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Evaluation of single right atrial volume and function with magnetic resonance imaging in children with hypoplastic left heart

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Abstract

Background

Standardized methods to evaluate atrial properties in single ventricles are lacking.

Objective

To determine the feasibility of quantifying right atrial volumes and function in hypoplastic left heart using MRI.

Materials and methods

We studied 15 infants with hypoplastic left heart prior to Glenn surgery (mean age 4.2 months [standard deviation 0.3]) who underwent cardiac MRI with evaluation of atrial volumes and emptying fraction using monoplane two-chamber, monoplane four-chamber, and biplane methods, all of which were compared to the atrial short-axial oblique stack method. We compared atrial end-diastolic volume, end-systolic volume and emptying fraction among these methods. We analyzed reproducibility of the methods using Bland‒Altman plots.

Results

Both four-chamber and biplane methods showed high correlations for atrial end-diastolic volume (r = 0.7 and r = 0.8, respectively; P < 0.01) and end-systolic volume (r = 0.8 and r = 0.9, respectively; P < 0.01) with small mean differences (−0.2 ± 2.9 standard deviation [SD] ml and −0.8 ± 1.6 ml, respectively, for atrial end-diastolic volume and −0.8 ± 1.5 ml and −0.9 ± 0.9 ml, respectively, for atrial end-systolic volume). The short-axial oblique method was the most reproducible, followed by the four-chamber method.

Conclusion

MRI assessment of atrial volume and function is feasible in hypoplastic left heart and might provide further insight into single-ventricle mechanics.

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Acknowledgments

We thank the staff and administrators of the cardiac MRI units at Alberta Children’s Hospital, Calgary, and the Mazankowski Alberta Heart Institute, University of Alberta, for their great assistance with the images and manuscript preparation. We would like to specifically acknowledge Dr. Julaporn Pooliam of the Clinical Epidemiology Unit Center, Office of Research and Development and the Faculty of Medicine, Siriraj Hospital, Mahidol University, for her assistance with the statistics.

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Authors and Affiliations

  1. Faculty of Medicine and Dentistry, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada

    Chodchanok Vijarnsorn, Michelle Noga, Cinzia Crawley & Edythe Tham

  2. Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok, 10700, Thailand

    Chodchanok Vijarnsorn

  3. Section of Pediatric Cardiology, Department of Pediatrics, Department of Pediatrics, Alberta Children’s Hospital, Calgary, AB, Canada

    Kimberley Myers & David J. Patton

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  1. Chodchanok Vijarnsorn
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Correspondence to Chodchanok Vijarnsorn.

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Appendix

Appendix

Table 4 Mean difference (bias) and limit of agreement with 95% confidence interval of atrial end-diastolic volume, atrial end-systolic volume and atrial emptying fraction between short-axial oblique method and monoplane four-chamber, monoplane two-chamber and biplane methods (n = 15)
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Vijarnsorn, C., Myers, K., Patton, D.J. et al. Evaluation of single right atrial volume and function with magnetic resonance imaging in children with hypoplastic left heart. Pediatr Radiol 46, 991–1002 (2016). https://doi.org/10.1007/s00247-015-3534-2

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  • DOI: https://doi.org/10.1007/s00247-015-3534-2

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