| 이미래, 변경민, 김은영, 양정훈, 이성호, 박성범, 정승민, 박정의, 최연현, 이상철 |
Background: Cardiac magnetic resonance (CMR) is known to be the most accurate method of assessing left ventricular (LV) systolic function and myocardial mass. As echocardiography (echo) is the most widely used method of assessing these parameters, we compared the values of LV function, volume and mass on everyday echo and CMR.
Methods: We retrospectively reviewed 193 consecutive patients (67.4% male; mean age 55±13.6 years) studied by echo and CMR within a one-month time interval for all purposes. LV ejection fraction (EF), LV end-systolic volume (ESV), LV end-diastolic volume (EDV), and LV mass index (MI) assessed by the modified method of disks on 2-D echo and CMR; E and A wave velocities and deceleration time (DT) of mitral inflow obtained by Doppler echo and phase-contrast CMR were compared using interclass correlation coefficient (ICC) and paired-samples T test. Correlations of LVMI on CMR with left atrial volume index (LAVI) calculated by the area-length method on 2-D echo and E/e’ on Doppler echo were also evaluated using correlation coefficient (r).
Results: There were good agreements in LVEF, LVESV, LEDV, and LVMI between echo and CMR (ICC 0.91, 0.95, 0.88, 0.82, respectively, p<0.001). However, echo significantly underestimated the LVEF, LVESV, and LVEDV (echo vs. CMR: 52.7±16.02 vs. 57.3±20.19%, 63.7±4.39 vs. 82.06±5.77ml, 119.4±4.94 vs. 159.6±5.45ml, respectively, p<0.001) and overestimated LVMI (echo vs. CMR: 106.6±38.90 vs. 74.9±29.87 mg/m2, p<0.001). The E/A ratio and DT showed lower level of agreement than LV volume and LV mass between two tests (ICC 0.73 and 0.50 respectively, p <0.001) with significant differences in absolute values (echo vs. CMR: 1.19±0.854 vs. 1.39±0.880, p=0.003; 222±81.9 vs. 173±46.5 msec, p<0.001, respectively). LVMI on CMR showed significant correlation with LAVI and E/e’ ratio on echo, but the correlation degree was relatively weak (r=0.372 and 0.303 respectively, p<0.001).
Conclusion: On everyday examinations, there are significant differences in the absolute values of each LVEF, LV volume, and LV mass measured by echo and CMR.
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