Inter-study reproducibility of cardiovascular magnetic resonance-derived hemodynamic force assessments
Torben Lange1,2, Sören J Backhaus1,2,3, Alexander Schulz1,2
1Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
Insights
Cardiovascular magnetic resonance (CMR)-derived hemodynamic force (HDF) analysis shows excellent reproducibility for clinical use. Systolic forces are more reproducible than diastolic forces, requiring smaller sample sizes for detection of changes.
Area of Science:
- Cardiovascular imaging and diagnostics
- Biomedical engineering
- Cardiac mechanics
Background:
- Cardiovascular magnetic resonance (CMR) enables advanced cardiac function assessment through hemodynamic force (HDF) analysis.
- Quantifying inter-study reproducibility of novel CMR-derived HDF is crucial for clinical adoption.
Purpose of the Study:
- To evaluate the inter-study reproducibility of CMR-derived HDF measurements.
- To determine the sample sizes needed to detect relative changes in HDF parameters.
- To assess intra- and inter-observer variability.
Main Methods:
- Serial CMR imaging in 11 healthy participants with a median interval of 63 days.
- Assessment of various HDF parameters including longitudinal, systolic, diastolic, and atrial forces.
- Calculation of inter-study reproducibility, coefficients of variation (CoV), and required sample sizes.
Main Results:
- Excellent intra- and inter-observer reproducibility for all HDF parameters (ICC > 0.80).
- Excellent inter-study reproducibility for all HDF parameters (ICC ≥ 0.80).
- Systolic HDF parameters demonstrated lower CoV (e.g., 15.2% for systolic impulse) compared to diastolic parameters (e.g., 30.9% for atrial thrust).
- Sample sizes ranged from 12 to 200 participants to detect 10-20% relative changes.
Conclusions:
- CMR-derived HDF assessment exhibits sufficient inter-study reproducibility for clinical application.
- Systolic HDF measurements show greater reproducibility and require smaller sample sizes than diastolic HDF analyses.
- These findings support the clinical utility of HDF analysis in cardiovascular magnetic resonance imaging.
Abstract:
Cardiovascular magnetic resonance (CMR)-derived hemodynamic force (HDF) analyses have been introduced recently enabling more in-depth cardiac function evaluation. Inter-study reproducibility is important for a widespread clinical use but has not been quantified for this novel CMR post-processing tool yet. Serial CMR imaging was performed in 11 healthy participants in a median interval of 63 days (range 49-87). HDF assessment included left ventricular (LV) longitudinal, systolic peak and impulse, systolic/diastolic transition, diastolic deceleration as well as atrial thrust acceleration forces. Inter-study reproducibility and study sample sizes required to demonstrate 10%, 15% or 20% relative changes of HDF measurements were calculated. In addition, intra- and inter-observer analyses were performed. Intra- and inter-observer reproducibility was excellent for all HDF parameters according to intraclass correlation coefficient (ICC) values (> 0.80 for all). Inter-study reproducibility of all HDF parameters was excellent (ICC ≥ 0.80 for all) with systolic parameters showing lower coeffients of variation (CoV) than diastolic measurements (CoV 15.2% for systolic impulse vs. CoV 30.9% for atrial thrust). Calculated sample sizes to detect relative changes ranged from n = 12 for the detection of a 20% relative change in systolic impulse to n = 200 for the detection of 10% relative change in atrial thrust. Overall inter-study reproducibility of CMR-derived HDF assessments was sufficient with systolic HDF measurements showing lower inter-study variation than diastolic HDF analyses.
