Intra-observer and interobserver variability of biventricular function, volumes and mass in patients with congenital heart disease measured by CMR imaging

Objective

The aim of this study was to assess intra-observer and interobserver variability of biventricular function, volumes and mass in a heterogeneous group of patients with congenital heart disease (CHD) using cardiovascular magnetic resonance (CMR) imaging.

Background

CMR imaging provides highly accurate measurements of biventricular volumes and mass and is frequently used in the follow-up of patients with acquired and congenital heart disease. Data on reproducibility are limited in patients with CHD, while measurements should be reproducible, since CMR imaging has a main contribution to decision making and timing of (re)interventions.

Methods

Thirty-five patients with CHD (26 males, 9 females; age range 7 – 62 years) were included in this study. A short axis set of contiguous slices was acquired with CMR imaging using a steady-state free precession (SSFP) pulse sequence. Intra-observer and interobserver variability was assessed for left ventricular (LV) and right ventricular (RV) volumes, function and mass by calculating the coefficient of variability.

Results

Intra-observer variability was between 2.9% and 6.8%, with the smallest variations in LV and RV end-diastolic volume (EDV) and the highest variations in LV end-systolic volume (ESV) and RV mass. Interobserver variability was between 3.9% and 10.2%, with the smallest variations in LV ejection fraction (EF) and RV EDV and the highest variations in biventricular ESV and mass.

Conclusion

Intra-observer and interobserver variability of biventricular parameters assessed by CMR imaging is good for a heterogeneous group of patients with CHD. CMR imaging is an accurate and reliable method for follow-up of biventricular function, volumes and mass and should allow adequate assessment of changes in ventricular size and global ventricular function.

Supported by NHF grant 2006B095