title: Assessment of left ventricular parameters in orthotopic heart transplant recipients using dual-source CT and contrast-enhanced echocardiography: comparison with MRI.
abstract: OBJECTIVE
  To establish the accuracy and reliability of cardiac dual-source CT (DSCT) and two-dimensional contrast-enhanced echocardiography (CE-Echo) in estimating left ventricular (LV) parameters with respect to cardiac magnetic resonance imaging (CMR) as the reference standard.
  
  
  METHODS
  Twenty-five consecutive heart transplant recipients (20 male, mean age 62.7±10.4 years, mean time since transplantation 8.1±5.9 years) were prospectively recruited. Two blinded readers independently assessed LV ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), and stroke volume (SV) for each patient after manual tracing of the endo- and epicardial contours in DSCT, CE-Echo and CMR cine images. Student's t-test for paired samples for differences, and Bland and Altman plots and Lin's concordance-correlation coefficients (CCC) for agreement were calculated.
  
  
  RESULTS
  There was no statistical difference between left ventricular parameters determined by DSCT and CMR. CE-Echo resulted in significant underestimation of left ventricular volumes (mean difference EDV: 15.94±14.19 ml and 17.1±17.06 ml, ESV: 8.5±9.3 and 7.32±9.14 ml with respect to DSCT and CMR), and overestimation of EF compared with the cross-sectional imaging modalities (3.78±8.47% and 2.14±8.35% with respect to DSCT and CMR). Concordance correlation coefficients for LV parameters using DSCT and CMR were higher (CCC≥0.75) than CCC values observed between CE-Echo and DSCT- or CMR-derived data (CCC≥0.54 and CCC≥0.49, respectively). Interobserver agreement was higher for DSCT and CMR values (CCC≥0.72 and CCC≥0.87, respectively).
  
  
  CONCLUSIONS
  In orthotopic heart transplantation cardiac DSCT allows accurate and reliable estimation of LV parameters compared with CMR, whereas CE-Echo seems to be insufficient to obtain precise measurements.
authors.affiliation: Department of Radiology, Clínica Universidad de Navarra, Department of Radiology, Section of Ambulatory Radiology, Complejo Hospitalario de Navarra, Pamplona, Spain. arraiza81@gmail.com
authors.forename: Maria
authors.initials: M
authors.lastname: Arraiza
authors.forename: Pedro M
authors.initials: PM
authors.lastname: Azcárate
authors.forename: Carlo Nicola
authors.initials: CN
authors.lastname: De Cecco
authors.forename: Guillermo
authors.initials: G
authors.lastname: Viteri
authors.forename: Isabel
authors.initials: I
authors.lastname: Simón-Yarza
authors.forename: Rafael
authors.initials: R
authors.lastname: Hernández-Estefanía
authors.forename: Gregorio
authors.initials: G
authors.lastname: Rábago
authors.forename: Gorka
authors.initials: G
authors.lastname: Bastarrika
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D016027:Heart Transplantation / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000601:surgery*
chemical_list: D003287:Contrast Media