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Gustav Smith, MD, PhD

Gustav Smith

Associate professor

Gustav Smith, MD, PhD

Noninvasive Assessment of Left Ventricular Pressure-Volume Relations : Inter- and Intraobserver Variability and Assessment Across Heart Failure Subtypes

Author

  • Jonathan Edlund
  • Per M Arvidsson
  • Anders Nelsson
  • J Gustav Smith
  • Martin Magnusson
  • Einar Heiberg
  • Katarina Steding-Ehrenborg
  • Håkan Arheden

Summary, in English

A novel method to derive pressure-volume (PV) loops noninvasively from cardiac magnetic resonance images has recently been developed. The aim of this study was to evaluate inter- and intraobserver variability of hemodynamic parameters obtained from noninvasive PV loops in healthy controls, subclinical diastolic dysfunction (SDD), and patients with heart failure with preserved ejection fraction, mildly reduced ejection fraction, and reduced ejection fraction. We included 75 subjects, of whom 15 were healthy controls, 15 subjects with SDD (defined as fulfilling 1 to 2 echocardiographic criteria for diastolic dysfunction), and 15 patients with preserved ejection fraction, 15 with mildly reduced ejection fraction, and 15 with reduced ejection fraction. PV loops were computed using time-resolved left ventricular volumes from cardiac magnetic resonance images and a brachial blood pressure. Inter- and intraobserver variability and intergroup differences of PV loop-derived hemodynamic parameters were assessed. Bias was low and limits of agreement were narrow for all hemodynamic parameters in the inter- and intraobserver comparisons. Interobserver difference for stroke work was 2 ± 9%, potential energy was 4 ± 11%, and maximal ventricular elastance was -4 ± 7%. Intraobserver for stroke work was -1 ± 7%, potential energy was 3 ± 4%, and maximal ventricular elastance was 1 ± 5%. In conclusion, this study presents a fully noninvasive left ventricular PV loop analysis across healthy controls, subjects with SDD, and patients with heart failure with preserved or impaired systolic function. In conclusion, the method for PV loop computation from clinical-standard manual left ventricular segmentation was rapid and robust, bridging the gap between clinical and research settings.

Department/s

  • Lund Cardiac MR Group
  • Clinical Physiology (Lund)
  • WCMM-Wallenberg Centre for Molecular Medicine
  • Heart Failure and Mechanical Support
  • Cardiovascular Epigenetics
  • Cardiology
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence of Diabetes Research in Sweden
  • Molecular Epidemiology and Cardiology
  • Cardiovascular Research - Hypertension
  • LTH Profile Area: Engineering Health

Publishing year

2022-12-01

Language

English

Pages

48-55

Publication/Series

American Journal of Cardiology

Volume

184

Document type

Journal article

Publisher

Excerpta Medica

Topic

  • Cardiac and Cardiovascular Systems

Status

Published

Research group

  • Lund Cardiac MR Group
  • Heart Failure and Mechanical Support
  • Cardiovascular Epigenetics
  • Molecular Epidemiology and Cardiology
  • Cardiovascular Research - Hypertension

ISBN/ISSN/Other

  • ISSN: 1879-1913