Cardiac magnetic resonance imaging for the assessment of ventricular function, geometry, and viability before and after surgical ventricular reconstruction

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Presentation transcript:

Cardiac magnetic resonance imaging for the assessment of ventricular function, geometry, and viability before and after surgical ventricular reconstruction Jan Hüther, Torsten Doenst, MD, PhD, Stefan Nitzsche, MD, Holger Thiele, MD, PhD, Friedrich-Wilhelm Mohr, MD, PhD, Matthias Gutberlet, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 6, Pages 1515-1522.e1 (December 2011) DOI: 10.1016/j.jtcvs.2011.04.040 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Determination of the examined geometry and functional indices. A, SpI is determined as the ratio of the internal diameters in SAL and LAL. B, ACI is determined as the ratio of the internal diameters in AAL and SAL. C, AVI is determined by the volume in the apical half of equidistant slices applied to the preoperative ventricle. D, For determination of the postoperative AVI, the volume in the same number of basal slices and the volume in the remaining apical slices are calculated and divided by each other (apical/basal). E, Regional basal EF is determined as the ratio of the mean end-diastolic and the mean end-systolic volume of the 3 most basal slices. SAL, Short-axis length; LAL, long-axis length; AAL, apical axi length; ACI, apical conicity index; SpI, sphericity index. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1515-1522.e1DOI: (10.1016/j.jtcvs.2011.04.040) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 EF (%) of all patients before and after SVR and their individual direction of change. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1515-1522.e1DOI: (10.1016/j.jtcvs.2011.04.040) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, Fractional scar content of myocardial scar tissue in the apical, mid-cavity, and basal regions illustrated for the subgroups of patients with ΔEF < 12% (open bars) and ΔEF > 12% (filled bars). B, AVI before and after SVR in the subgroups of patients with ΔEF < 12% (open bars) and ΔEF > 12% (filled bars) showing the significant difference between the groups. A, B, Note the significantly smaller amount of basal scar and the significantly greater reduction in AVI in patients with better functional improvement. AVI, Apical volume index; EF, ejection fraction. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1515-1522.e1DOI: (10.1016/j.jtcvs.2011.04.040) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Kaplan–Meier survival curve for the 2 examined subgroups (ΔEF < 12% red line and ΔEF > 12% black line). EF, Ejection fraction. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 1515-1522.e1DOI: (10.1016/j.jtcvs.2011.04.040) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions