TY - JOUR
T1 - Comparative Assessment of 2-Dimensional Echocardiography vs Cardiac Magnetic Resonance Imaging in Measuring Left Ventricular Mass in Patients With and Without End-Stage Renal Disease
AU - Jakubovic, Baruch D.
AU - Wald, Ron
AU - Goldstein, Marc B.
AU - Leong-Poi, Howard
AU - Yuen, Darren A.
AU - Perl, Jeffrey
AU - Lima, Joao A.
AU - Liu, Jerome J.
AU - Kirpalani, Anish
AU - Dacouris, Niki
AU - Wald, Rachel
AU - Connelly, Kim A.
AU - Yan, Andrew T.
N1 - Funding Information:
This study was supported by an operating grant from the Canadian Institutes of Health Research . Baruch Jakubovic was supported by funding from the University of Toronto Faculty of Medicine CREMS Summer Student Program and the Heart and Stroke Foundation of Ontario. Dr Kim Connelly was supported by a Heart and Stroke Foundation of Canada Phase 1 Clinician Scientist Award. Ron Wald is supported by an unrestricted educational grant from Amgen . Dr Darren Yuen was sponsored by a KRESCENT postdoctoral fellowship and is currently supported by a Canadian Institutes of Health Research fellowship. Dr Andrew Yan is supported by a New Investigator Award from the Heart and Stroke Foundation of Ontario.
Funding Information:
Dr Wald is supported by an unrestricted educational grant from Amgen . The other authors have no conflicts of interest to disclose.
Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/3
Y1 - 2013/3
N2 - Background: While echocardiography (ECHO)-measured left ventricular mass (LVM) predicts adverse cardiovascular events that are common in hemodialysis (HD) recipients, cardiac magnetic resonance imaging (CMR) is now considered the reference standard for determination of LVM. This study aimed to evaluate concordance between LVM measurements across ECHO and CMR among chronic HD recipients and matched controls. Methods: A single-centre, cross-sectional study of 41 chronic HD patients and 41 matched controls with normal kidney function was performed to compare LVM measurements and left ventricular hypertrophy (LVH) designation by ECHO and CMR. Results: In both groups, ECHO, compared with CMR, overestimated LVM. Bland-Altman analysis demonstrated wider agreement limits in LVM measurements by ECHO and CMR in the chronic HD group (mean difference, 60.8 g; limits -23 g to 144.6 g) than in the group with normal renal function (mean difference, 51.4 g; limits -10.5 g to 113.3 g). LVH prevalence by ECHO and CMR in the chronic HD group was 37.5% and 22.5%, respectively, while 17.5% and 12.5% had LVH by ECHO and CMR, respectively, in the normal kidney function group. Intermodality agreement in the designation of LVH was modest in the chronic HD patients (κ = 0.42, P = 0.005) but strong (κ = 0.81, P < 0.001) in the patients with preserved kidney function. Agreement was strong in assessing LVH by ECHO and CMR only in those with normal kidney function. Conclusions: Our results suggest that the limitations of LVM measurement by ECHO may be more pronounced in patients receiving HD, and provide additional support for the use of CMR in research and clinical practice when rigourous assessment of LVM is essential.
AB - Background: While echocardiography (ECHO)-measured left ventricular mass (LVM) predicts adverse cardiovascular events that are common in hemodialysis (HD) recipients, cardiac magnetic resonance imaging (CMR) is now considered the reference standard for determination of LVM. This study aimed to evaluate concordance between LVM measurements across ECHO and CMR among chronic HD recipients and matched controls. Methods: A single-centre, cross-sectional study of 41 chronic HD patients and 41 matched controls with normal kidney function was performed to compare LVM measurements and left ventricular hypertrophy (LVH) designation by ECHO and CMR. Results: In both groups, ECHO, compared with CMR, overestimated LVM. Bland-Altman analysis demonstrated wider agreement limits in LVM measurements by ECHO and CMR in the chronic HD group (mean difference, 60.8 g; limits -23 g to 144.6 g) than in the group with normal renal function (mean difference, 51.4 g; limits -10.5 g to 113.3 g). LVH prevalence by ECHO and CMR in the chronic HD group was 37.5% and 22.5%, respectively, while 17.5% and 12.5% had LVH by ECHO and CMR, respectively, in the normal kidney function group. Intermodality agreement in the designation of LVH was modest in the chronic HD patients (κ = 0.42, P = 0.005) but strong (κ = 0.81, P < 0.001) in the patients with preserved kidney function. Agreement was strong in assessing LVH by ECHO and CMR only in those with normal kidney function. Conclusions: Our results suggest that the limitations of LVM measurement by ECHO may be more pronounced in patients receiving HD, and provide additional support for the use of CMR in research and clinical practice when rigourous assessment of LVM is essential.
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U2 - 10.1016/j.cjca.2012.07.013
DO - 10.1016/j.cjca.2012.07.013
M3 - Article
C2 - 23103220
AN - SCOPUS:84874340093
VL - 29
SP - 384
EP - 390
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
SN - 0828-282X
IS - 3
ER -