Abstract

Aims: To determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and cardiovascular magnetic resonance (CMR) in left ventricular (LV) function [including end-systolic volume (LVESV), end-diastolic volume (LVEDV), and ejection fraction (LVEF)] in chronic total occlusion (CTO) patients.Methods: Eighty-eight CTO patients were enrolled in this study. All patients underwent 2DTTE and CMR within 1 week. The correlation and agreement of LVEF, LVESV, and LVEDV as measured by 2DTTE and CMR were assessed using Pearson correlation, Kappa analysis, and Bland–Altman method.Results: The mean age of patients enrolled was 57 ± 10 years. There was a strong correlation (r = 0.71, 0.90, and 0.80, respectively, all P < 0.001) and a moderately strong agreement (Kappa = 0.62, P < 0.001) between the two modalities in measurement of LV function. The agreement in patients with EF ≧50% was better than in those with an EF <50%. CTO patients without echocardiographic wall motion abnormality (WMA) had stronger intermodality correlations (r = 0.84, 0.96, and 0.87, respectively) and smaller biases in LV function measurement.Conclusions: The difference in measurement between 2DTTE and CMR should be noticed in CTO patients with EF <50% or abnormal ventricular motion. CMR should be considered in these conditions.

Highlights

  • For patients with coronary chronic total occlusion (CTO), left ventricular (LV) function assessment before revascularization is crucial for clinical decision-making and has reference value in evaluating the improvement of cardiac function status after revascularization [1, 2]

  • A total of 88 patients with 90 CTO vessels were included in this study

  • Most of CTO lesions located in the right coronary artery (RCA) (44.4%), followed by left ascending branch (LAD) (40.0%) and left circumflex branch (LCX) (15.6%)

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Summary

Introduction

For patients with coronary chronic total occlusion (CTO), left ventricular (LV) function assessment before revascularization is crucial for clinical decision-making and has reference value in evaluating the improvement of cardiac function status after revascularization [1, 2]. LV function can be measured by several non-invasive cardiac imaging modalities, including echocardiography, cardiac magnetic resonance (CMR), and cardiac computed tomography. Many studies regarding the comparison among these techniques have been reported. Most of them enroll healthy subjects or patients with different cardiac diseases. Data about the agreement in ventricular function determined by these different modalities in CTO patients are still sparse. The aim of this study was to determine the agreement between two-dimensional transthoracic echocardiography (2DTTE) and CMR in the assessment of LV function in CTO patients

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