Intra-observer and interobserver reproducibility of right ventricle volumes, function and mass by cardiac magnetic resonance.
OBJECTIVE
Cardiac magnetic resonance (CMR) allows quick and non-invasive evaluation both of right ventricle (RV) volume and function, which are important in many heart diseases. We have evaluated CMR intra- and interobserver reproducibility in different conditions of RV dimension and function.


METHODS
We have analysed CMR exams of 45 subjects, randomly selected from our database according to RV end-diastolic volume (EDV; 15-subject groups with EDV < 25th, 25-75th and > 75th percentiles of a normal control population). Selected subjects were of both sexes (male/female 33/12) and of variable age (8-83 years) and body surface (0.9-2.3 m). RV end-diastolic and end-systolic volumes (ESV), ejection fraction (EF) and mass were blindly evaluated by two operators. Bland-Altman bias and coefficient of variability (CoV) were used to assess intra- and interobserver reproducibility.


RESULTS
A wide range of EDV (range = 46-239 ml), ESV (20-129 ml) and EF (6-64%) was observed. The intra-observer bias was -5 ml for EDV, -2 ml for ESV, -1% for EF and 5 g for mass, with a CoV of 7-12%. The interobserver bias was 5 ml for EDV, 2 ml for ESV, 2% for EF and 6 g for mass, with a CoV of 8-13%. Analysis by tertiles showed EF assessment variability to be higher in the lower tertiles at intra-observer (P < 0.036) and, above all, at interobserver (P < 0.000) analysis. Mass assessment variability was higher in the upper tertile (P < 0.004) at intra-observer analysis.


CONCLUSIONS
Intra- and interobserver reproducibility of RV parameters assessed by CMR are adequate in a wide range of RV dimensions and function. However, caution is required with respect to the significance of small changes of EF and mass in the case of poor function and hypertrophy of the RV, respectively.
Catalano
Oronzo
O
Division of Cardiology, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy. ocatalano@fsm.it
Antonaci
Serena
S
Opasich
Cristina
C
Moro
Guido
G
Mussida
Maria
M
Perotti
Mariarosa
M
Calsamiglia
Giuseppe
G
Frascaroli
Mauro
M
Baldi
Maurizia
M
Cobelli
Franco
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003971:Diastole / Q000502:physiology; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009929:Organ Size; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D016276:Ventricular Function