Comparison of cine cardiac magnetic resonance and echocardiography derived diameters of the aortic root in a large population-based cohort

TY - JOUR

T1 - Comparison of cine cardiac magnetic resonance and echocardiography derived diameters of the aortic root in a large population-based cohort

AU - Wenzel, Jan-Per

AU - Nikorowitsch, Julius

AU - Bei der Kellen, Ramona

AU - Dohm, Luisa

AU - Girdauskas, Evaldas

AU - Lund, Gunnar

AU - Bannas, Peter

AU - Blankenberg, Stefan

AU - Kölbel, Tilo

AU - Cavus, Ersin

AU - Müllerleile, Kai

AU - Kaul, Michael Gerhard

AU - Adam, Gerhard

AU - Weinrich, Julius Matthias

N1 - © 2022. The Author(s).

PY - 2022/9/12

Y1 - 2022/9/12

N2 - Transthoracic echocardiography (TTE) and cine cardiac magnetic resonance imaging (CMR) are established imaging methods of the aortic root. We aimed to evaluate the comparability of measurements in TTE and standard cine CMR sequences of the aortic root. Our study included 741 subjects (mean age 63.5 ± 8 years, 43.7% female) from the Hamburg City Health Study (HCHS). Subjects underwent CMR and TTE. Aortic root measurements were performed at the level of the aortic annulus (AoAn), sinus of Valsalva (SoV), and sinotubular junction (STJ) by standard cine CMR in left ventricular long axis and left ventricular outflow tract view. Measurements were performed applying the leading-edge to leading-edge (LL) convention and inner-edge to inner-edge (II) convention in TTE and the II convention in CMR. Inter correlation coefficients (ICCs) demonstrated high inter- and intraobserver reproducibility for CMR and TTE measurements of SoV and STJ (ICCs 0.9-0.98) and moderate reproducibility for AoAn (ICCs 0.68-0.91). CMR measurements of SoV and STJ showed strong agreement with TTE: while correlations were comparable (r = 0.75-0.85) bias was lower with TTE II (bias - 0.1 to - 0.74) versus TTE LL measurements (mean bias - 1.49 to - 2.58 mm). The agreement for AoAn was fair (r = 0.51-0.57) with variable bias (mean bias 0.39-3.9). Standard cine CMR and TTE derived aortic root measurements are reproducible and comparable with higher agreement for TTE II instead of LL measurements. These results support an interchangeable application of TTE and standard CMR for screening of aortic root diseases thereby possibly reducing redundant multimodality imaging.

AB - Transthoracic echocardiography (TTE) and cine cardiac magnetic resonance imaging (CMR) are established imaging methods of the aortic root. We aimed to evaluate the comparability of measurements in TTE and standard cine CMR sequences of the aortic root. Our study included 741 subjects (mean age 63.5 ± 8 years, 43.7% female) from the Hamburg City Health Study (HCHS). Subjects underwent CMR and TTE. Aortic root measurements were performed at the level of the aortic annulus (AoAn), sinus of Valsalva (SoV), and sinotubular junction (STJ) by standard cine CMR in left ventricular long axis and left ventricular outflow tract view. Measurements were performed applying the leading-edge to leading-edge (LL) convention and inner-edge to inner-edge (II) convention in TTE and the II convention in CMR. Inter correlation coefficients (ICCs) demonstrated high inter- and intraobserver reproducibility for CMR and TTE measurements of SoV and STJ (ICCs 0.9-0.98) and moderate reproducibility for AoAn (ICCs 0.68-0.91). CMR measurements of SoV and STJ showed strong agreement with TTE: while correlations were comparable (r = 0.75-0.85) bias was lower with TTE II (bias - 0.1 to - 0.74) versus TTE LL measurements (mean bias - 1.49 to - 2.58 mm). The agreement for AoAn was fair (r = 0.51-0.57) with variable bias (mean bias 0.39-3.9). Standard cine CMR and TTE derived aortic root measurements are reproducible and comparable with higher agreement for TTE II instead of LL measurements. These results support an interchangeable application of TTE and standard CMR for screening of aortic root diseases thereby possibly reducing redundant multimodality imaging.

KW - Aged

KW - Aortic Diseases

KW - Aortic Valve/diagnostic imaging

KW - Echocardiography/methods

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Magnetic Resonance Spectroscopy

KW - Male

KW - Middle Aged

KW - Reproducibility of Results

U2 - 10.1038/s41598-022-19461-5

DO - 10.1038/s41598-022-19461-5

M3 - SCORING: Journal article

C2 - 36096919

VL - 12

JO - SCI REP-UK

JF - SCI REP-UK

SN - 2045-2322

IS - 1

M1 - 15307

ER -