Perbandingan Pengukuran Fraksi Ejeksi Ventrikel Kiri Menggunakan Metode Long Axis, Short Axis MRI Cardiac, dan Trans Thoracic Echocardiography

PAULINA YESSICA PRAMADITA MEGAPUTRI, Dr.dr.Lina Choridah, Sp.Rad (K) - PRP; dr.Sudarmanta Sp.Rad (K) - RI

2024 | Tesis | S2 Kedokteran Klinik

Latar Belakang : Penyakit kardiovaskuler menjadi penyebab utama kematian di dunia dengan 17,9 juta orang meninggal setiap tahunnya. Radiologi berperan dalam diagnosis dan penilaian left ventricular ejection fraction (LVEF).  Terdapat berbagai metode pengukuran non invasif LVEF seperti dengan MRI cardiac dan transthoracic echocardiography (TTE)

Tujuan : Mengetahui kesepakatan  nilai LVEF dengan menggunakan metode long axis, short axis pada MRI cardiac dan TTE

Metode : Penelitian dengan data sekunder terhadap 40 pasien dilakukan di RSUP Dr.Sardjito Yogyakarta selama periode tahun 2022-2023 terhadap pasien yang menjalani pemeriksaan MRI cardiac dan TTE dengan jarak pemeriksaan 1 bulan. Nilai LVEF (biplane ellipsoid model dan short axis) MRI cardiac dan TTE dibandingkan dengan menggunakan analisis bland-altman. 

Hasil : Analisis bland-altman menunjukkan nilai pengukuran LVEF CMR LAx dan SAx, CMR LAx dan TTE, dan CMR SAx dan TTE masih dalam limit of agreement. Median fraksi ejeksi TTE (65,5%), CMR LAx (63,4%), dan CMR SAx (57,0%). 

Kesimpulan : Analisis bland-altman menunjukkan kesepakatan antara metode long axis, short axis, dan TTE. Rerata LVEF metode long axis lebih mendekati rerata fraksi ejeksi TTE dibandingkan rerata fraksi ejeksi short axis.

Background: Cardiovascular disease is the most common cause of death worldwide, causing 17.9 million people to die every year.  Imaging plays a role in diagnosing and assessing left ventricular ejection fraction (LVEF), a marker of heart disease. There are various methods of noninvasive measurement of LVEF, such as cardiac magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE). 

Objective: To compare the agreement value of LVEF measurement using the calculation of the long and short axes in cardiac MRI and also in TTE.

Methods: This study was conducted at Dr. Sardjito Public Hospital in Yogyakarta using secondary data from 40 patients between 2022 and 2023 who underwent cardiac MRI and TTE within 1 month. LVEF values measured in the long-axis biplane ellipsoid model and the short axis were compared with LVEF obtained by TTE. These values were analyzed using a Bland-Altman plot.

Results:  Bland-Altman analysis showed agreement between the LVEF long axis, short axis, and TTE methods. The median ejection fractions were TTE (65.5%), CMR long-axis (63.4%), and CMR short-axis (57.0%).

Conclusion: Bland-Altman analysis showed agreement between the LVEF long axis, short axis, and TTE methods. The mean LVEF obtained using the long-axis method was closer to the mean TTE than to the mean short-axis ejection fraction. 

Kata Kunci : ejection fraction, magnetic resonance imaging, echocardiography