Cardiac MRI is superior to gated blood pool imaging in the assessment of left ventricular function in patients post-cardiac transplantation.
BACKGROUND
Gated Blood Pool Imaging (GBPI) has low inter-test variability compared to echocardiography, and is often used when accurate repeated measurements of left ventricular ejection fraction are required such as in the surveillance of post-transplant patients. The aim of this study was to determine if cardiac MRI (CMR) could replace Gated Blood Pool Imaging for annual assessment of left ventricular (LV) function in the surveillance of patients post-cardiac transplantation.


METHODS
Forty-nine patients at various stages of post-cardiac transplantation presenting for annual review underwent LV functional assessment with GBPI and CMR. LV ejection fractions (EF) obtained from the two methods were compared and limits of agreement determined.


RESULTS
The mean EF (plus and minus two standard deviations) was 58.3+/-18% for GBPI and 57.6+/-18% for CMR. The two methods were found to provide clinically equivalent results.


CONCLUSIONS
Assessment of LVEF with CMR offers comparable values to GBPI in post-heart transplant patients. However, CMR also allows quantitative volumetric analysis of ventricular volumes and assessment of wall motion and valvular function. As is now accepted in native heart assessment, CMR should be considered the "gold standard" for post-transplant volumetric and functional evaluation. CMR offers information over-and-above traditional imaging modalities.
Strugnell
Wendy E
WE
Queensland Centre of Excellence in Cardiovascular MRI, Department of Medical Imaging, The Prince Charles Hospital, Rode Road, Chermside, Queensland 4032, Australia. wendystrugnell@internode.on.net
Hamilton-Craig
Christian R
CR
Parry
Temeeka A
TA
Bartlett
Harold J G
HJ
Slaughter
Richard E
RE
D000328:Adult; D000368:Aged; D005260:Female; D015637:Gated Blood-Pool Imaging; D016027:Heart Transplantation; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*; D016277:Ventricular Function, Left