title: Clinical impact of left ventricular eccentricity index using cardiac MRI in assessment of right ventricular hemodynamics and myocardial fibrosis in congenital heart disease.
abstract: OBJECTIVE
  To investigate the utility of eccentricity index (EI) using cardiac cine MRI for the assessment of right ventricular (RV) hemodynamics in congenital heart disease (CHD).
  
  
  METHODS
  Fifty-five patients with CHD (32 women; mean age, 40.7 ± 20.9 years) underwent both cardiac MRI and right heart catheterization. EI was defined as the ratio of the distance between the anterior-posterior wall and the septal-lateral wall measured in the short-axis of mid-ventricular cine MRI. Correlations between EIs and RV hemodynamic parameters were analyzed. EIs were compared between patients with and without late gadolinium enhancement (LGE).
  
  
  RESULTS
  A strong correlation between mean pulmonary artery pressure (PAP) and systolic EI (r = 0.81, p < 0.0001) and a moderate negative correlation between diastolic EI and RV ejection fraction (EF) (r = -0.62, p < 0.0001) were observed. Receiver operating characteristic analysis revealed optimal EI thresholds for detecting patients with mean PAP ≥40 mmHg with C-statistics of 0.90 and patients with RVEF <40 % with C-statistics of 0.78. Systolic EIs were significantly greater for patients with LGE (1.45 ± 0.05) than for those without LGE (1.15 ± 0.07; p < 0.001).
  
  
  CONCLUSIONS
  EI offers a simple, comprehensive index that can predict pulmonary hypertension and RV dysfunction in CHD.
  
  
  CONCLUSIONS
  • EI offers a simple and comprehensive index of RV hemodynamics. • EI could predict pulmonary hypertension and RV dysfunction. • Left ventricular deformation expressed as high EI is related to myocardial fibrosis.
authors.affiliation: Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. yyama@radiol.med.kyushu-u.ac.jp.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yamasaki
authors.affiliation: Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Michinobu
authors.initials: M
authors.lastname: Nagao
authors.affiliation: Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kamitani
authors.affiliation: Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Torahiko
authors.initials: T
authors.lastname: Yamanouchi
authors.affiliation: Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawanami
authors.affiliation: Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Yamamura
authors.affiliation: Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakamoto
authors.affiliation: Health SciencesGraduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hidetake
authors.initials: H
authors.lastname: Yabuuchi
authors.affiliation: Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization / Q000379:methods; D005260:Female; D005355:Fibrosis; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012372:ROC Curve; D013599:Systole / Q000502:physiology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016278:Ventricular Function, Right / Q000502:physiology; D055815:Young Adult
keywords: Cardiac MRI; Congenital heart disease; Eccentricity index; Pulmonary artery hypertension