Transthoracic echocardiography significantly underestimated right ventricular ejection fraction compared to cardiac magnetic resonance imaging (36.1% vs 47.8%, P=0.002) and had lower image quality.
Cross-Sectional (n=12)
Does cardiac magnetic resonance imaging improve image quality, baffle visualization, and right ventricular ejection fraction assessment compared to transthoracic echocardiography in patients status post atrial switch procedure?
CMR provides superior image quality, better baffle visualization, and higher right ventricular ejection fraction estimates compared to TTE in patients post atrial switch, suggesting it should be considered first-line imaging.
Absolute Event Rate: 36.1% vs 47.8%
p-value: p=.002
OBJECTIVES: This study compares image quality, cost, right ventricular ejection fraction analysis, and baffle visualization between transthoracic echocardiography and cardiac magnetic resonance imaging in those status post atrial switch for transposition of the great arteries. BACKGROUND: This population requires imaging for serial evaluations. Transthoracic echocardiography is often first line but has drawbacks, many of which are addressed by cardiac magnetic resonance imaging. METHODS: Twelve patients (mean age 25 years) with relatively concurrent (mean 157 days) studies were included. Three separate echocardiography and magnetic resonance imaging physicians independently analyzed baffles, image quality, and right ventricular ejection fractions. Institutional and Medicaid charges were compared. RESULTS: For right ventricular ejection fraction, echocardiography (36.1%) underestimated cardiac magnetic resonance imaging (47.8%, P = .002). Image quality for transthoracic echocardiography was significantly rated lower than cardiac magnetic resonance imaging (P = .002). Baffles were better seen in cardiac magnetic resonance imaging (transthoracic echocardiography vs. cardiac magnetic resonance imaging: superior vena cava 86% vs. 100% P = .063; inferior vena cava 33% vs. 97% P = .002; pulmonary vein 92% vs. 100% P = .250). Comparing hospital charges and Medicaid reimbursement, transthoracic echocardiography respectively costs 18% and 38% less than cardiac magnetic resonance imaging. CONCLUSIONS: In conclusion, transthoracic echocardiography underestimated right ventricular ejection fraction compared to cardiac magnetic resonance imaging. Cardiac magnetic resonance imaging had consistently higher image quality and better visualization of the baffles. Cost differences are minimal. We propose that cardiac magnetic resonance imaging be considered first line for imaging in certain patients' status post atrial switch procedure.
Ho et al. (2011) conducted a cross-sectional in Status post atrial switch for transposition of the great arteries (n=12). Transthoracic echocardiography vs. Cardiac magnetic resonance imaging was evaluated on Right ventricular ejection fraction (p=.002). Transthoracic echocardiography significantly underestimated right ventricular ejection fraction compared to cardiac magnetic resonance imaging (36.1% vs 47.8%, P=0.002) and had lower image quality.
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