Cardiovascular MR dobutamine stress in adult tetralogy of fallot: Disparity between CMR volumetry and flow for cardiovascular function
✍ Scribed by Israel Valverde; Victoria Parish; Aphrodite Tzifa; Catherine Head; Samir Sarikouch; Gerald Greil; Tobias Schaeffter; Reza Razavi; Philipp Beerbaum
- Publisher
- John Wiley and Sons
- Year
- 2011
- Tongue
- English
- Weight
- 410 KB
- Volume
- 33
- Category
- Article
- ISSN
- 1053-1807
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✦ Synopsis
Abstract
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 μg/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. J. Magn. Reson. Imaging 2011;33:1341–1350. © 2011 Wiley‐Liss, Inc.