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首页> 外文期刊>Acta Radiologica >Assessment of global left ventricular function with dual-source computed tomography in patients with valvular heart disease
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Assessment of global left ventricular function with dual-source computed tomography in patients with valvular heart disease

机译：双源计算机断层扫描在瓣膜性心脏病患者中评估整体左心室功能

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摘要

Background: Left ventricular (LV) function is a vital parameter for prognosis, therapy guidance, and followup of cardiovascular disease. Dual-source computed tomography (DSCT) provides an accurate analysis of global LV function. Purpose: To assess the performance of DSCT in the determination of global LV functional parameters in comparison with cardiovascular magnetic resonance (CMR) and two-dimensional transthoracic echocardiography (2D-TTE) in patients with valvular heart disease (VHD). Material and Methods: A total of 111 patients (58 men, mean age 49.9 years) with known VHD and who underwent DSCT, 2D-TTE, and CMR a period of 2 weeks before undergoing valve surgery were included in this study. LV end-systolic volume (ESV), end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF) were calculated by DSCT using the threshold-based technique, by 2D-TTE using a modified Simpson's method, and by CMR using Simpson's method. Agreement for parameters of LV global function was determined with the Pearson's correlation coefficient (r) and Bland-Altman analysis. All the DSCT and CMR data-sets were assessed independently by two readers. Results: Fifty of the total 111 patients had aortic VHD, 29 patients had mitral VHD, and 32 patients had mixed aortic and mitral VHD. An excellent inter-observer agreement was seen for the assessment of global LV function using DSCT (r = 0.910-0.983) and CMR (r = 0.854-0.965). An excellent or good correlation (r = 0.93, 0.95, 0.87, and 0.71, respectively, P < 0.001) was noted between the DSCT and 2D-TTE values for EDV, ESV, SV, and EF. EDV (33.7 mL, P < 0.001), ESV (12.1 mL, P < 0.001), SV (21.2 mL, P < 0.001), and EF (1.6%, P = 0.019) were significantly overestimated by DSCT when compared with 2D-TTE. An excellent correlation (r = 0.96, 0.97, 0.91, and 0.94, respectively, P < 0.001) between DSCT and CMR was seen in the evaluation of EDV, ESV, SV, and EF. EDV (15.9 mL, P < 0.001), ESV (7.3 mL, P < 0.001), and SV (8.5 mL, P < 0.001) were significantly underestimated, but EF (1.1%, P = 0.002) was significantly overestimated by DSCT when compared with CMR. Conclusion: Our study showed that DSCT measurements of global LV function using the threshold-based technique were highly reproducible and compared more favorably with CMR measurements using Simpson's method than those of 2D-TTE using the modified Simpson's method. DSCT enables accurate quantification of global LV function in patients with VHD.
机译：背景：左心室（LV）功能是预后，治疗指导和心血管疾病随访的重要参数。双源计算机断层扫描（DSCT）提供了对全球左室功能的准确分析。目的：与瓣膜性心脏病（VHD）患者相比，DSCT与心血管磁共振（CMR）和二维经胸超声心动图（2D-TTE）评估在确定总体左室功能参数方面的性能。材料和方法：本研究共纳入111名VHD已知且在进行瓣膜手术前2周接受DSCT，2D-TTE和CMR的患者（58名男性，平均年龄49.9岁）。左室收缩末期容积（ESV），舒张末期容积（EDV），中风容积（SV）和射血分数（EF）通过DSCT使用基于阈值的技术计算，通过2D-TTE使用改良的Simpson方法计算，并由CMR使用辛普森的方法。 LV全局功能参数的一致性是通过Pearson相关系数（r）和Bland-Altman分析确定的。所有DSCT和CMR数据集均由两名读者独立评估。结果：111名主动脉VHD患者中有50名，二尖瓣VHD患者29名，主动脉和二尖瓣VHD混合患者32名。使用DSCT（r = 0.910-0.983）和CMR（r = 0.854-0.965）评估整体左室功能时，观察者之间达成了极好的协议。在ECT，ESV，SV和EF的DSCT和2D-TTE值之间发现了极好的或良好的相关性（分别为r = 0.93、0.95、0.87和0.71，P <0.001）。与2D-相比，DSCT显着高估了EDV（33.7 mL，P <0.001），ESV（12.1 mL，P <0.001），SV（21.2 mL，P <0.001）和EF（1.6％，P = 0.019）。 TTE。在EDV，ESV，SV和EF的评估中，DSCT和CMR之间具有极好的相关性（分别为r = 0.96、0.97、0.91和0.94，P <0.001）。 EDV（15.9 mL，P <0.001），ESV（7.3 mL，P <0.001）和SV（8.5 mL，P <0.001）被显着低估，但EF（1.1％，P = 0.002）被DSCT显着高估与CMR相比。结论：我们的研究表明，使用基于阈值的技术进行的DSCT整体左室功能测量具有较高的可重复性，与使用改进的Simpson方法进行的2D-TTE测量相比，使用Simpson方法进行的CMR测量具有更好的对比性。 DSCT可以准确量化VHD患者的整体LV功能。

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