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Cardiac output and cardiac index measured with cardiovascular magnetic resonance in healthy subjects, elite athletes and patients with congestive heart failure

Carlsson, Marcus LU ; Andersson, Ruslana LU ; Markenroth Bloch, Karin LU ; Steding Ehrenborg, Katarina LU ; Mosén, Henrik LU ; Ståhlberg, Freddy LU ; Lövgren-Ekmehag, Björn LU and Arheden, Håkan LU (2012) In Journal of Cardiovascular Magnetic Resonance 14.
Abstract
Background: Cardiovascular Magnetic Resonance (CMR) enables non-invasive quantification of cardiac output (CO) and thereby cardiac index (CI, CO indexed to body surface area). The aim of this study was to establish if CI decreases with age and compare the values to CI for athletes and for patients with congestive heart failure (CHF). Methods: CI was measured in 144 healthy volunteers (39 +/- 16 years, range 21-81 years, 68 females), in 60 athletes (29 +/- 6 years, 30 females) and in 157 CHF patients with ejection fraction (EF) below 40% (60 +/- 13 years, 33 females). CI was calculated using aortic flow by velocity-encoded CMR and is presented as mean +/- SD. Flow was validated in vitro using a flow phantom and in 25 subjects with aorta and... (More)
Background: Cardiovascular Magnetic Resonance (CMR) enables non-invasive quantification of cardiac output (CO) and thereby cardiac index (CI, CO indexed to body surface area). The aim of this study was to establish if CI decreases with age and compare the values to CI for athletes and for patients with congestive heart failure (CHF). Methods: CI was measured in 144 healthy volunteers (39 +/- 16 years, range 21-81 years, 68 females), in 60 athletes (29 +/- 6 years, 30 females) and in 157 CHF patients with ejection fraction (EF) below 40% (60 +/- 13 years, 33 females). CI was calculated using aortic flow by velocity-encoded CMR and is presented as mean +/- SD. Flow was validated in vitro using a flow phantom and in 25 subjects with aorta and pulmonary flow measurements. Results: There was a slight decrease of CI with age in healthy subjects (8 ml/min/m(2) per year, r(2) = 0.07, p = 0.001). CI in males (3.2 +/- 0.5 l/min/m(2)) and females (3.1 +/- 0.4 l/min/m(2)) did not differ (p = 0.64). The mean +/- SD of CI in healthy subjects in the age range of 20-29 was 3.3 +/- 0.4 l/min/m(2), in 30-39 years 3.3 +/- 0.5 l/min/m(2), in 40-49 years 3.1 +/- 0.5 l/min/m(2), 50-59 years 3.0 +/- 0.4 l/min/m(2) and >60 years 3.0 +/- 0.4 l/min/m(2). There was no difference in CI between athletes and age-controlled healthy subjects but HR was lower and indexed SV higher in athletes. CI in CHF patients (2.3 +/- 0.6 l/min/m(2)) was lower compared to the healthy population (p < 0.001). There was a weak correlation between CI and EF in CHF patients (r(2) = 0.07, p < 0.001) but CI did not differ between patients with NYHA-classes I-II compared to III-IV (n = 97, p = 0.16) or patients with or without hospitalization in the previous year (n = 100, p = 0.72). In vitro phantom validation showed low bias (-0.8 +/- 19.8 ml/s) and in vivo validation in 25 subjects also showed low bias (0.26 +/- 0.61 l/min, QP/QS 1.04 +/- 0.09) between pulmonary and aortic flow. Conclusions: CI decreases in healthy subjects with age but does not differ between males and females. We found no difference in CI between athletes and healthy subjects at rest but CI was lower in patients with congestive heart failure. The presented values can be used as reference values for flow velocity mapping CMR. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac output, Heart failure, Left ventricle, Cardiovascular magnetic, resonance
in
Journal of Cardiovascular Magnetic Resonance
volume
14
publisher
BioMed Central
external identifiers
  • wos:000307880200001
  • scopus:84864234898
ISSN
1097-6647
DOI
10.1186/1532-429X-14-51
language
English
LU publication?
yes
id
89e21821-8831-467c-8439-ff7ddd9b5cb5 (old id 3151993)
date added to LUP
2012-11-01 09:36:23
date last changed
2017-11-19 03:02:34
@article{89e21821-8831-467c-8439-ff7ddd9b5cb5,
  abstract     = {Background: Cardiovascular Magnetic Resonance (CMR) enables non-invasive quantification of cardiac output (CO) and thereby cardiac index (CI, CO indexed to body surface area). The aim of this study was to establish if CI decreases with age and compare the values to CI for athletes and for patients with congestive heart failure (CHF). Methods: CI was measured in 144 healthy volunteers (39 +/- 16 years, range 21-81 years, 68 females), in 60 athletes (29 +/- 6 years, 30 females) and in 157 CHF patients with ejection fraction (EF) below 40% (60 +/- 13 years, 33 females). CI was calculated using aortic flow by velocity-encoded CMR and is presented as mean +/- SD. Flow was validated in vitro using a flow phantom and in 25 subjects with aorta and pulmonary flow measurements. Results: There was a slight decrease of CI with age in healthy subjects (8 ml/min/m(2) per year, r(2) = 0.07, p = 0.001). CI in males (3.2 +/- 0.5 l/min/m(2)) and females (3.1 +/- 0.4 l/min/m(2)) did not differ (p = 0.64). The mean +/- SD of CI in healthy subjects in the age range of 20-29 was 3.3 +/- 0.4 l/min/m(2), in 30-39 years 3.3 +/- 0.5 l/min/m(2), in 40-49 years 3.1 +/- 0.5 l/min/m(2), 50-59 years 3.0 +/- 0.4 l/min/m(2) and &gt;60 years 3.0 +/- 0.4 l/min/m(2). There was no difference in CI between athletes and age-controlled healthy subjects but HR was lower and indexed SV higher in athletes. CI in CHF patients (2.3 +/- 0.6 l/min/m(2)) was lower compared to the healthy population (p &lt; 0.001). There was a weak correlation between CI and EF in CHF patients (r(2) = 0.07, p &lt; 0.001) but CI did not differ between patients with NYHA-classes I-II compared to III-IV (n = 97, p = 0.16) or patients with or without hospitalization in the previous year (n = 100, p = 0.72). In vitro phantom validation showed low bias (-0.8 +/- 19.8 ml/s) and in vivo validation in 25 subjects also showed low bias (0.26 +/- 0.61 l/min, QP/QS 1.04 +/- 0.09) between pulmonary and aortic flow. Conclusions: CI decreases in healthy subjects with age but does not differ between males and females. We found no difference in CI between athletes and healthy subjects at rest but CI was lower in patients with congestive heart failure. The presented values can be used as reference values for flow velocity mapping CMR.},
  author       = {Carlsson, Marcus and Andersson, Ruslana and Markenroth Bloch, Karin and Steding Ehrenborg, Katarina and Mosén, Henrik and Ståhlberg, Freddy and Lövgren-Ekmehag, Björn and Arheden, Håkan},
  issn         = {1097-6647},
  keyword      = {Cardiac output,Heart failure,Left ventricle,Cardiovascular magnetic,resonance},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Journal of Cardiovascular Magnetic Resonance},
  title        = {Cardiac output and cardiac index measured with cardiovascular magnetic resonance in healthy subjects, elite athletes and patients with congestive heart failure},
  url          = {http://dx.doi.org/10.1186/1532-429X-14-51},
  volume       = {14},
  year         = {2012},
}