Reproducibility of Semi-automated Three-dimensional Volumetric Analysis using Cardiac Computed Tomography in Patients With Left Ventricular Assist Device.

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 20(5):381-386, 2019 05.PMID: 30772192Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Heart Failure/th [Therapy] | *Heart-Assist Devices | *Imaging, Three-Dimensional | *Multidetector Computed Tomography | *Prosthesis Implantation/is [Instrumentation] | *Stroke Volume | *Ventricular Dysfunction, Left/th [Therapy] | *Ventricular Function, Left | Automation | Cardiac-Gated Imaging Techniques | Electrocardiography | Female | Heart Failure/dg [Diagnostic Imaging] | Heart Failure/pp [Physiopathology] | Humans | Male | Middle Aged | Observer Variation | Predictive Value of Tests | Reproducibility of Results | Retrospective Studies | Treatment Outcome | Ventricular Dysfunction, Left/dg [Diagnostic Imaging] | Ventricular Dysfunction, Left/pp [Physiopathology]Year: 2019Local holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Multi-detector gated cardiac computed tomography (CCT) allows three-dimensional (3D) quantification of cardiac chambers and is clinically indicated to assess left ventricular assist device (LVAD) malfunction and complications. Automated volumetric analysis is, however, disrupted by inflow cannula artifact in patients with LVAD. With this study, we evaluated intra-observer variability in semi-automated 3D cardiac volumetric analysis using CCT in patients with LVADs.CONCLUSIONS: Our results for semi-automated 3D volumetric analysis showed excellent reproducibility for both volumetric and derived data.Copyright (c) 2019 Elsevier Inc. All rights reserved.METHODS: Ten clinically indicated CCTs were studied retrospectively from 9 patients with LVADs. 3D chamber quantification included left and right ventricles end-systolic and end-diastolic volumes (ESV, EDV); and left and right atrial ESV. Derived measurements included cardiac output (CO), ejection fraction (EF), and stroke volume (SV). Automated volumetric analysis was performed, and manual corrections were added when necessary. Absolute and relative differences, Bland-Altman plots, and interclass correlation coefficients (ICCs) were used to assess intra-observer reproducibility for these measurements.RESULTS: Intra-observer reproducibility was excellent for volumetric (ICC >0.99) and derived data (ICC >0.91). Comparing right vs left heart volumetric assessments, the former had a higher relative difference (atria 2.8% vs 1.6%, ESV 3.0% vs 1.9%, EDV 2.7% vs 1.3%), which also translated to a greater relative difference in right-side derived data (CO 11.1% vs. 8.8%, EF 10.5% vs. 9.9%, SV 10.9% vs. 9.0%). The mean difference in left ventricular ejection fraction was 0.4% (limits of agreement [LOA]: -2 and 3.2) and right ventricular ejection fraction was 1.2% (LOA: -4.7 and 7.1).SUMMARY: Electrocardiography-gated cardiac computed tomography with semi-automated volumetric analysis has excellent reproducibility in patients with left ventricular assist device making it imaging modality of choice for functional assessment in this patient population, where cardiac magnetic resonance imaging is contraindicated and transthoracic echocardiography may be limited by poor acoustic windows.All authors: Garcia-Garcia HM, Gill GS, Medvedofsky D, Meirovich YF, Mohammed SF, Waksman R, Weissman GOriginally published: Cardiovascular Revascularization Medicine. 2019 Jan 23Fiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-03-14
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30772192 Available 30772192

Available in print through MWHC library: 2002 - present

BACKGROUND: Multi-detector gated cardiac computed tomography (CCT) allows three-dimensional (3D) quantification of cardiac chambers and is clinically indicated to assess left ventricular assist device (LVAD) malfunction and complications. Automated volumetric analysis is, however, disrupted by inflow cannula artifact in patients with LVAD. With this study, we evaluated intra-observer variability in semi-automated 3D cardiac volumetric analysis using CCT in patients with LVADs.

CONCLUSIONS: Our results for semi-automated 3D volumetric analysis showed excellent reproducibility for both volumetric and derived data.

Copyright (c) 2019 Elsevier Inc. All rights reserved.

METHODS: Ten clinically indicated CCTs were studied retrospectively from 9 patients with LVADs. 3D chamber quantification included left and right ventricles end-systolic and end-diastolic volumes (ESV, EDV); and left and right atrial ESV. Derived measurements included cardiac output (CO), ejection fraction (EF), and stroke volume (SV). Automated volumetric analysis was performed, and manual corrections were added when necessary. Absolute and relative differences, Bland-Altman plots, and interclass correlation coefficients (ICCs) were used to assess intra-observer reproducibility for these measurements.

RESULTS: Intra-observer reproducibility was excellent for volumetric (ICC >0.99) and derived data (ICC >0.91). Comparing right vs left heart volumetric assessments, the former had a higher relative difference (atria 2.8% vs 1.6%, ESV 3.0% vs 1.9%, EDV 2.7% vs 1.3%), which also translated to a greater relative difference in right-side derived data (CO 11.1% vs. 8.8%, EF 10.5% vs. 9.9%, SV 10.9% vs. 9.0%). The mean difference in left ventricular ejection fraction was 0.4% (limits of agreement [LOA]: -2 and 3.2) and right ventricular ejection fraction was 1.2% (LOA: -4.7 and 7.1).

SUMMARY: Electrocardiography-gated cardiac computed tomography with semi-automated volumetric analysis has excellent reproducibility in patients with left ventricular assist device making it imaging modality of choice for functional assessment in this patient population, where cardiac magnetic resonance imaging is contraindicated and transthoracic echocardiography may be limited by poor acoustic windows.

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