Abstract 14224: Evaluation of Left and Right Ventricular Mass by CMR; Comparison to Recipient Heart After Heart Transplant
Background: CMR is considered the ‘gold standard’ for non-invasive LV and RV mass quantitation. This information is predominantly based on animal and phantom data never having been prospectively or retrospectively validated in humans, undermining its credibility. Further, RV validation data is virtually non-existent. The surest way to validate the accuracy and thus the true ’gold standard’ of CMR derived mass is through autopsy but obviously neither practical nor feasible Objective: To validate CMR derived LV and RV mass as compared to autopsy mass of ex vivo hearts from transplant patients.
Methods: Over a two-year period, 58 recipient hearts were obtained immediately upon orthotopic heart transplantation from the OR. They were rapidly cleaned, LVAD cores removed, suspended in a saline-filled container and scanned via contiguous SSFP-CMR slices in short axis orientation. The LV and RV structures were planimetered defining mass (g). The explanted hearts were then dissected shaving off the atria at the AV valve plane with ventricles surgically separated at the inter-ventricular septum. The weights of the LV and RV were measured via a high-fidelity scale for comparison with CMR-determined mass.
Results: The CMR measured LV mass (314±80g) strongly correlated with the actual weighed LV mass (326±91g). The Pearson product moment (PPM) correlation was 0.86 (Figure 1A ). The equation y = 1.01x - 6.6b regressed the LV (r = 0.95). The CMR measured RV mass (184±52g) significantly predicted the actual RV mass (134±43g). The PPM correlation was 0.72 (Figure 1B ). The combined CMR measured LV + RV mass (497±116g) significantly predicted actual LV + RV mass (467±114g). The PPM correlation for this sample was 0.90 (Figure 1C ).
Conclusions: Via a recipient transplant hearts vs. autopsy comparison, we show for the first time the long-awaited ‘proof’ behind CMR’s claim to be the ‘gold standard’ for non-invasive estimation of cardiac mass.
- © 2013 by American Heart Association, Inc.