Left atrial 4D flow cardiovascular magnetic resonance: a reproducibility study in sinus rhythm and atrial fibrillation

Autor: Vanessa M Ferreira, Peter Manley, Guilherme Pessoa-Amorim, Aaron T. Hess, Alison M Fletcher, Stefan Neubauer, Barbara Casadei, Antonio Stracquadanio, Adam Von Ende, Rohan S. Wijesurendra, Marco Spartera
Rok vydání: 2021
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Velocities
4D flow
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
0302 clinical medicine
Heart Rate
Atrial Fibrillation
Sinus rhythm
Prospective Studies
Observer Variation
Radiological and Ultrasound Technology
medicine.diagnostic_test
Atrial fibrillation
Middle Aged
Stasis
Reproducibility
Left atrium
Cardiology
Atrial Function
Left

Female
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
Magnetic Resonance Imaging
Cine

03 medical and health sciences
Predictive Value of Tests
Internal medicine
Heart rate
medicine
Humans
Radiology
Nuclear Medicine and imaging

Heart Atria
Thrombus
Aged
Angiology
business.industry
Research
Reproducibility of Results
Magnetic resonance imaging
Blood flow
medicine.disease
Cardioembolic risk
Vorticity
Blood pressure
lcsh:RC666-701
Case-Control Studies
Cardiovascular magnetic resonance
business
Vortex
Zdroj: Journal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-11 (2021)
Journal of Cardiovascular Magnetic Resonance
ISSN: 1532-429X
Popis: Background Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) allows sophisticated quantification of left atrial (LA) blood flow, and could yield novel biomarkers of propensity for intra-cardiac thrombus formation and embolic stroke. As reproducibility is critically important to diagnostic performance, we systematically investigated technical and temporal variation of LA 4D flow in atrial fibrillation (AF) and sinus rhythm (SR). Methods Eighty-six subjects (SR, n = 64; AF, n = 22) with wide-ranging stroke risk (CHA2DS2VASc 0–6) underwent LA 4D flow assessment of peak and mean velocity, vorticity, vortex volume, and stasis. Eighty-five (99%) underwent a second acquisition within the same session, and 74 (86%) also returned at 30 (27–35) days for an interval scan. We assessed variability attributable to manual contouring (intra- and inter-observer), and subject repositioning and reacquisition of data, both within the same session (same-day scan–rescan), and over time (interval scan). Within-subject coefficients of variation (CV) and bootstrapped 95% CIs were calculated and compared. Results Same-day scan–rescan CVs were 6% for peak velocity, 5% for mean velocity, 7% for vorticity, 9% for vortex volume, and 10% for stasis, and were similar between SR and AF subjects (all p > 0.05). Interval-scan variability was similar to same-day scan–rescan variability for peak velocity, vorticity, and vortex volume (all p > 0.05), and higher for stasis and mean velocity (interval scan CVs of 14% and 8%, respectively, both p 0.05). SR subjects showed significantly greater interval-scan variability than AF patients for mean velocity, vortex volume, and stasis (all p 0.05). Conclusions LA peak velocity and vorticity are the most reproducible and temporally stable novel LA 4D flow biomarkers, and are robust to changes in heart rate, blood pressure, and differences in heart rhythm.
Databáze: OpenAIRE