Elsevier

American Heart Journal

Volume 147, Issue 2, February 2004, Pages 218-223
American Heart Journal

Progress in cardiology
Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance

https://doi.org/10.1016/j.ahj.2003.10.005Get rights and content

Abstract

Background

Cardiovascular magnetic resonance (CMR) has shown excellent results for interstudy reproducibility in the assessment of left ventricular (LV) parameters. However, interstudy reproducibility data for the more complex-shaped right ventricle in a large study group have not yet been reported. We sought to determine the interstudy reproducibility of measurements of right ventricular (RV) volumes, function, and mass with CMR and compare it with correspondent LV values.

Methods

Sixty subjects (47 men; 20 healthy volunteers, 20 patients with heart failure, 20 patients with ventricular hypertrophy) underwent 2 CMR studies for assessment of RV measurements with a minimum time interval between each study.

Results

The overall interstudy reproducibility (range between groups) for the RV was 6.2% (4.2%–7.8%) for end-diastolic volume, 14.1% (8.1%–18.1%) for end-systolic volume, 8.3% (4.3%–10.4%) for ejection fraction (EF), and 8.7% (7.8%–9.4%) for RV mass. RV reproducibility was not as good as for the LV for all measures in all 3 groups, but this was only statistically significant for EF (P <.01).

Conclusions

CMR showed good interstudy reproducibility for RV function parameters in healthy subjects, patients with heart failure, and patients with hypertrophy, which suggests that CMR is reliable for serial RV assessment. These data can be used to power sample sizes for longitudinal research studies of RV volume and function. The reproducibility values were similar to, but generally lower than, the reproducibility values for the LV in the same study population, which indicates that sample sizes for RV studies are in general larger than those for LV studies.

Section snippets

Study population

The population has been previously reported on for assessment of reproducibility of LV functional parameters.4 In brief, we investigated 60 subjects (47 men; mean age, 51 ± 18 years). The study group consisted of 20 healthy volunteers without cardiac history or risk factors, 20 patients with previously documented LV hypertrophy (LVH), and 20 patients with stable congestive heart failure (CHF) of ischemic or dilated cardiomyopathy origin who had a dilated left ventricle with systolic dysfunction

Results

CMR was well tolerated by all subjects. The age and sex distribution of all 3 subgroups and the RV parameters are listed in Table I. Healthy subjects were significantly younger than members of the other 2 groups (P <.001), but there were no differences in body habitus. RV EDV, ESV, and mass were comparable in the subgroups. RV stroke volume and EF were decreased in the heart failure group compared with healthy subjects and paients with LVH (P <.01).

Importance of the right ventricle

The importance of the right ventricle in cardiac disease has been underestimated in the past, and early reports suggested that RV pump function is not relevant to overall cardiac function.25, 26 More recent studies show, however, that RV function is a major determinant of prognosis in myocardial infarction27 and cardiac symptoms and exercise capacity in chronic heart failure.28, 29 Similarly, RV function in congenital heart disease is a key clinical issue.30 Because of ventricular interaction,

References (50)

  • B.J Baker et al.

    Relation of right ventricular ejection fraction to exercise capacity of patients with chronic left ventricular failure

    Am J Cardiol

    (1984)
  • T.S Hornung et al.

    Excessive right ventricular hypertrophic response in adults with the mustard procedure for transposition of the great arteries

    Am J Cardiol

    (2002)
  • K.T Weber et al.

    Contractile mechanics and interaction of the right and left ventricles

    Am J Cardiol

    (1981)
  • L La Vecchia et al.

    Reduced right ventricular ejection fraction as a marker for idiopathic dilated cardiomyopathy compared with ischemic left ventricular dysfunction

    Am Heart J

    (2001)
  • B.V Manno et al.

    Right ventricular functionmethodologic and clinical considerations in noninvasive scintigraphic assessment

    J Am Coll Cardiol

    (1984)
  • K.M McDonald et al.

    Rapid, accurate and simultaneous noninvasive assessment of right and left ventricular mass with nuclear magnetic resonance imaging using the snapshot gradient method

    J Am Coll Cardiol

    (1992)
  • P.M Pattynama et al.

    Reproducibility of MRI-derived measurements of right ventricular volumes and myocardial mass

    Magn Reson Imaging

    (1995)
  • U Sechtem et al.

    Measurement of right and left ventricular volumes in healthy individuals with cine MR imaging

    Radiology

    (1987)
  • D.N Firmin et al.

    In vivo validation of magnetic resonance velocity imaging

    J Comput Assist Tomogr

    (1987)
  • R.C Semelka et al.

    Normal left ventricular dimensions and functioninterstudy reproducibility of measurements with cine MR imaging

    Radiology

    (1990)
  • P.M Pattynama et al.

    Left ventricular measurements with cine and spin-echo MR imaginga study of reproducibility with variance component analysis

    Radiology

    (1993)
  • N.G Bellenger et al.

    Reduction in sample size for studies of remodelling in heart failure by the use of cardiovascular magnetic resonance

    J Cardiovasc Magn Reson

    (2000)
  • C.H Lorenz et al.

    Normal human right and left ventricular mass, systolic function and gender differences by cine magnetic resonance imaging

    J Cardiovasc Magn Reson

    (1999)
  • W Markiewiczk et al.

    Measurement of ventricular volumes in the dog by nuclear magnetic resonance imaging

    J Am Coll Cardiol

    (1987)
  • J Mogelvang et al.

    Evaluation of right ventricular volumes measured by magnetic resonance imaging

    Eur Heart J

    (1988)
  • Cited by (0)

    Supported by CORDA and the Wellcome Trust (London, UK), ADUMED Foundation (Zurich, Switzerland), GlaxoSmithKline (Harlow, UK), and the British Heart Foundation (London, UK).

    View full text