Cardiovascular magnetic resonance (CMR) is an accurate tool for the determination of right and left ventricular volumes and ejection fractions. However, the current standard short-axis technique is time-consuming and thus, often not practicable for routine daily use, because papillary muscles and trabeculations have to be marked and their volumes subtracted from the total ventricular volume. To reduce calculation time we evaluated the volumetric data that included papillary muscle and trabecular volumes and compared the outcome with the results of the standard technique. Thirty patients (17 healthy, 13 with coronary heart disease) were examined by CMR using TrueFISP (Magnetom, Siemens, Erlangen, Germany). Right and left ventricular volumes and ejection fractions were calculated using the standard short-axis technique and then again without subtracting papillary and trabecular volumes. The two methods were compared by determining the differences in results for ventricular volumes and ejection fractions. Statistically significant differences were found between the two methods for right and left ventricular stroke volumes and end-systolic volumes, and left ventricular end-diastolic volumes (EDV) (p < or = 0.011). No significant difference was found for right ventricular end-diastolic volumes (p > or = 0.149) or left or right ventricular ejection fraction (p > or = 0.130). Except in the case of left ventricular EDV, the deviations in the results of method 1 and method 2 did not vary significantly with the presence or absence of heart disease. Measurements were obtained considerably more quickly with the modified method than with the standard short-axis method (25 +/- 4 min vs. 13 +/- 3 min, p = 0.000). Although systematic differences were found when papillary and trabecular volumes were not subtracted, these differences are small and may not be of clinical relevance in healthy subjects or patients with coronary heart disease. Not subtracting the volumes of these structures enables faster determination of right and left ventricular volumes and ejection fractions without loss of the accuracy associated with the standard short-axis technique.
Right ventricular wall motion abnormalities are one of the criteria for the diagnosis of arrhythmogenic right ventricular cardiomyopathy. However, our findings indicate that they may also be seen around the insertion of the moderator band in healthy subjects, so that the significance of their presence at this site in patients undergoing diagnostic investigations for this disease should be interpreted with caution.
The single and biplane methods, regardless of whether TrueFISP or FLASH is used, are a reasonable and rapid alternative to the conventional short-axis approach for left ventricular volume and EF assessment in patients with heart failure and impaired ventricular function.
LAEDD differ significantly according to the image plane. We provide reference values for CMR using prospective triggering in the evaluation of left atrial diameters to identify patients with enlarged left atria and for follow-up studies.
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