학술논문

Left ventricular fibrosis in arrhythmic mitral valve prolapse: quantification and comparison of semi-automated techniques assessed by cardiac magnetic resonance.
Document Type
Academic Journal
Author
Cecere A; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; Cipriani A; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; De Lazzari M; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; Graziano F; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; Brunetti G; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; De Conti G; Radiology Unit, University of Padua-Azienda Ospedaliera, Padua, Italy.; Motta R; Department of Medicine, University of Padua-Azienda Ospedaliera, Padua, Italy.; Ravagnin A; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; Lorenzoni G; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy.; Gregori D; Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, Unit of Biostatistics, Epidemiology and Public Health, University of Padova, Padova, Italy.; Basso C; Cardiovascular Pathology Unit, University Hospital of Padua, Padua, Italy.; Tona F; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; Lee YJ; Clinical Radiology, Cardiac and Pulmonary Imaging, University of California, San Francisco, CA, USA.; Delling FN; Department of Medicine (Cardiovascular Division), University of California San Francisco, San Francisco, CA, USA.; Iliceto S; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy.; Marra MP; Cardiology Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua-Azienda Ospedaliera, Via Giustiniani, 2, 35128, Padua, Italy. martina.perazzolomarra@unipd.it.
Source
Publisher: Springer Country of Publication: United States NLM ID: 100969716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1875-8312 (Electronic) Linking ISSN: 15695794 NLM ISO Abbreviation: Int J Cardiovasc Imaging Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: Left ventricular (LV) fibrosis has a key role in arrhythmogenesis in patients with mitral valve prolapse (MVP). Cardiac magnetic resonance identifies LV fibrosis by using late gadolinium enhancement (LGE) technique. LGE assessment and quantification in patients with MVP lacks of standardization protocols.
Methods: 66 MVP patients with normal systolic function and without significant regurgitation were enrolled. Semi-automated gray-scale thresholding techniques using full width at half maximum (FWHM) and 2, 3 and 5 standard deviation (SD) above the remote myocardium were used and compared with the visual assessment, considered as the gold standard.
Results: LGE was identified in 41 MVP patients (62%) and quantified. The mean quantity of LGE visually assessed was 2.40 ± 1.07% or 1.40 ± 0.82 g. With FWHM, LGE resulted 3.56 ± 1.23% or 1.99 ± 1.13 g. Using thresholding, the mean LGE quantity was 9.2 ± 3.1% or 4.82 ± 2.28 g for 2-SD, 5.72 ± 1.75% or 3.06 ± 1.47 g for 3-SD and 2.36 ± 0.99% or 1.29 ± 0.79 g for 5-SD. The 5-SD measurement in percentage demonstrated a good correlation with LGE quantification visually assessed (2.40 ± 1.07 vs. 2.363 ± 0.9909, p = 0.543). When compared with the gold standard, the 5-SD threshold quantification, both in percentage and in grams, revealed the least intra-observer (respectively, ICC: 0.976 and 0.966) and inter-observer variability (respectively ICC: 0.948 and 0.935).
Conclusion: The 5-SD gray-scale threshold technique in percentage revealed the best correlation with the visual assessment and an optimal reproducibility in MVP patient.
(© 2023. The Author(s).)