Suchergebnisse

Introduction: Both echocardiography and CMR imaging are used to quantify longitudinal function. Inter-method variability for mitral (MAPSE) and tricuspid (TAPSE) annular plane systolic excursion, and variability between directly measured MAPSE and TAPSE and as based on atrioventricular plane displacement (AVPD) analysis by CMR, are, however, not known. This study, therefore, assessed inter-method variability and variability between annular plane systolic excursion and AVPD-based values in a healthy adult population. Methods: Echocardiography and CMR were performed in 111 adults (35 [32–38] years). Method comparisons were assessed with Deming regression, Bland–Altman analysis and coefficient of variation. Observer reproducibility was assessed by the concordance correlation coefficient. Results: Echocardiography and semi-automatic CMR agreed on MAPSE (17 ± 2 mm vs. 17 ± 2 mm, p = 0.1) and TAPSE (25 ± 3 mm vs. 25 ± 3 mm, p = 0.5), correlated highly between methods (fitted-slope 1.22 [95% CI 1.07–1.38] and 1.12 [95% CI 0.95–1.29]) and showed low bias (0.42 [95% CI − 2.05 to 2.88] and − 0.18 [95% CI − 4.78 to 4.43]). Intra-/ inter-observer reproducibility was high for both methods for both. MAPSE (echocardiography 0.96/0.86; CMR 0.87/0.85) and TAPSE (echocardiography 0.96/0.95; CMR 0.97/0.96). MAPSE (16 ± 2 mm vs. 17 ± 2 mm; p < 0.001) and TAPSE (24 ± 3 vs. 25 ± 3 mm; p < 0.001) based on AVPD were similar but statistically different compared with semi-automatic CMR. Conclusions: Echocardiography and semi-automatic CMR have low variability and provide similar values for MAPSE and TAPSE and are thus interchangeable for follow- up studies. Lateral values based on tracked data from AVPD analysis are not clinically significantly different and could be used as a representation of annular displacement. ; Erasmus Mundus Region of Skane Skane University Hospital Lund Medical Faculty at Lund University Knut & Alice Wallenberg Foundation Instituto de Salud Carlos III European Commission PI15/00130 PI14/00226 PI17/00675 INT16/00168 por el ISCIII-Subdireccion General de Evaluacion y el Fondo Europeo de Desarrollo Regional (FEDER) `Otra manera de hacer Europa' (Spain) Erasmus + Programme of the European Union 2013-0040 La Caixa Foundation LCF/PR/GN14/10270005 AGAUR 2014 SGR grant 928 Swedish Heart-Lung Foundation ; Versión publicada - versión final del editor

Objective: There is a need for standardized reference values for cardiac dimensions in prenatal life. The objective of the present study was to construct nomograms for fetal cardiac dimensions using a well-defined echocardiographic methodology in a low-risk population. Methods: This is a prospective cohort study including 602 low-risk singleton pregnancies undergoing a standardized fetal echocardiography to accurately assess fetal cardiac, ventricular, and atrial dimensions. Parametric regressions were tested to model each measurement against gestational age from 18 to 41 weeks of gestation. Results: Nomograms were constructed for fetal cardiac dimensions (transverse and longitudinal diameters and areas) of the whole heart, atria, and ventricles, as well as myocardial wall thicknesses. All dimensions showed a progressive increase with gestational age. The best model for most parameters was a second-degree linear polynomial. Fetal cardiac, ventricular, and atrial diameters and areas were successfully obtained in 98.6% of the fetuses, while myocardial wall thicknesses could be obtained in 96.5% of the population. The results showed excellent interobserver and intraobserver reproducibility (intraclass correlation coefficient, ICC > 0.811 and ICC > 0.957, respectively). Conclusions: We provide standardized and comprehensively evaluated reference values for fetal cardiac morphometric parameters across gestation in a low-risk population. These no mograms would enable the early identification of different patterns of fetal cardiac remodeling. ; European Union (EU) 2013-0040 La Caixa Foundation LCF/PR/GN14/10270005 Instituto de Salud Carlos III PI14/00226 INT16/00168 PI17/00675 PI15/00263 PI15/00130 Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK) AGAUR 2017 SGR grant 1531 Ajut Josep Font (Hospital Clinic de Barcelona, Spain) Agencia de Gestio D'Ajuts Universitaris de Recerca Agaur (AGAUR) 2016FI_B01184