Congenital heart diseaseCardiac Magnetic Resonance Imaging and the Assessment of Ebstein Anomaly in Adults
Section snippets
Methods
Consecutive adults with an unrepaired Ebstein anomaly who had been referred for a CMR study from May 2004 to December 2009 at our hospital were retrospectively identified. This initial point was chosen, because it reflected a change in the CMR imaging protocol and sequence acquisition at our institution that continues to be used at present. The patients were included if the CMR studies were technically adequate for image analysis with a complete complement of cine views (4-chamber, axial, and
Results
Clinical data were available for 31 patients (median age at CMR study 39 years, range 21 to 68; 72% women). Most were classified as New York Heart Association (NYHA) functional class I (20 [65%]) or NYHA functional class II (10 [32%]), with 1 as NYHA functional class III (3%) and none as NYHA functional class IV. A significant subset (15 [48%]) of patients had atrial level shunts (patent foramen ovale or secundum atrial septal defect) on the echocardiogram and/or CMR imaging study; moderate or
Discussion
The present study is the first to have focused on the CMR features of Ebstein anomaly. Quantitative measures of right heart size and systolic function were achievable and reproducible using contemporary CMR methods, even in the presence of severe disease and significant distortion in the RV anatomy. Axial imaging appeared to provide more reliable measurements than short-axis imaging in this setting. New expressions of disease severity, such as the atrialized RV volume, have emerged from the
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Left, but not right, ventricular status determines heart failure in adults with Ebstein anomaly – A case-control study based on magnetic resonance
2022, International Journal of CardiologyCone reconstruction for Ebstein anomaly: Late biventricular function and possible remodeling
2021, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Although all CMR data were evaluated by a single specialist imaging cardiologist, minimizing inter- and intraobserver variability to give good reproducibility remains an important issue. A recent study by our center showed reasonable reproducibility for a single CMR parameter in patients with Ebstein anomaly,15 and Yalonetsky and colleagues16 showed that RV size and function can reliably be assessed among observers. Until now, few studies have used CMR to investigate RV function and possible remodeling after cone reconstruction, although the advantages of CMR are clear.
SCMR Position Paper (2020) on clinical indications for cardiovascular magnetic resonance
2020, Journal of Cardiovascular Magnetic ResonanceSeverity Scores for Ebstein Anomaly: Credibility and Usefulness of Echocardiographic vs Magnetic Resonance Assessments of the Celermajer Index
2019, Canadian Journal of CardiologyCitation Excerpt :Because patients with an implantable device were not included in the study (because of probable artifacts disabling proper analysis in CMR), we consider this fact a potential selection bias. The methodology for the delineating and calculating the volumes of the right heart chambers in CMR varies between studies,13,17 which may contribute to inconsistent outcomes and obscured comparison and interpretation of the results. Echocardiographic measurements of the distorted and dilated RV also may be impaired by a poor acoustic window.
Tricuspid Valve Imaging and Intervention in Pediatric and Adult Patients With Congenital Heart Disease
2019, JACC: Cardiovascular ImagingCitation Excerpt :These can also be the alternative imaging techniques for patients with poor acoustic windows. In addition, these modalities allow accurate quantification of RV size and function (14,15), which is important in EA because of coexisting RV cardiomyopathy. RV size and function quantification by CMR imaging is done by obtaining a stack of steady-state free precession images of the heart in axial or short-axis planes.
Cardiac imaging in Ebstein anomaly
2018, Trends in Cardiovascular Medicine