Authors:
G. Bastarrika, J. Arias, M. Ferreira, M. Arraiza, G. Viteri, G. Rabago; Pamplona/ES
DOI:
10.1594/ecr2010/C-0548
Purpose
Accurate assessment of atrial function has a significant impact in the follow-up of patients with orthotopic heart transplantation (1). Traditionally, most of cardiac transplantations have been performed according to the biatrial anastomotic technique (2). This surgical technique results in sinus node dysfunction (3), valvular insufficiency (4), and thrombus formation(5) . Development of bicaval technique (6-8) has shown to derive in smaller atrial volumes, more physiologic atrial contraction, more synchronous function of these chambers, and fewer atrioventricular valve regurgitation (9, 10). Moreover, the bicaval technique apparently provides superior results in terms of reduction in long-term post-transplant complications (11).
Assessment of atrial volumes and function can be performed with different imaging modalities including transthoracic echocardiography (12) and magnetic resonance imaging (MRI) (9), which is considered the current standard of reference for this purpose. These techniques, however, do not lack of limitations, especially in heart transplant recipients(13). Multidetector computed tomography (MDCT), with some limitations, is increasingly being employed in heart transplant recipients to assess cardiac allograft vasculopathy (14-16) and evaluate allograft function (14). Limited temporal resolution of conventional MDCT has been surpassed by the recently introduced dual-source CT system (DSCT), which due to the combination of high temporal and spatial resolution seems to be a more promising tool to evaluate coronary artery vasculature in this specific population (17-20). Little is known, however, about the ability of DSCT to evaluate atrial function (21).
To the best of our knowledge reliability and accuracy of quantifying atrial performance with DSCT with respect to MRI has not been evaluated yet. The present study was performed with the aim of comparing left atrial volumes and function quantification derived from cardiac dual-source CT (DSCT) exams with respect to MRI in orthotopic heart transplant recipients operated with biatrial and bicaval anastomotic techniques.