Echocardiographic Indices of Right Ventricular Systolic Function: A Cardiac Magnetic Resonance Comparative Study

TE-Av e. TE-Av e was the best predictor (AUC of 0.91) with a TE−e of >−5 ms having a sensitivity of 83% and specificity of 83% in identifying an LVEDP >15. Conclusion: We have demonstrated that TE−e may be a useful marker of elevated LVEDP. The occurrence of peak e velocity prior to peak mitral E velocity (i.e. a negative TE−e ) is a useful tool in identifying elevated LVEDP noninvasively. doi:10.1016/j.hlc.2010.06.428 421 Does Using an ACIST CVi Contrast Management System Reduce the Contrast Volume Delivered During Diagnostic Coronary Angiography? J. Crowhurst ∗ , M. Savage, S. Barbour, N. Faint, D. Walters The Prince Charles Hospital, Australia Background: Iodine based Contrast media has known nephro-toxic properties. The ACIST CVi (Advanced Contrast Injection System Technology) is designed for “ease of operation whilst maintaining high quality images and delivering less contrast to the patient”. This study was designed to assess the difference in contrast volume used when the ACIST CVi is used in comparison to a Hand injection system. Method: 1740 diagnostic coronary angiograms performed at The Prince Charles Hospital from 01/2009 to 12/2009 were included in this study. 1625 patients were imaged using one of two ACIST CVi units and 115 patients were imaged using a traditional hand injection system. All patients were examined on one of two Siemens Axiom Artis dBc digital X-ray systems in single plane configuration. These studies were further divided into sub-groups where a LV (Left Ventriculogram) angiogram was and was not performed. Results: Overall, in studies using the ACIST CVi unit, the contrast used was not significantly lower in comparison to a hand injection system (104 ml vs 101 ml, p = 0.427) when an LV was performed or when an LV was not performed (78 ml vs 75 ml, p = 0.687). Conclusion: This study demonstrates that an ACIST CVi contrast management system does not significantly reduce the volume of contrast used during routine diagnostic coronary angiography. However, the ACIST CVi unit does have other features, which may make it advantageous to a hand injection system. doi:10.1016/j.hlc.2010.06.429

Abstracts

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422 Echocardiographic Indices of Right Ventricular Systolic Function: A Cardiac Magnetic Resonance Comparative Study D. Leong 1,2,∗ , S. Grover 1,3 , P. Molaee 2 , N. Shipp 2 , A. Penhall 1 , R. Perry 1,3 , M. Shirazi 1 , A. Chakrabarty 3 , M. Joseph 1 , J. Selvanayagam 1,3 1 Cardiac Imaging Research Centre, Flinders Medical Centre, Adelaide, Australia 2 Cardiovascular Research Centre, Department of Cardiology, Royal Adelaide Hospital and the Discipline of Medicine University of Adelaide, Adelaide, Australia 3 Flinders University, Adelaide, Australia

Background: Echocardiographic measurement of RV ejection fraction (RVEF) is challenging owing to the unique geometry of the RV. Alternate echocardiographic indices of RV function have prognostic value in heart failure: tricuspid annular plane systolic excursion (TAPSE), peak tricuspid annular systolic velocity (RV S ), and RV fractional area change (RV FAC). Comparison between these techniques is limited. We sought to compare these techniques against cardiac magnetic resonance (CMR) RVEF. Methods: We prospectively recruited 56 patients with heart failure (age 55 ± 27 years) and 17 healthy controls (age 53 ± 8 years). Subjects underwent echocardiography, CMR, and 6-min walk test. TAPSE was measured by Mmode echocardiography. RV S was measured as the peak velocity of the lateral tricuspid annulus during systole. RV areas were measured from 2D-echocardiographic images to calculate RV FAC. Ventricular volumes were measured from short-axis CMR images. Results: TAPSE exhibited strongest correlation with CMR RVEF (r2 = 0.42, p < 0.001). RV S and RV FAC demonstrated only moderate correlation with CMR RVEF (r2 = 0.23, p < 0.001 and r2 = 0.28, p = 0.002, respectively). ROC curve analysis suggested optimal cut-off values to estimate CMR RVEF <45% of TAPSE 1.7 cm (AUC 0.78), RV S 7.4 cm/s (AUC 0.77) and RV FAC 48% (AUC 0.56). CMR LVEF (r2 = 0.18, p = 0.001), CMR RV end-diastolic volume (r2 = 0.08, p = 0.03), RV S (r2 = 0.15, p = 0.004) and E (r2 = 0.15, p = 0.001) were significantly associated with 6min walk distance, whereas CMR RVEF, TAPSE, RV FAC, transmitral E velocity, E/A and E/E were not. Conclusions: TAPSE correlated strongly with CMR RVE; RV S and RV FAC exhibited only moderate correlation. RV S was the only index of RV function that was associated with functional capacity. doi:10.1016/j.hlc.2010.06.430

ABSTRACTS

Heart, Lung and Circulation 2010;19S:S1–S268