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Cardiovascular magnetic resonance validation of fractional changes in annulo‐apical angles and tricuspid annular plane systolic excursion for rapid assessment of right ventricular systolic function
Author(s) -
Zakeri Simon A.,
Panayotova Rosica,
Borg Alexander N.,
Miller Christopher A.,
Schmitt Matthias
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24342
Subject(s) - intraclass correlation , cardiology , medicine , ejection fraction , receiver operating characteristic , cardiac magnetic resonance imaging , magnetic resonance imaging , heart failure , radiology , clinical psychology , psychometrics
Purpose To evaluate the use of right ventricular (RV) annulo‐apical angle (AA) changes acquired by magnetic resonance imaging (MRI), alongside tricuspid annular plane systolic excursion (TAPSE), for its association with RV systolic function. Materials and Methods Thirty patients with varying RV dysfunction and 10 normal controls were enrolled and scanned after obtaining written consent. Systolic change in AAs, alpha (α), beta (β), and theta (θ), subtended by a triangle connecting the septal and lateral extent of the tricuspid valve annulus and RV apex, and TAPSE were measured. Spearman rank correlations of parameters with RV ejection fraction (RVEF) were performed. Receiver operating characteristic (ROC) analysis was used to determine accuracy of these surrogate markers for detecting abnormal RVEF. Results Correlations with RVEF included: TAPSE ( r = 0.74 P < 0.001), fractional systolic changes in α angle (0.64, P < 0.001), β angle (−0.39, P < 0.05), and θ angle (−0.77, P < 0.001). The best markers for RVEF <50% were fractional θ angle change ≥ –25.5% (eg, −24%) (sensitivity of 97% and specificity of 91%), and TAPSE ≤1.87 cm (sensitivity of 100% and specificity of 82%). Intra‐ and inter‐observer agreement was excellent, with intraclass correlation coefficients for fractional θ angle change (intra = 0.96, inter = 0.94) and TAPSE (intra = 0.98, inter = 0.87). Conclusion Fractional θ angle change is a useful semiquantitative parameter associated with the presence and severity of RV systolic dysfunction, with high observer agreement. J. Magn. Reson. Imaging 2014;40:133–139 . © 2013 Wiley Periodicals, Inc .