Cardiovascular MR dobutamine stress in adult tetralogy of fallot: Disparity between CMR volumetry and flow for cardiovascular function

Israel Valverde, Victoria Parish, Aphrodite Tzifa, Catherine Head, Samir Sarikouch, Gerald Greil, Tobias Schaeffter, Reza Razavi, Philipp Beerbaum

Research output: Contribution to journalArticle

10 Citations (Scopus)

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 (LVSV) versus aortic forward flow (AOFF)], (ii) Pulmonary output [right ventricle stroke volume (RVSV) versus pulmonary forward flow (PAFF)], (iii) PR volume [(RV SV-LVSV) versus pulmonary backward flow (PA BF)], (iv) PR fraction [(RVSV-LVSV/RV SV) versus (PABF/PAFF)]. Results: We found excellent Bland-Altman agreement (mean difference ± limits of agreement, mL/beat/m2) 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.

Original languageEnglish (US)
Pages (from-to)1341-1350
Number of pages10
JournalJournal of Magnetic Resonance Imaging
Volume33
Issue number6
DOIs
StatePublished - Jun 1 2011

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Pulmonary Valve Insufficiency
Dobutamine
Tetralogy of Fallot
Stroke Volume
Heart Ventricles
Lung

Keywords

  • blood flow
  • cardiac volume
  • MRI
  • stress
  • tetralogy of Fallot

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Cardiovascular MR dobutamine stress in adult tetralogy of fallot : Disparity between CMR volumetry and flow for cardiovascular function. / Valverde, Israel; Parish, Victoria; Tzifa, Aphrodite; Head, Catherine; Sarikouch, Samir; Greil, Gerald; Schaeffter, Tobias; Razavi, Reza; Beerbaum, Philipp.

In: Journal of Magnetic Resonance Imaging, Vol. 33, No. 6, 01.06.2011, p. 1341-1350.

Research output: Contribution to journalArticle

Valverde, Israel ; Parish, Victoria ; Tzifa, Aphrodite ; Head, Catherine ; Sarikouch, Samir ; Greil, Gerald ; Schaeffter, Tobias ; Razavi, Reza ; Beerbaum, Philipp. / Cardiovascular MR dobutamine stress in adult tetralogy of fallot : Disparity between CMR volumetry and flow for cardiovascular function. In: Journal of Magnetic Resonance Imaging. 2011 ; Vol. 33, No. 6. pp. 1341-1350.
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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 (LVSV) versus aortic forward flow (AOFF)], (ii) Pulmonary output [right ventricle stroke volume (RVSV) versus pulmonary forward flow (PAFF)], (iii) PR volume [(RV SV-LVSV) versus pulmonary backward flow (PA BF)], (iv) PR fraction [(RVSV-LVSV/RV SV) versus (PABF/PAFF)]. Results: We found excellent Bland-Altman agreement (mean difference ± limits of agreement, mL/beat/m2) 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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T1 - Cardiovascular MR dobutamine stress in adult tetralogy of fallot

T2 - Disparity between CMR volumetry and flow for cardiovascular function

AU - Valverde, Israel

AU - Parish, Victoria

AU - Tzifa, Aphrodite

AU - Head, Catherine

AU - Sarikouch, Samir

AU - Greil, Gerald

AU - Schaeffter, Tobias

AU - Razavi, Reza

AU - Beerbaum, Philipp

PY - 2011/6/1

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N2 - 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 (LVSV) versus aortic forward flow (AOFF)], (ii) Pulmonary output [right ventricle stroke volume (RVSV) versus pulmonary forward flow (PAFF)], (iii) PR volume [(RV SV-LVSV) versus pulmonary backward flow (PA BF)], (iv) PR fraction [(RVSV-LVSV/RV SV) versus (PABF/PAFF)]. Results: We found excellent Bland-Altman agreement (mean difference ± limits of agreement, mL/beat/m2) 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.

AB - 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 (LVSV) versus aortic forward flow (AOFF)], (ii) Pulmonary output [right ventricle stroke volume (RVSV) versus pulmonary forward flow (PAFF)], (iii) PR volume [(RV SV-LVSV) versus pulmonary backward flow (PA BF)], (iv) PR fraction [(RVSV-LVSV/RV SV) versus (PABF/PAFF)]. Results: We found excellent Bland-Altman agreement (mean difference ± limits of agreement, mL/beat/m2) 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.

KW - blood flow

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KW - MRI

KW - stress

KW - tetralogy of Fallot

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