Head-to-Head Comparison of Left Ventricular Function Assessment with 64-Row Computed Tomography, Biplane Left Cineventriculography, and Both 2- and 3-Dimensional Transthoracic Echocardiography: Comparison With Magnetic Resonance Imaging as the Reference S

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• 作者：Johannes Greupner ; MD^鈦?/sup> ; Elke Zimmermann ; MD^鈦?/sup> ; Andrea Grohmann ; MD^&dagger ; ; Hans-Peter Dü ; bel ; MD ; PhD^&dagger ; ; Till Althoff ; MD^&dagger ; ; Adrian C. Borges ; MD ; PhD^&dagger ; ; Wolfgang Rutsch ; MD ; PhD^&dagger ; ; Peter Schlattmann ; PhD^&Dagger ; ; Bernd Hamm ; MD ; PhD^鈦?/sup> ; Marc Dewey ; MD ; PhD^鈦?/sup> ; ^{dewey@charite.de}
• 关键词：computed tomography ; echocardiography ; left ventricular function ; magnetic resonance imaging
• 刊名：Journal of the American College of Cardiology
• 出版年：2012
• 期刊代码：201_07351097
• 类别：med
• 出版时间：22 May, 2012
• 卷：59
• 期：21
• 页码：1897-1907
• 文件大小：1364 K

摘要

| Figures/TablesFigures/Tables | ReferencesReferences<h4 class="h4">Objectivesh4>This study was designed to compare the accuracy of 64-row contrast computed tomography (CT), invasive cineventriculography (CVG), 2-dimensional echocardiography (2D Echo), and 3-dimensional echocardiography (3D Echo) for left ventricular (LV) function assessment with magnetic resonance imaging (MRI).<h4 class="h4">Backgroundh4>

Cardiac function is an important determinant of therapy and is a major predictor for long-term survival in patients with coronary artery disease. A number of methods are available for assessment of function, but there are limited data on the comparison between these multiple methods in the same patients.<h4 class="h4">Methodsh4>

A total of 36 patients prospectively underwent 64-row CT, CVG, 2D Echo, 3D Echo, and MRI (as the reference standard). Global and regional LV wall motion and ejection fraction (EF) were measured. In addition, assessment of interobserver agreement was performed.<h4 class="h4">Resultsh4>

For the global EF, Bland-Altman analysis showed significantly higher agreement between CT and MRI (p < 0.005, 95%confidence interval: 卤14.2%) than for CVG (卤20.2%) and 3D Echo (卤21.2%). Only CVG (59.5 卤 13.9%, p = 0.03) significantly overestimated EF in comparison with MRI (55.6 卤 16.0%). CT showed significantly better agreement for stroke volume than 2D Echo, 3D Echo, and CVG. In comparison with MRI, CVG鈥攂ut not CT鈥攕ignificantly overestimated the end-diastolic volume (p < 0.001), whereas 2D Echo and 3D Echo significantly underestimated the EDV (p < 0.05). There was no significant difference in diagnostic accuracy (range: 76%to 88%) for regional LV function assessment between the 4 methods when compared with MRI. Interobserver agreement for EF showed high intraclass correlation for 64-row CT, MRI, 2D Echo, and 3D Echo (intraclass correlation coefficient >0.8), whereas agreement was lower for CVG (intraclass correlation coefficient = 0.58).<h4 class="h4">Conclusionsh4>

64-row CT may be more accurate than CVG, 2D Echo, and 3D Echo in comparison with MRI as the reference standard for assessment of global LV function.