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European Radiology

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01-09-2018 | Cardiac

Reference ranges of left ventricular structure and function assessed by contrast-enhanced cardiac MR and changes related to ageing and hypertension in a population-based study

Authors: Robin Bülow, Till Ittermann, Marcus Dörr, Axel Poesch, Sönke Langner, Henry Völzke, Norbert Hosten, Marc Dewey

Published in: European Radiology | Issue 9/2018

Abstract

Objectives

Reference ranges of left ventricular (LV) parameters from cardiac magnetic resonance (CMR) were established to investigate the impact of ageing and hypertension as important determinants of cardiac structure and function.

Methods

One thousand five hundred twenty-five contrast-enhanced CMRs were conducted in the Study of Health in Pomerania. LV end-diastolic volume (LVEDV), end-systolic volume (LVESV), stroke volume (LVSV), ejection fraction (LVEF), and myocardial mass (LVMM) were determined using long- and short-axis steady-state free-precession sequences. The reference population was defined as participants without late enhancement, hypertension, and prior cardiovascular diseases. Reference ranges were established by quantile regression (5th and 95th percentile) and compared with an additional sample of treated and untreated hypertensives.

Results

LV volumes in the reference population (n = 634, 300 males, 334 females, 52.1 ± 13.3 years) aged between 20-69 years were lower with higher age (p = 0.001), whereas LVEFs were higher (p ≤ 0.020). LVMM was lower only in males (p = 0.002). Compared with the reference population, hypertension was associated with lower LVEDV in males (n = 258, p ≤ 0.032). Antihypertensive therapy was associated with higher LVEF in males (n = 258, +2.5%, p = 0.002) and females (n = 180, +2.1%, p = 0.001).

Conclusions

Population-based LV reference ranges were derived from contrast-enhanced CMR. Hypertension-related changes were identified by comparing these values with those of hypertensives, and they might be used to monitor cardiac function in these patients.

Key Points

• Left ventricular function changed slightly but significantly between 20-69 years.

• Reference values of BSA-indexed myocardial mass decreased with age in males.

• Hypertension was associated with lower LV end-diastolic volume only in males.

• CMR may allow assessing remodelling related to hypertension or antihypertensive treatment.

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Miller AL, Dib C, Li L et al (2012) Left ventricular ejection fraction assessment among patients with acute myocardial infarction and its association with hospital quality of care and evidence-based therapy use. Circ Cardiovasc Qual Outcomes 5:662–671CrossRefPubMed

Mewton N, Opdahl A, Choi EY et al (2013) Left ventricular global function index by magnetic resonance imaging--a novel marker for assessment of cardiac performance for the prediction of cardiovascular events: the multi-ethnic study of atherosclerosis. Hypertension 61:770–778CrossRefPubMedPubMedCentral

Grebe O, Kestler HA, Merkle N et al (2004) Assessment of left ventricular function with steady-state-free-precession magnetic resonance imaging. Reference values and a comparison to left ventriculography. Z Kardiol 93:686–695CrossRefPubMed

Fiechter M, Fuchs TA, Gebhard C et al (2013) Age-related normal structural and functional ventricular values in cardiac function assessed by magnetic resonance. BMC Med Imaging 13:6CrossRefPubMedPubMedCentral

Alfakih K, Plein S, Thiele H, Jones T, Ridgway JP, Sivananthan MU (2003) Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences. J Magn Reson Imaging 17:323–329CrossRefPubMed

Cain PA, Ahl R, Hedstrom E et al (2009) Age and gender specific normal values of left ventricular mass, volume and function for gradient echo magnetic resonance imaging: a cross sectional study. BMC Med Imaging 9:2CrossRefPubMedPubMedCentral

Kawel-Boehm N, Maceira A, Valsangiacomo-Buechel ER et al (2015) Normal values for cardiovascular magnetic resonance in adults and children. J Cardiovasc Magn Reson 17:29CrossRefPubMedPubMedCentral

Natori S, Lai S, Finn JP et al (2006) Cardiovascular function in multi-ethnic study of atherosclerosis: normal values by age, sex, and ethnicity. AJR Am J Roentgenol 186:S357–S365CrossRefPubMed

Chuang ML, Gona P, Hautvast GL et al (2014) CMR reference values for left ventricular volumes, mass, and ejection fraction using computer-aided analysis: the Framingham Heart Study. J Magn Reson Imaging 39:895–900CrossRefPubMed

10.

Petersen SE, Aung N, Sanghvi MM et al (2017) Reference ranges for cardiac structure and function using cardiovascular magnetic resonance (CMR) in Caucasians from the UK Biobank population cohort. J Cardiovasc Magn Reson 19:18CrossRefPubMedPubMedCentral

11.

Volzke H, Alte D, Schmidt CO et al (2011) Cohort profile: the study of health in Pomerania. Int J Epidemiol 40:294–307CrossRefPubMed

12.

Hegenscheid K, Kuhn JP, Volzke H, Biffar R, Hosten N, Puls R (2009) Whole-body magnetic resonance imaging of healthy volunteers: pilot study results from the population-based SHIP study. Rofo 181:748–759CrossRefPubMed

13.

(2014) Observational studies: getting clear about transparency. PLoS Med 11:e1001711

14.

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 130:461–470CrossRefPubMed

15.

Kieback AG, Lorbeer R, Wallaschofski H et al (2012) Claudication, in contrast to angina pectoris, independently predicts mortality risk in the general population. Vasa 41:105–113CrossRefPubMed

16.

Juergens KU, Grude M, Maintz D et al (2004) Multi-detector row CT of left ventricular function with dedicated analysis software versus MR imaging: initial experience. Radiology 230:403–410CrossRefPubMed

17.

Schulz-Menger J, Bluemke DA, Bremerich J et al (2013) Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson 15:35CrossRefPubMedPubMedCentral

18.

Du Bois D, Du Bois EF (1989) A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition 5:303–311 discussion 312-303PubMed

19.

Giavarina D (2015) Understanding Bland Altman analysis. Biochem Med (Zagreb) 25:141–151CrossRef

20.

Wei Y, Pere A, Koenker R, He X (2006) Quantile regression methods for reference growth charts. Stat Med 25:1369–1382CrossRefPubMed

21.

Hudsmith LE, Petersen SE, Francis JM, Robson MD, Neubauer S (2005) Normal human left and right ventricular and left atrial dimensions using steady state free precession magnetic resonance imaging. J Cardiovasc Magn Reson 7:775–782CrossRefPubMed

22.

Yeon SB, Salton CJ, Gona P et al (2015) Impact of age, sex, and indexation method on MR left ventricular reference values in the Framingham Heart Study offspring cohort. J Magn Reson Imaging 41:1038–1045CrossRefPubMed

23.

Pfluger HB, Maeder MT, LaGerche A, Taylor AJ (2010) One- and two-dimensional estimation of right and left ventricular size and function-comparison with cardiac magnetic resonance imaging volumetric analysis. Heart Lung Circ 19:541–548CrossRefPubMed

24.

Berkovic P, Hemmink M, Parizel PM, Vrints CJ, Paelinck BP (2010) MR image analysis: Longitudinal cardiac motion influences left ventricular measurements. Eur J Radiol 73:260–265CrossRefPubMed

25.

de Simone G, Devereux RB, Izzo R et al (2013) Lack of reduction of left ventricular mass in treated hypertension: the strong heart study. J Am Heart Assoc 2:e000144CrossRefPubMedPubMedCentral

26.

Eng J, McClelland RL, Gomes AS et al (2016) Adverse Left Ventricular Remodeling and Age Assessed with Cardiac MR Imaging: The Multi-Ethnic Study of Atherosclerosis. Radiology 278:714–722CrossRefPubMed

27.

Ambale-Venkatesh B, Lima JA (2015) Cardiac MRI: a central prognostic tool in myocardial fibrosis. Nat Rev Cardiol 12:18–29CrossRefPubMed

Title: Reference ranges of left ventricular structure and function assessed by contrast-enhanced cardiac MR and changes related to ageing and hypertension in a population-based study
Authors: Robin Bülow
Till Ittermann
Marcus Dörr
Axel Poesch
Sönke Langner
Henry Völzke
Norbert Hosten
Marc Dewey
Publication date: 01-09-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 9/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5345-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reference ranges of left ventricular structure and function assessed by contrast-enhanced cardiac MR and changes related to ageing and hypertension in a population-based study

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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