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Noninvasive Assessment of Left Ventricular Pressure-Volume Relations : Inter- and Intraobserver Variability and Assessment Across Heart Failure Subtypes

Edlund, Jonathan LU orcid ; Arvidsson, Per M LU ; Nelsson, Anders LU ; Smith, J Gustav LU ; Magnusson, Martin LU orcid ; Heiberg, Einar LU ; Steding-Ehrenborg, Katarina LU and Arheden, Håkan LU (2022) In American Journal of Cardiology 184. p.48-55
Abstract

A novel method to derive pressure-volume (PV) loops noninvasively from cardiac magnetic resonance images has recently been developed. The aim of this study was to evaluate inter- and intraobserver variability of hemodynamic parameters obtained from noninvasive PV loops in healthy controls, subclinical diastolic dysfunction (SDD), and patients with heart failure with preserved ejection fraction, mildly reduced ejection fraction, and reduced ejection fraction. We included 75 subjects, of whom 15 were healthy controls, 15 subjects with SDD (defined as fulfilling 1 to 2 echocardiographic criteria for diastolic dysfunction), and 15 patients with preserved ejection fraction, 15 with mildly reduced ejection fraction, and 15 with reduced... (More)

A novel method to derive pressure-volume (PV) loops noninvasively from cardiac magnetic resonance images has recently been developed. The aim of this study was to evaluate inter- and intraobserver variability of hemodynamic parameters obtained from noninvasive PV loops in healthy controls, subclinical diastolic dysfunction (SDD), and patients with heart failure with preserved ejection fraction, mildly reduced ejection fraction, and reduced ejection fraction. We included 75 subjects, of whom 15 were healthy controls, 15 subjects with SDD (defined as fulfilling 1 to 2 echocardiographic criteria for diastolic dysfunction), and 15 patients with preserved ejection fraction, 15 with mildly reduced ejection fraction, and 15 with reduced ejection fraction. PV loops were computed using time-resolved left ventricular volumes from cardiac magnetic resonance images and a brachial blood pressure. Inter- and intraobserver variability and intergroup differences of PV loop-derived hemodynamic parameters were assessed. Bias was low and limits of agreement were narrow for all hemodynamic parameters in the inter- and intraobserver comparisons. Interobserver difference for stroke work was 2 ± 9%, potential energy was 4 ± 11%, and maximal ventricular elastance was -4 ± 7%. Intraobserver for stroke work was -1 ± 7%, potential energy was 3 ± 4%, and maximal ventricular elastance was 1 ± 5%. In conclusion, this study presents a fully noninvasive left ventricular PV loop analysis across healthy controls, subjects with SDD, and patients with heart failure with preserved or impaired systolic function. In conclusion, the method for PV loop computation from clinical-standard manual left ventricular segmentation was rapid and robust, bridging the gap between clinical and research settings.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Cardiology
volume
184
pages
8 pages
publisher
Excerpta Medica
external identifiers
  • pmid:36192197
  • scopus:85139027454
ISSN
1879-1913
DOI
10.1016/j.amjcard.2022.09.001
language
English
LU publication?
yes
id
bba8e70c-22c3-43fd-b847-d54dd2897995
date added to LUP
2022-10-10 10:48:11
date last changed
2024-04-18 14:51:53
@article{bba8e70c-22c3-43fd-b847-d54dd2897995,
  abstract     = {{<p>A novel method to derive pressure-volume (PV) loops noninvasively from cardiac magnetic resonance images has recently been developed. The aim of this study was to evaluate inter- and intraobserver variability of hemodynamic parameters obtained from noninvasive PV loops in healthy controls, subclinical diastolic dysfunction (SDD), and patients with heart failure with preserved ejection fraction, mildly reduced ejection fraction, and reduced ejection fraction. We included 75 subjects, of whom 15 were healthy controls, 15 subjects with SDD (defined as fulfilling 1 to 2 echocardiographic criteria for diastolic dysfunction), and 15 patients with preserved ejection fraction, 15 with mildly reduced ejection fraction, and 15 with reduced ejection fraction. PV loops were computed using time-resolved left ventricular volumes from cardiac magnetic resonance images and a brachial blood pressure. Inter- and intraobserver variability and intergroup differences of PV loop-derived hemodynamic parameters were assessed. Bias was low and limits of agreement were narrow for all hemodynamic parameters in the inter- and intraobserver comparisons. Interobserver difference for stroke work was 2 ± 9%, potential energy was 4 ± 11%, and maximal ventricular elastance was -4 ± 7%. Intraobserver for stroke work was -1 ± 7%, potential energy was 3 ± 4%, and maximal ventricular elastance was 1 ± 5%. In conclusion, this study presents a fully noninvasive left ventricular PV loop analysis across healthy controls, subjects with SDD, and patients with heart failure with preserved or impaired systolic function. In conclusion, the method for PV loop computation from clinical-standard manual left ventricular segmentation was rapid and robust, bridging the gap between clinical and research settings.</p>}},
  author       = {{Edlund, Jonathan and Arvidsson, Per M and Nelsson, Anders and Smith, J Gustav and Magnusson, Martin and Heiberg, Einar and Steding-Ehrenborg, Katarina and Arheden, Håkan}},
  issn         = {{1879-1913}},
  language     = {{eng}},
  month        = {{12}},
  pages        = {{48--55}},
  publisher    = {{Excerpta Medica}},
  series       = {{American Journal of Cardiology}},
  title        = {{Noninvasive Assessment of Left Ventricular Pressure-Volume Relations : Inter- and Intraobserver Variability and Assessment Across Heart Failure Subtypes}},
  url          = {{http://dx.doi.org/10.1016/j.amjcard.2022.09.001}},
  doi          = {{10.1016/j.amjcard.2022.09.001}},
  volume       = {{184}},
  year         = {{2022}},
}