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Cardiovascular magnetic resonance of cardiac morphology and function: impact of different strategies of contour drawing and indexing

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Abstract

Background

Cardiovascular magnetic resonance (CMR) is the gold standard for the quantitative assessment of cardiac volumes, mass and function. There are, however, various strategies for establishing endocardial borders, the cardiac phase used for measurements and the body dimensions used for indexing these results. The aim of the study was to assess the impact of different strategies on reference values.

Methods and results

362 healthy volunteers (190 men, mean age 51 ± 13 years) underwent a standard CMR protocol. Left ventricular end-diastolic (LV-EDV) and end-systolic (LV-ESV) volumes and LV mass (LV-M) were measured at end systole and end diastole in SSFP sequences using two methods, one of which included papillary muscles and trabecular tissue in the LV-M (“include” approach), while the other excluded this tissue (“exclude” approach). There was a strong correlation between the results for LV volumes and LV ejection fraction (LV-EF) between the “include” and the “exclude” approach, while the mean values were different: LV-EDV: 149.7 ± 32.5 ml vs 160.5 ± 35.0 ml, p < 0.0001; LV-ESV: 48.7 ± 14.5 ml vs 56.4 ± 16.7 ml, p < 0.0001; LV-EF: 67.7 ± 5.4% vs 65.1 ± 5.6%, p < 0.0001. When comparing end-systolic with end-diastolic data, values for LV-M were significantly higher in end systole irrespective of whether papillary muscles and trabecular tissues were included or not. Furthermore, LV-M missed overweight-induced LV hypertrophy when indexed to body surface area (BSA) instead of height.

Conclusion

Quantitative assessment of LV volumes and mass with inclusion of papillary muscles and trabeculae to myocardial mass resulted in significantly different values, while indexing to BSA and not height may miss LV hypertrophy in terms of overweight.

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Abbreviations

CMR:

Cardiovascular magnetic resonance

LV:

Left ventricular

RV:

Right ventricular

LV-EDV:

Left ventricular end-diastolic volume

LV-ESV:

Left ventricular end-systolic volume

RV-EDV:

Right ventricular enddiastolic volume

RV-ESV:

Right ventricular endsystolic volume

LV-EF:

Left ventricular ejection fraction

LV-M:

LV mass

BSA:

Body surface area

SSFP:

Steady-state free precession

SD:

Standard deviation

FIG:

Figure

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Acknowledgements

We thank our technologists Daniel Helm, Melanie Feiner, Miriam Hess and Leonie Siegmund for image acquisition.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany

    Johannes H. Riffel, Katharina Schmucker, Florian Andre, Marco Ochs, Kristof Hirschberg, Ebe Schaub, Thomas Fritz, Matthias Mueller-Hennessen, Evangelos Giannitsis, Hugo A. Katus & Matthias G. Friedrich

  2. DZHK (German Centre for cardiovascular Research), partner site Heidelberg, Heidelberg, Germany

    Matthias Mueller-Hennessen, Evangelos Giannitsis, Hugo A. Katus & Matthias G. Friedrich

Authors
  1. Johannes H. Riffel
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  2. Katharina Schmucker
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  3. Florian Andre
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  4. Marco Ochs
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  5. Kristof Hirschberg
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  6. Ebe Schaub
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  7. Thomas Fritz
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  8. Matthias Mueller-Hennessen
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  9. Evangelos Giannitsis
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  10. Hugo A. Katus
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  11. Matthias G. Friedrich
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Contributions

JR—drafting of the manuscript, acquisition and analysis of data, interpretation of data. KS—drafting of the manuscript, analysis and interpretation of data. FA—acquisition of data, analysis and interpretation of data. MO—acquisition of data, revising the manuscript critically for important intellectual content. KH—acquisition of data, revising the manuscript critically for important intellectual content. ES—acquisition of data, revising the manuscript critically for important intellectual content. TF—analysis of data, revising the manuscript critically for important intellectual content. MM—acquisition of data, revising the manuscript critically for important intellectual content. EG—analysis and interpretation of data, revising the manuscript critically for important intellectual content. HK—drafting of the manuscript, final approval of the manuscript submitted. MF—drafting of the manuscript, conception and design, analysis and interpretation of data.

Corresponding author

Correspondence to Johannes H. Riffel.

Ethics declarations

Conflict of interest

Matthias G. Friedrich is advisor, board member and shareholder of Circle Cardiovascular Imaging Inc., Calgary.

Ethics approval

The study was approved by the local ethics committee (Ethikkommission Medizinische Fakultät Heidelberg (S038-2007)).

Consent for publication

Not applicable.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Supplementary material 1 (DOCX 22 KB)

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Riffel, J.H., Schmucker, K., Andre, F. et al. Cardiovascular magnetic resonance of cardiac morphology and function: impact of different strategies of contour drawing and indexing. Clin Res Cardiol 108, 411–429 (2019). https://doi.org/10.1007/s00392-018-1371-7

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  • DOI: https://doi.org/10.1007/s00392-018-1371-7

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