
iss. 6
Page start
p. 1341
Page end
p. 50
Subject
ONCOL 5: Aetiology, screening and detectionAbstract
PURPOSE: To evaluate the MR agreement of cardiac function parameters between volumetric (cine SSFP) and phase contrast flow (PC-flow) assessment in patients with repaired tetralogy of Fallot (r-TOF) and chronic pulmonary regurgitation (PR) at rest and under dobutamine stress (DS-MR). MATERIALS AND METHODS: We studied 18 patients with r-TOF and severe chronic PR (34 +/- 12.7 years, PR fraction([flow]) 44 +/- 15%) by cardiac MR at rest, 10 and 20 mug/kg/min of dobutamine. We compared analogous functional parameters by volumetry and PC-flow: (i) Systemic output [left ventricle stroke volume (LV(SV)) versus aortic forward flow (AO(FF))], (ii) Pulmonary output [right ventricle stroke volume (RV(SV)) versus pulmonary forward flow (PA(FF))], (iii) PR volume [(RV(SV)-LV(SV)) versus pulmonary backward flow (PA(BF))], (iv) PR fraction [(RV(SV)-LV(SV)/RV(SV)) versus (PA(BF)/PA(FF))]. RESULTS: We found excellent Bland-Altman agreement (mean difference +/- limits of agreement, mL/beat/m(2)) at rest for both the systemic (-0.8 +/- 5.7) and pulmonary strokes volumes (-0.1 +/- 7.6), which slightly deteriorates during DS-MR. The PR volume showed acceptable agreement at rest (-3.6 +/- 15.1), but also further deteriorated during stress (5.4 +/- 24). In contrast, the PR fraction showed poor agreement equally at rest (-5.6 +/- 22.8) and DS-MR (3.2 +/- 19.2). CONCLUSION: In r-TOF with chronic PR, analogous functional parameters should not be used interchangeably between volumetric and PC-flow assessment during DS-MR evaluation.
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- Academic publications [227900]
- Faculty of Medical Sciences [86236]
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