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 Scopus citations

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 2011

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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