Right ventricular dysfunction and dilatation in patients with mitral regurgitation: analysis using ECG-gated multidetector row computed tomography.
BACKGROUND
This study prospectively compared the accuracy of a sixty-four slice multidetector row CT (64-MDCT) in cardiac magnetic resonance imaging (MRI) for the assessment of right ventricular (RV) dysfunction and dilatation in patients with mitral regurgitation.


METHODS
Eighty-four patients underwent ECG-gated 64-MDCT for the assessment of RV dysfunction and dilatation; 54 of these patients had known mitral regurgitation. End-diastolic and end-systolic volumes, stroke volume, and ejection fraction were measured using the 64-MDCT, and these results were retrospectively compared to the results of MRI (reference standard). Agreement between the 64-MDCT and MRI results was investigated using linear regression and Bland-Altman analyses. Receiver operating characteristic analyses calculated the sensitivity and specificity of RV dilatation on 64-MDCT scans for the prediction of mitral regurgitation severity and dysfunction, respectively.


RESULTS
No significant differences in RV function parameters were calculated between 64-MDCT and MRI (r=0.87 to 0.94; all p<0.001). Good intertechnique agreement was obtained using linear regression and Bland-Altman analyses. ROC analyses revealed that RV enlargement (>33 mm) on 64-MDCT scans predicted the RV dysfunction of mitral regurgitation with a sensitivity of 92.9% and a specificity of 82.9%.


CONCLUSIONS
ECG-gated 64-MDCT accurately and reliably assessed RV function in patients with and without mitral regurgitation. Moreover, the presence of RV dilatation on the 64-MDCT scan assisted in the prediction of RV dysfunction and mitral regurgitation severity.