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Pressure overloaded right ventricles: a multicenter study on the importance of trabeculae in RV function measured by CMR

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Abstract

Cardiac magnetic resonance (CMR) imaging is the preferred method to measure right ventricular (RV) volumes and ejection fraction (RVEF). This study aimed to determine the impact of excluding trabeculae and papillary muscles on RV volumes and function in patients with RV pressure and/or volume overload and healthy controls and its reproducibility using semi-automatic software. Eighty patients (pulmonary hypertension, transposition of the great arteries after arterial switch operation and after atrial switch procedure and repaired Tetralogy of Fallot) and 20 controls underwent short-axis multislice cine CMR. End diastolic volume (EDV), end systolic volume (ESV), RV mass and RVEF were measured using 2 methods. First, manual contour tracing of RV endo- and epi-cardial borders was performed. Thereafter, trabeculae were excluded from the RV blood volume using semi-automatic pixel-intensity based software. Both methods were compared using a Student T test and 25 datasets were re-analyzed for reproducibility. Exclusion of trabeculae resulted in significantly decreased EDV; ranging from −5.7 ± 1.7 ml/m2 in controls to −29.2 ± 6.6 ml/m2 in patients after atrial switch procedure. RVEF significantly increased in all groups, ranging from an absolute increase of 3.4 ± 0.8 % in healthy controls to 10.1 ± 2.3 % in patients after atrial switch procedure. Interobserver agreement of method 2 was equal to method 1 for RVEDV, RVESV and RVEF and superior for RV mass. In patients with overloaded RVs exclusion of trabeculae from the blood volume results in a significant change in RV volumes, RVEF and RV mass. Exclusion of trabeculae is highly reproducible when semi-automatic pixel-intensity based software is used.

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Authors and Affiliations

  1. Department of Cardiology, University Medical Center Utrecht, University of Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands

    Mieke M. P. Driessen, Folkert J. Meijboom & Gertjan Tj. Sieswerda

  2. The Interuniversity Cardiology Institute of The Netherlands (ICIN), Netherlands Heart Institute, PO Box 19258, 3501 DG, Utrecht, The Netherlands

    Mieke M. P. Driessen

  3. Department of Radiology, University Medical Center Utrecht, University of Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands

    Vivan J. M. Baggen, Pieter A. Doevendans & Tim Leiner

  4. Department of Radiology, University Medical Center Groningen, University of Groningen, PO Box 30001, 1 Hanzeplein, 9700 RB, Groningen, The Netherlands

    Hendrik G. Freling & Tineke P. Willems

  5. Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands

    Petronella G. Pieper

  6. Department of Cardiology, Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands

    Arie P. van Dijk

  7. Department of Pulmonology, St. Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands

    Repke J. Snijder

  8. Department of Cardiology, St. Antonius Hospital, PO Box 2500, 3430 EM, Nieuwegein, The Netherlands

    Marco C. Post

Authors
  1. Mieke M. P. Driessen
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  2. Vivan J. M. Baggen
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  3. Hendrik G. Freling
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  4. Petronella G. Pieper
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  5. Arie P. van Dijk
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  6. Pieter A. Doevendans
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  7. Repke J. Snijder
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  8. Marco C. Post
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  9. Folkert J. Meijboom
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  10. Gertjan Tj. Sieswerda
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  11. Tim Leiner
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  12. Tineke P. Willems
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Corresponding author

Correspondence to Tineke P. Willems.

Additional information

Mieke M. P. Driessen and Vivan J. M. Baggen shared first authorship.

Tim Leiner and Tineke P. Willems shared last authorship.

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Driessen, M.M.P., Baggen, V.J.M., Freling, H.G. et al. Pressure overloaded right ventricles: a multicenter study on the importance of trabeculae in RV function measured by CMR. Int J Cardiovasc Imaging 30, 599–608 (2014). https://doi.org/10.1007/s10554-014-0367-2

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  • DOI: https://doi.org/10.1007/s10554-014-0367-2

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