Evaluation of left ventricular function using volumetric computed tomography in the clinical setting

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A. Tomografía computarizada en la cual se observa el flap de disección aórtica (flechas) tanto en aorta ascendente como descendente; diferenciándose la luz verdadera (a) de la luz falsa (b), y la presencia de un hematoma intramural en aorta descendente. B. Procedimiento de Bentall (vista del primer ayudante). Se observa el conducto de Dacrón® (1), así como el momento de la anastomosis de la arteria coronaria izquierda (2), y la aorta nativa (3). Pinza de aorta (4). Vena cava superior (5). Cánula venosa superior (6). 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Trevino, Lilia Sierra-Galan, José R. Azpiri-Lopez, José L. Assad-Morell, Jacobo Kirsch, Su Min Chang" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Erasmo" "apellidos" => "de la Peña-Almaguer" "email" => array:1 [ 0 => "edelapena@itesm.mx" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Alejandro R." "apellidos" => "Trevino" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Lilia" "apellidos" => "Sierra-Galan" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "José R." "apellidos" => "Azpiri-Lopez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "José L." "apellidos" => "Assad-Morell" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "Jacobo" "apellidos" => "Kirsch" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 6 => array:3 [ "nombre" => "Su Min" "apellidos" => "Chang" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Cátedra de Cardiología, Departamento de Investigación Básica y Transferencia, Instituto de Cardiología y Medicina Vascular, Hospital Zambrano Helión, Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, San Pedro Garza García, Nuevo León, Mexico" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Cátedra de Cardiología, Departamento de Cardiología, Hospital San José, Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, Mexico" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Imagen Cardiovascular, Departamento de Cardiología, Centro Médico ABC, México, D.F., Mexico" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Cardiología, Hospital Christus Muguerza Alta Especialidad, Universidad de Monterrey, Escuela de Medicina, Monterrey, Nuevo León, Mexico" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Cardiovascular Imaging, Department of Radiology, Cleveland Clinic Florida Hospital, Cleveland Clinic, Weston, FL, United States" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Cardiovascular Imaging, Department of Cardiology, DeBakey Heart and Vascular Center, The Methodist Hospital, Weill Cornell College of Medicine, Houston, TX, United States" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Centro Médico Zambrano-Helión, Batallón de San Patricio 112, Edificio Instituto de Cardiología y Medicina Vascular 2do piso, Real de San Agustín, San Pedro Garza García, Nuevo León 66278, Mexico. Tel.: +52 81 88880500; fax: +52 81 88880500." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación de la función ventricular con tomografía computada volumétrica en el ámbito clínico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1608 "Ancho" => 3274 "Tamanyo" => 252305 ] ] "descripcion" => array:1 [ "en" => "A strong correlation between computed tomography (CT) and cardiovascular magnetic resonance (CMR) was seen when assessing left ventricular mass, end systolic volume (ESV), end diastolic volume (EDV) and left ventricle ejection fraction (LVEF)." ] ] ] "textoCompleto" => "IntroductionThe evaluation of left ventricular function and mass has both prognostic and therapeutic implications; therefore, pharmacological, interventional or surgical interventions of left ventricular dysfunction require an adequate tool for staging and follow-up.<a class="elsevierStyleCrossRefs" href="#bib0065">1,2</a>Cardiovascular magnetic resonance (CMR) at 1.5T has been proven reliable for the evaluation of left ventricular (LV) function and is still used in many centers for cardiac assessment. It is currently accepted as the standard of reference for the evaluation of LV volumes, ejection fraction, and mass.<a class="elsevierStyleCrossRefs" href="#bib0070">2,3</a> The use of CMR at 3T has increased over the last few years. 3-T CMR provides a higher magnetic field, which translates into an increased contrast to noise ratio and signal to noise ratio, resulting in a clearer image of anatomical structures. It also allows faster image acquisition and a shorter repetition time. However, technical difficulties, such as compromise in B0 and B1 homogeneity, increased artifact resulting in signal loss, and increased specific absorption rate, which may approach the upper limit, have arisen from this technique.<a class="elsevierStyleCrossRefs" href="#bib0080">4–6</a>Multi-Slice Cardiovascular Computed Tomography using 16 slices or higher is another tool that has proved to be effective in the evaluation of coronary artery disease. This method allows concurrent evaluation of coronary anatomy and ventricular function, showing accurate values when compared to the reference standard, CMR.<a class="elsevierStyleCrossRefs" href="#bib0095">7–10</a>The objectives of this study are to evaluate the correlation between LV parameters, global and regional wall motion abnormalities, and the presence of artifacts using 3-T CMR and 64-slice Volumetric Computed Tomography (VCT), in patients with known or suspected coronary artery disease.Materials and methodsSubjectsThirty patients (23 men, aged 54.3±8 years) who presented with known or suspected coronary artery disease between April 2006 and July 2007 and who were referred for computed tomography coronary angiography and CMR underwent examination on a 3T MR scanner and cardiac VCT. Patient preparation and screening for contraindications were essential to ensure patient safety and optimal quality studies. Exclusion criteria for CT examination were renal insufficiency (serum creatinine>1.5mgs/dl), atrial fibrillation or another irregular rhythm. Patients with an unstable condition or an intervention between the different examinations were excluded. All patients provided written informed consent for contrast administration and the hospital ethics and research committee approved the study protocol.Magnetic resonance imagingImage acquisitionA 3-T MRI system using a cardiac 8 channel coil, with 23 to 50mT/m, slew rate of 80–150T/m/s was used (Signa Excite HD, GE Medical Systems, Milwaukee,WI). Cine-MRI was performed in short axis (SAX) (6–8 slices, steady-state free precession sequences) with additional horizontal long axis (HLA) and vertical long axis (VLA) slices, using a 10-mm thickness, no spacing, Flip Angle 40, Field of View (FOV) 38–44cm, Partial FOV of 0.75, phase 320, frequency 224, 1 NEX, 24 vps. Offline analysis of Global functional parameters were obtained with commercially available software (MASS analysis v6.1, Medis, NL) and as needed, corrected by using manual definition of the LV borders, applying the same method for the CT studies. Also, measurements were obtained twice for both methods to analyze interobserver variability of LV parameters.Myocardial delayed imagingMyocardial Delayed Enhanced (MDE) images were obtained in short axis (6–8 slices), HLA, and VLA 10min after 0.2mmolkg−1 Gd-DTPA at a 3mls−1 rate was administered. An inversion recovery-fast-gradient-echo (IR-FGRE) sequence was used with a slice thickness of 10mm, no spacing, flip angle 20°, whole gradient, Partial FOV 44cm, NEX 2, Phase 128, Frequency 128, 24 vps, with an inversion time of 175–250ms, adjusted to obtain proper myocardial saturation. Myocardial necrosis was defined as the region of the myocardial wall in which the persistence of the contrast agent was observed in two contiguous slices in the area of at least one coronary territory. A transmurality score was obtained (thickness of the contrast enhanced wall divided by the thickness of the whole myocardial wall×100%) and classified according to its extension from such images and classified as follows: 1–25%, 26–50%, 51–75% and >75%, for the assessment of abnormal regions and to determine whether a segmental wall motion abnormality (WMA) was due to an artifact, an infarct or both.Cardiac tomography acquisitionA 64-slice VCT (GE Medical Systems, Milwaukee, WI) was used for ECG-gated cardiac data acquisition. After a right antecubital 18 Fr vein access was obtained, intravenous beta blocker was administered in all patients with no oral beta blocker or contraindication (metroprolol 5–30mg IV) to reduce heart rate to <65beats/min. Sequential images were acquired at the level of the aorta and pulmonary artery using 20ml of a non-ionic contrast (Iopamidol, 370, Bracco Diagnostics, Inc, Monroe Township, NJ) at 5–7mls−1, followed by a saline bolus of 20ml for timing of the arrival of contrast; 3s were added to the time delay. The scanner parameters were cardiac segment or cardiac burst, retrospective ECG-gating with ECG modulation for dose reduction, gantry rotation of 350ms, gantry tilt 0, slice thickness of 0.625mm×0.625mm, speed 6.0, pitch 0.3:1, SFOV Large, Kv 100–120, ECG Modulated mA of 400–740.Images were acquired during apnea after hyperventilation. A retrospective reconstruction of the cardiac cycle was performed using 10% space intervals to obtain a complete cardiac cycle. Offline analysis of the images was performed at a workstation (Advantage Windows v4.2, GE Medical Systems, Milwaukee, WI). These were 6–10 SAX, HLA, and VLA obtained in a manner similar to that of cardiac MRI, with a 10-mm slice thickness and a 0.5-mm interval.Left ventricular function parametersGlobal parametersGlobal left ventricular ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and myocardial mass parameters were obtained and compared to those of VCT.Assessment of wall motion abnormalityFor VCT and CMR, cine loops of short axis slices (basal, mid-ventricular, apical,) as well as the 2 and 4 chamber orientation and graded using a 17-segment LV model according to the American Heart Association/American College of Cardiology guidelines were evaluated by 2 independent, blinded, experienced cardiologists, who had no knowledge of clinical information.<a class="elsevierStyleCrossRef" href="#bib0115">11</a> Images were scored as follows: normal=0, hypokinesis=1, akinesis=2 and dyskinesis=3. The WMA was also matched to its corresponding segment on the MDE images.Evaluation of Image quality and Artifacts MRIMRI and CT artifacts were graded as the amount of LV myocardial wall not visualized in its entirety due to artifacts in each of the 17 segments as follows: 0=normal, 1=myocardium not visualized<25%, 2=myocardium not visualized>26–50%, 3=myocardium not visualized>51–75%, 4=myocardium not visualized>76–100%.Statistical analysisData are expressed as mean values±standard deviation (SD). Comparisons between groups were assessed by a Two-sample t test and chi-square analysis for continuous and categorical variables. The correlation between continuous variables was assessed by Pearson's test, and Bland–Altman analysis was used to compare the quantitative data of CT with the reference standard CMR. The degree of agreement was expressed as the mean difference, limits of agreement (2 SD), and standard error of the mean differences. Kappa analyses of the global agreement between two observers in image quality and regional wall motion scores between VCT and CMR were performed and valued as follows: 0–0.2 low, 0.21–0.40 moderate, 0.41–0.60 substantial, 0.61–0.80 good, and ≥0.81 perfect agreement. The correlations between HR and the percent difference of EF, EDV, ESV (percent difference (%)=[(CT−CMR)/CMR]–100%), and summed scores between VCT and CMR, were additionally assessed by linear regression and correlation coefficient analyses. Data are expressed as means±standard deviation (SD). A P value <0.05 was considered statistically significant.ResultsThirty patients with a mean age of 55±12 years were included; 22 were men (73%) and 8 were women (27%). The mean time between scans was 1.2 days. No intervention was performed nor major hemodynamically or significant clinical events occurred during such scans. Clinical indications for the scans were ischemic heart disease, 21 (70%), dilated cardiomyopathy, 4 (13.3%), hypertension, 3 (10%), hypertrophic cardiomyopathy, 1 (3.3%), and pericarditis, 1 (3.3%). (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>)<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Left ventricular functionOverall, a strong correlation between LV function values for both methods was obtained. An overestimation of mass for CT was noted, although this was not statistically significant. The results for left ventricular indices were (for MRI and CT, respectively) mass 86.4±25.8 vs CT 82.7±27.6g (P=0.31), ESV 45.5±27.8 vs. 48.7±40.4ml (P=0.405), EDV 101.3±32.7 vs 105.1±44.0ml (P=0.475), SV 55.9±16.1 vs 56.8±15.6ml (P=0.713); LVEF 57.5±13.2% vs 56.9±12.4% (P=0.630). (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) No significant differences were found in intraobserver variability for either method CT r=0.96 r2=0.92, P<0.0001 and MR r=0.96 r2=0.93, P<0.0001 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia>The rank correlation analysis included 1020 segments assessed by two experienced observers. Observers analyzed segmental wall motion abnormalities as previously described in the methods section. A strong correlation for both methods was found among observers, Spearman ρ=0.554; P<0.001 Kendall τ–c=0.211; P<0.001. (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>)<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Interobserver variability assessing wall motion was low for both methods with a slight difference in documenting normal versus hypokinesis; CT had an observed concordance=0.796, an expected concordance=0.701 κ=0.3178; 95% CI=0.2302–0.4350; P<0.00001. (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>) When compared to VCT, CMR had fewer non-interpretable studies, but had a greater number of variability between observers; observed concordance=0.78, expected concordance=0.66, κ=0.3496; 95% CI=0.2702–0.4290 (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>). The incidence of artifacts was not statistically different among methods, where most artifacts involved less than 25–50% of subendocardial border visualization.<elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia>DiscussionThe use of high field magnetic resonance imposes certain benefits over the conventional standard of reference, CMR at 1.5T; however, initial results have shown a higher incidence of artifacts with 3T. High-field CMR offers a better temporal and spatial resolution, which translates into a faster anatomical evaluation due to faster sequences. The resonance spins are increased, providing robust fat saturation. There is a better response on blood oxygen level dependency (BOLD) effect for fMRI, as well as a greater peak dispersion, making it ideal for spectroscopy studies.<a class="elsevierStyleCrossRef" href="#bib0120">12</a> However, a little or no data are available on 3T for the evaluation of LV function and WMA, as compared to data analyzed by CT and other modalities.<a class="elsevierStyleCrossRefs" href="#bib0100">8–10</a>Clinical scenarios where CMR is used can be diverse, including research in normal volunteers, in which no pathology is present and normal hemodynamics and breathing patterns are observed. Imaging patients with pathology may pose some image acquisition problems when compared to normal subjects. Therefore, the limitations of this study include inherent variables due to pathologies, the presence of increased intravascular volumes due to contrast injection during the acquisition of CT datasets, where a non-significant increase in LV volumes was noted in those of CMR, and the use of beta blockers, which may affect stroke volume and exert a negative inotropic effect.We found a close correlation in the evaluation of global LV function systolic indices; however, in our study 64-slice VCT showed a non-significant tendency to underestimate LV mass. Regional wall motion assessment had a highly significant correlation between both methods, although 75% of the segments analyzed were normal. Interestingly, wall motion of septal segments does not correlate as well as that of the rest of the LV segments. Interobserver variability for wall motion assessed by 64-VCT goes beyond that expected by chance. No significant difference was found in the presence of artifacts when assessing global and regional LV systolic function by 64-VCT.ConclusionIn this study, 3-T CMR was comparable to 64-VCT in the assessment of LVEF, WMA, volumes, and LV mass without a significant incidence of artifacts. This makes 3-T CMR an excellent option to evaluate these parameters.Responsabilidades éticasProtección de personas y animalesLos autores declaran que para esta investigación no se han realizado experimentos en seres humanos ni en animales.Confidencialidad de los datosLos autores declaran que en este artículo no aparecen datos de pacientes.Derecho a la privacidad y consentimiento informadoLos autores han obtenido el consentimiento informado de los pacientes y/o sujetos referidos en el artículo. Este documento obra en poder del autor de correspondencia.FundingThis work was partially supported by Endowed Chair in Cardiology-Tec de Monterrey 0020CAT131.Conflict of interestThe authors declare no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:17 [ 0 => array:3 [ "identificador" => "xres607576" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec621364" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres607577" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec621363" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Subjects" ] ] ] 6 => array:3 [ "identificador" => "sec0020" "titulo" => "Magnetic resonance imaging" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Image acquisition" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Myocardial delayed imaging" ] ] ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Cardiac tomography acquisition" ] 8 => array:3 [ "identificador" => "sec0040" "titulo" => "Left ventricular function parameters" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Global parameters" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Assessment of wall motion abnormality" ] 2 => array:2 [ "identificador" => "sec0055" "titulo" => "Evaluation of Image quality and Artifacts MRI" ] ] ] 9 => array:2 [ "identificador" => "sec0060" "titulo" => "Statistical analysis" ] 10 => array:3 [ "identificador" => "sec0065" "titulo" => "Results" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0070" "titulo" => "Left ventricular function" ] ] ] 11 => array:2 [ "identificador" => "sec0075" "titulo" => "Discussion" ] 12 => array:2 [ "identificador" => "sec0080" "titulo" => "Conclusion" ] 13 => array:3 [ "identificador" => "sec0085" "titulo" => "Responsabilidades éticas" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0090" "titulo" => "Protección de personas y animales" ] 1 => array:2 [ "identificador" => "sec0095" "titulo" => "Confidencialidad de los datos" ] 2 => array:2 [ "identificador" => "sec0100" "titulo" => "Derecho a la privacidad y consentimiento informado" ] ] ] 14 => array:2 [ "identificador" => "sec0105" "titulo" => "Funding" ] 15 => array:2 [ "identificador" => "sec0110" "titulo" => "Conflict of interest" ] 16 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2015-04-29" "fechaAceptado" => "2015-05-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec621364" "palabras" => array:4 [ 0 => "Computed tomography" 1 => "Cardiovascular magnetic resonance" 2 => "Ejection fraction" 3 => "Mexico" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec621363" "palabras" => array:4 [ 0 => "Tomografía computarizada" 1 => "Resonancia magnética cardiaca" 2 => "Fracción de eyección" 3 => "México" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "ObjectiveTo correlate the left ventricular parameters obtained with 64-slice Volumetric Computed Tomography (VCT) with those obtained with the reference standard, cardiovascular magnetic resonance (CMR) imaging. MethodsVCT and a 3.0T MRI scanner were used. Results from both studies were independently evaluated by two cardiologists. A linear correlation and a paired Student's t test were used to analyze the data with a P<0.05 being considered significant. ResultsThirty consecutive patients were evaluated with VCT and CMR. The left ventricular indices for CMR and VCT were, respectively, mass 86.4±25.8 vs. 82.7±27.6g (P=0.31); ESV 45.5±27.8 vs. 48.7±40.4ml (P=.405); EDV 101.3±32.7 vs. 105.1±44.0ml (P=0.475); SV 55.9±16.1 vs. 56.8±15.6ml (P=0.713); LVEF 57.5±13.2% vs. 56.9±12.4% (P=0.630). No differences in intraobserver variability for both methods were found, CT r=0.96, r2=0.92 P<0.0001 and MR r=0.96 r2=0.93 P<0.0001. There was no significant statistical difference in the presence of artifacts. ConclusionThere is a close correlation between CMRI and VCT in the evaluation of LV function. VCT is as useful as 3T CMR, and could be incorporated as another resource for evaluating LV function." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "ObjetivoCorrelacionar los parámetros del ventrículo izquierdo obtenidos con la tomografía computarizada volumétrica (TCV) de 64 cortes con el estándar de referencia, la resonancia magnética cardiaca (RMC). MétodosSe usó una TCV de 64 cortes y una RMC de 3.0 Teslas. Ambos estudios fueron interpretados de manera independiente por dos cardiólogos. Los datos se analizaron con la prueba t de Student y una correlación lineal, resultando significativo valores de P<0.05. ResultadosTreinta pacientes consecutivos fueron evaluados con TCV y RMC. Los índices del ventrículo izquierdo mediante RMC y TCV fueron, respectivamente, masa 86.4±25.8 vs. 82.7±27.6g (P=0.31); volumen telesistólico 45.5±27.8 vs. 48.7±40.4ml (P=0.405); volumen telediastólico 101.3±32.7 vs. 105.1±44.0ml (P=0.475); volumen latido 55.9±16.1 vs. 56.8±15.6ml (P=0.713); fracción de eyección de ventrículo izquierdo 57.5±13.2% vs. 56.9±12.4% (P=0.630). No hubo diferencias entre la variabilidad intraobservador para ambos métodos, CT r=0.96 r2= 0.92 P<0.0001 y MR r=0.96 r2r=0.93, P<0.0001. No se encontraron diferencias significativas en la presencia de artefactos. ConclusiónHay correlación estrecha entre RMC y TCV en la evaluación de la función ventricular. La TCV es tan útil como la RMC y pudiera incorporarse como otro recurso para valorar la función ventricular." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1608 "Ancho" => 3274 "Tamanyo" => 252305 ] ] "descripcion" => array:1 [ "en" => "A strong correlation between computed tomography (CT) and cardiovascular magnetic resonance (CMR) was seen when assessing left ventricular mass, end systolic volume (ESV), end diastolic volume (EDV) and left ventricle ejection fraction (LVEF)." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "MDE+MR, myocardial delayed enhanced+magnetic resonance" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age, years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55±12 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (73) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mean time between scans \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.2 days \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Comorbidities:</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Ischemic heart disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21 (70) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dilated cardiomyopathy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (13.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypertension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (10) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hyperthrophic cardiomyopathy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Pericarditis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">MDE+MR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab994868.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Patient demographics." ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CMR, cardiovascular magnetic resonance; VCT, volumetric computed tomography; EDV, end diastolic volume; ESV, end systolic volume; LVEF, left ventricular ejection fraction; SV, stroke volume." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameter \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CT (n=30) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CMR (n=30) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">P \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Mass, g \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">86.4±25.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82.7±27.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.311 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">ESV, ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.5±27.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.7±40.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.405 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">EDV, ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">101.3±32.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">105.1±44.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.475 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">SV, ml \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">55.9±16.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.8±15.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.713 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LVEF, % \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57.5±13.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.9±12.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.63 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab994871.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Global left ventricular function assessed by cardiovascular magnetic resonance (CMR) and computed tomography." ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CMR, cardiovascular magnetic resonance; VCT, volumetric computed tomography; WMA, wall motion abnormalities." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">CMR-17 segments WMA</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non interpretable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Normal \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hypokinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Akinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dyskinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top">VCT-64–17 segments WMA</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Non interpretable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">764 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">846 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypokinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Akinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dyskinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">822 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">117 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1020 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab994872.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Correlation between volumetric computed tomography and cardiovascular magnetic resonance when evaluating wall motion abnormalities. Spearman ρ=0.554; p<0.001 Kendall τ–c=0.211; p<0.001." ] ] 4 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CT, volumetric computed tomography; WMA, wall motion abnormalities." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">WMA-VCT-64 Observer 1</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non interpretable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Normal \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hypokinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Akinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dyskinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top">WMA-VCT-64 Observer 2</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Non interpretable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">382 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">420 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypokinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Akinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dyskinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">427 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">510 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab994870.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Interobserver variability of wall motion abnormalities with volumetric computed tomography." ] ] 5 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "CMR, cardiovascular magnetic resonance; WMA, wall motion abnormalities." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">WMA CMR Observer 1</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non interpretable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Normal \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hypokinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Akinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dyskinesis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="7" align="left" valign="top">WMA CMR Observer 2</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Non interpretable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">372 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">397 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypokinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">76 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Akinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Dyskinesis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">426 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">510 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab994869.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Interobserver variability of wall motion abnormalities with cardiovascular magnetic resonance." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib0065" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of 15-year survival for men and women after initial medical or surgical treatment for coronary artery disease: a CASS registry study. Coronary Artery Surgery Study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K.B. Davis" 1 => "B. Chaitman" 2 => "T. Ryan" 3 => "V. Bittner" 4 => "J.W. Kennedy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "1995" "volumen" => "25" "paginaInicial" => "1000" "paginaFinal" => "1009" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7897108" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0070" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRI of left ventricular function" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F.H. 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Image in Cardiology

Evaluación de la función ventricular con tomografía computada volumétrica en el ámbito clínico

Erasmo de la Peña-Almaguera,

Corresponding author

edelapena@itesm.mx

Corresponding author at: Centro Médico Zambrano-Helión, Batallón de San Patricio 112, Edificio Instituto de Cardiología y Medicina Vascular 2do piso, Real de San Agustín, San Pedro Garza García, Nuevo León 66278, Mexico. Tel.: +52 81 88880500; fax: +52 81 88880500.

, Alejandro R. Trevinob, Lilia Sierra-Galanc, José R. Azpiri-Lopezd, José L. Assad-Morelld, Jacobo Kirsche, Su Min Changf

a Cátedra de Cardiología, Departamento de Investigación Básica y Transferencia, Instituto de Cardiología y Medicina Vascular, Hospital Zambrano Helión, Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, San Pedro Garza García, Nuevo León, Mexico

b Cátedra de Cardiología, Departamento de Cardiología, Hospital San José, Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, Mexico

c Imagen Cardiovascular, Departamento de Cardiología, Centro Médico ABC, México, D.F., Mexico

d Departamento de Cardiología, Hospital Christus Muguerza Alta Especialidad, Universidad de Monterrey, Escuela de Medicina, Monterrey, Nuevo León, Mexico

e Cardiovascular Imaging, Department of Radiology, Cleveland Clinic Florida Hospital, Cleveland Clinic, Weston, FL, United States

f Cardiovascular Imaging, Department of Cardiology, DeBakey Heart and Vascular Center, The Methodist Hospital, Weill Cornell College of Medicine, Houston, TX, United States

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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A strong correlation between computed tomography &#40;CT&#41; and cardiovascular magnetic resonance &#40;CMR&#41; was seen when assessing left ventricular mass&#44; end systolic volume &#40;ESV&#41;&#44; end diastolic volume &#40;EDV&#41; and left ventricle ejection fraction &#40;LVEF&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The evaluation of left ventricular function and mass has both prognostic and therapeutic implications&#59; therefore&#44; pharmacological&#44; interventional or surgical interventions of left ventricular dysfunction require an adequate tool for staging and follow-up&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Cardiovascular magnetic resonance &#40;CMR&#41; at 1&#46;5<span class="elsevierStyleHsp" style=""></span>T has been proven reliable for the evaluation of left ventricular &#40;LV&#41; function and is still used in many centers for cardiac assessment&#46; It is currently accepted as the standard of reference for the evaluation of LV volumes&#44; ejection fraction&#44; and mass&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">2&#44;3</span></a> The use of CMR at 3<span class="elsevierStyleHsp" style=""></span>T has increased over the last few years&#46; 3-T CMR provides a higher magnetic field&#44; which translates into an increased contrast to noise ratio and signal to noise ratio&#44; resulting in a clearer image of anatomical structures&#46; It also allows faster image acquisition and a shorter repetition time&#46; However&#44; technical difficulties&#44; such as compromise in B0 and B1 homogeneity&#44; increased artifact resulting in signal loss&#44; and increased specific absorption rate&#44; which may approach the upper limit&#44; have arisen from this technique&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">4&#8211;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Multi-Slice Cardiovascular Computed Tomography using 16 slices or higher is another tool that has proved to be effective in the evaluation of coronary artery disease&#46; This method allows concurrent evaluation of coronary anatomy and ventricular function&#44; showing accurate values when compared to the reference standard&#44; CMR&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">7&#8211;10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The objectives of this study are to evaluate the correlation between LV parameters&#44; global and regional wall motion abnormalities&#44; and the presence of artifacts using 3-T CMR and 64-slice Volumetric Computed Tomography &#40;VCT&#41;&#44; in patients with known or suspected coronary artery disease&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Subjects</span><p id="par0025" class="elsevierStylePara elsevierViewall">Thirty patients &#40;23 men&#44; aged 54&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8 years&#41; who presented with known or suspected coronary artery disease between April 2006 and July 2007 and who were referred for computed tomography coronary angiography and CMR underwent examination on a 3<span class="elsevierStyleHsp" style=""></span>T MR scanner and cardiac VCT&#46; Patient preparation and screening for contraindications were essential to ensure patient safety and optimal quality studies&#46; Exclusion criteria for CT examination were renal insufficiency &#40;serum creatinine<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>1&#46;5<span class="elsevierStyleHsp" style=""></span>mgs&#47;dl&#41;&#44; atrial fibrillation or another irregular rhythm&#46; Patients with an unstable condition or an intervention between the different examinations were excluded&#46; All patients provided written informed consent for contrast administration and the hospital ethics and research committee approved the study protocol&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Magnetic resonance imaging</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Image acquisition</span><p id="par0030" class="elsevierStylePara elsevierViewall">A 3-T MRI system using a cardiac 8 channel coil&#44; with 23 to 50<span class="elsevierStyleHsp" style=""></span>mT&#47;m&#44; slew rate of 80&#8211;150<span class="elsevierStyleHsp" style=""></span>T&#47;m&#47;s was used &#40;Signa Excite HD&#44; GE Medical Systems&#44; Milwaukee&#44;WI&#41;&#46; Cine-MRI was performed in short axis &#40;SAX&#41; &#40;6&#8211;8 slices&#44; steady-state free precession sequences&#41; with additional horizontal long axis &#40;HLA&#41; and vertical long axis &#40;VLA&#41; slices&#44; using a 10-mm thickness&#44; no spacing&#44; Flip Angle 40&#44; Field of View &#40;FOV&#41; 38&#8211;44<span class="elsevierStyleHsp" style=""></span>cm&#44; Partial FOV of 0&#46;75&#44; phase 320&#44; frequency 224&#44; 1 NEX&#44; 24 vps&#46; Offline analysis of Global functional parameters were obtained with commercially available software &#40;MASS analysis v6&#46;1&#44; Medis&#44; NL&#41; and as needed&#44; corrected by using manual definition of the LV borders&#44; applying the same method for the CT studies&#46; Also&#44; measurements were obtained twice for both methods to analyze interobserver variability of LV parameters&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Myocardial delayed imaging</span><p id="par0035" class="elsevierStylePara elsevierViewall">Myocardial Delayed Enhanced &#40;MDE&#41; images were obtained in short axis &#40;6&#8211;8 slices&#41;&#44; HLA&#44; and VLA 10<span class="elsevierStyleHsp" style=""></span>min after 0&#46;2<span class="elsevierStyleHsp" style=""></span>mmol<span class="elsevierStyleHsp" style=""></span>kg<span class="elsevierStyleSup">&#8722;1</span> Gd-DTPA at a 3<span class="elsevierStyleHsp" style=""></span>ml<span class="elsevierStyleHsp" style=""></span>s<span class="elsevierStyleSup">&#8722;1</span> rate was administered&#46; An inversion recovery-fast-gradient-echo &#40;IR-FGRE&#41; sequence was used with a slice thickness of 10<span class="elsevierStyleHsp" style=""></span>mm&#44; no spacing&#44; flip angle 20&#176;&#44; whole gradient&#44; Partial FOV 44<span class="elsevierStyleHsp" style=""></span>cm&#44; NEX 2&#44; Phase 128&#44; Frequency 128&#44; 24 vps&#44; with an inversion time of 175&#8211;250<span class="elsevierStyleHsp" style=""></span>ms&#44; adjusted to obtain proper myocardial saturation&#46; Myocardial necrosis was defined as the region of the myocardial wall in which the persistence of the contrast agent was observed in two contiguous slices in the area of at least one coronary territory&#46; A transmurality score was obtained &#40;thickness of the contrast enhanced wall divided by the thickness of the whole myocardial wall<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>100&#37;&#41; and classified according to its extension from such images and classified as follows&#58; 1&#8211;25&#37;&#44; 26&#8211;50&#37;&#44; 51&#8211;75&#37; and &#62;75&#37;&#44; for the assessment of abnormal regions and to determine whether a segmental wall motion abnormality &#40;WMA&#41; was due to an artifact&#44; an infarct or both&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Cardiac tomography acquisition</span><p id="par0040" class="elsevierStylePara elsevierViewall">A 64-slice VCT &#40;GE Medical Systems&#44; Milwaukee&#44; WI&#41; was used for ECG-gated cardiac data acquisition&#46; After a right antecubital 18 Fr vein access was obtained&#44; intravenous beta blocker was administered in all patients with no oral beta blocker or contraindication &#40;metroprolol 5&#8211;30<span class="elsevierStyleHsp" style=""></span>mg IV&#41; to reduce heart rate to &#60;65<span class="elsevierStyleHsp" style=""></span>beats&#47;min&#46; Sequential images were acquired at the level of the aorta and pulmonary artery using 20<span class="elsevierStyleHsp" style=""></span>ml of a non-ionic contrast &#40;Iopamidol&#44; 370&#44; Bracco Diagnostics&#44; Inc&#44; Monroe Township&#44; NJ&#41; at 5&#8211;7<span class="elsevierStyleHsp" style=""></span>ml<span class="elsevierStyleHsp" style=""></span>s<span class="elsevierStyleSup">&#8722;1</span>&#44; followed by a saline bolus of 20<span class="elsevierStyleHsp" style=""></span>ml for timing of the arrival of contrast&#59; 3<span class="elsevierStyleHsp" style=""></span>s were added to the time delay&#46; The scanner parameters were cardiac segment or cardiac burst&#44; retrospective ECG-gating with ECG modulation for dose reduction&#44; gantry rotation of 350<span class="elsevierStyleHsp" style=""></span>ms&#44; gantry tilt 0&#44; slice thickness of 0&#46;625<span class="elsevierStyleHsp" style=""></span>mm<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>0&#46;625<span class="elsevierStyleHsp" style=""></span>mm&#44; speed 6&#46;0&#44; pitch 0&#46;3&#58;1&#44; SFOV Large&#44; Kv 100&#8211;120&#44; ECG Modulated mA of 400&#8211;740&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Images were acquired during apnea after hyperventilation&#46; A retrospective reconstruction of the cardiac cycle was performed using 10&#37; space intervals to obtain a complete cardiac cycle&#46; Offline analysis of the images was performed at a workstation &#40;Advantage Windows v4&#46;2&#44; GE Medical Systems&#44; Milwaukee&#44; WI&#41;&#46; These were 6&#8211;10 SAX&#44; HLA&#44; and VLA obtained in a manner similar to that of cardiac MRI&#44; with a 10-mm slice thickness and a 0&#46;5-mm interval&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Left ventricular function parameters</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Global parameters</span><p id="par0050" class="elsevierStylePara elsevierViewall">Global left ventricular ejection fraction &#40;EF&#41;&#44; end-diastolic volume &#40;EDV&#41;&#44; end-systolic volume &#40;ESV&#41;&#44; stroke volume &#40;SV&#41; and myocardial mass parameters were obtained and compared to those of VCT&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Assessment of wall motion abnormality</span><p id="par0055" class="elsevierStylePara elsevierViewall">For VCT and CMR&#44; cine loops of short axis slices &#40;basal&#44; mid-ventricular&#44; apical&#44;&#41; as well as the 2 and 4 chamber orientation and graded using a 17-segment LV model according to the American Heart Association&#47;American College of Cardiology guidelines were evaluated by 2 independent&#44; blinded&#44; experienced cardiologists&#44; who had no knowledge of clinical information&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">11</span></a> Images were scored as follows&#58; normal<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44; hypokinesis<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44; akinesis<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2 and dyskinesis<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46; The WMA was also matched to its corresponding segment on the MDE images&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Evaluation of Image quality and Artifacts MRI</span><p id="par0060" class="elsevierStylePara elsevierViewall">MRI and CT artifacts were graded as the amount of LV myocardial wall not visualized in its entirety due to artifacts in each of the 17 segments as follows&#58; 0<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>normal&#44; 1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>myocardium not visualized<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>25&#37;&#44; 2<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>myocardium not visualized<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>26&#8211;50&#37;&#44; 3<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>myocardium not visualized<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>51&#8211;75&#37;&#44; 4<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>myocardium not visualized<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>76&#8211;100&#37;&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical analysis</span><p id="par0065" class="elsevierStylePara elsevierViewall">Data are expressed as mean values<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41;&#46; Comparisons between groups were assessed by a Two-sample <span class="elsevierStyleItalic">t</span> test and chi-square analysis for continuous and categorical variables&#46; The correlation between continuous variables was assessed by Pearson&#39;s test&#44; and Bland&#8211;Altman analysis was used to compare the quantitative data of CT with the reference standard CMR&#46; The degree of agreement was expressed as the mean difference&#44; limits of agreement &#40;2 SD&#41;&#44; and standard error of the mean differences&#46; Kappa analyses of the global agreement between two observers in image quality and regional wall motion scores between VCT and CMR were performed and valued as follows&#58; 0&#8211;0&#46;2 low&#44; 0&#46;21&#8211;0&#46;40 moderate&#44; 0&#46;41&#8211;0&#46;60 substantial&#44; 0&#46;61&#8211;0&#46;80 good&#44; and &#8805;0&#46;81 perfect agreement&#46; The correlations between HR and the percent difference of EF&#44; EDV&#44; ESV &#40;percent difference &#40;&#37;&#41;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#91;&#40;CT<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>CMR&#41;&#47;CMR&#93;<span class="elsevierStyleHsp" style=""></span>&#8211;<span class="elsevierStyleHsp" style=""></span>100&#37;&#41;&#44; and summed scores between VCT and CMR&#44; were additionally assessed by linear regression and correlation coefficient analyses&#46; Data are expressed as means<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41;&#46; A <span class="elsevierStyleItalic">P</span> value &#60;0&#46;05 was considered statistically significant&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0070" class="elsevierStylePara elsevierViewall">Thirty patients with a mean age of 55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12 years were included&#59; 22 were men &#40;73&#37;&#41; and 8 were women &#40;27&#37;&#41;&#46; The mean time between scans was 1&#46;2 days&#46; No intervention was performed nor major hemodynamically or significant clinical events occurred during such scans&#46; Clinical indications for the scans were ischemic heart disease&#44; 21 &#40;70&#37;&#41;&#44; dilated cardiomyopathy&#44; 4 &#40;13&#46;3&#37;&#41;&#44; hypertension&#44; 3 &#40;10&#37;&#41;&#44; hypertrophic cardiomyopathy&#44; 1 &#40;3&#46;3&#37;&#41;&#44; and pericarditis&#44; 1 &#40;3&#46;3&#37;&#41;&#46; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Left ventricular function</span><p id="par0075" class="elsevierStylePara elsevierViewall">Overall&#44; a strong correlation between LV function values for both methods was obtained&#46; An overestimation of mass for CT was noted&#44; although this was not statistically significant&#46; The results for left ventricular indices were &#40;for MRI and CT&#44; respectively&#41; mass 86&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;8 vs CT 82&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;6<span class="elsevierStyleHsp" style=""></span>g &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;31&#41;&#44; ESV 45&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;8 vs&#46; 48&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>40&#46;4<span class="elsevierStyleHsp" style=""></span>ml &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;405&#41;&#44; EDV 101&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#46;7 vs 105&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>44&#46;0<span class="elsevierStyleHsp" style=""></span>ml &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;475&#41;&#44; SV 55&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;1 vs 56&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;6<span class="elsevierStyleHsp" style=""></span>ml &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713&#41;&#59; LVEF 57&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;2&#37; vs 56&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;4&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;630&#41;&#46; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; No significant differences were found in intraobserver variability for either method CT <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96 <span class="elsevierStyleItalic">r</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;92&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 and MR <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96 <span class="elsevierStyleItalic">r</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;93&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The rank correlation analysis included 1020 segments assessed by two experienced observers&#46; Observers analyzed segmental wall motion abnormalities as previously described in the methods section&#46; A strong correlation for both methods was found among observers&#44; Spearman <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;554&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 Kendall <span class="elsevierStyleItalic">&#964;</span>&#8211;<span class="elsevierStyleItalic">c</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;211&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#46; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Interobserver variability assessing wall motion was low for both methods with a slight difference in documenting normal versus hypokinesis&#59; CT had an observed concordance<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;796&#44; an expected concordance<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;701 <span class="elsevierStyleItalic">&#954;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;3178&#59; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;2302&#8211;0&#46;4350&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;00001&#46; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41; When compared to VCT&#44; CMR had fewer non-interpretable studies&#44; but had a greater number of variability between observers&#59; observed concordance<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;78&#44; expected concordance<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;66&#44; <span class="elsevierStyleItalic">&#954;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;3496&#59; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;2702&#8211;0&#46;4290 &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41;&#46; The incidence of artifacts was not statistically different among methods&#44; where most artifacts involved less than 25&#8211;50&#37; of subendocardial border visualization&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">The use of high field magnetic resonance imposes certain benefits over the conventional standard of reference&#44; CMR at 1&#46;5<span class="elsevierStyleHsp" style=""></span>T&#59; however&#44; initial results have shown a higher incidence of artifacts with 3<span class="elsevierStyleHsp" style=""></span>T&#46; High-field CMR offers a better temporal and spatial resolution&#44; which translates into a faster anatomical evaluation due to faster sequences&#46; The resonance spins are increased&#44; providing robust fat saturation&#46; There is a better response on blood oxygen level dependency &#40;BOLD&#41; effect for fMRI&#44; as well as a greater peak dispersion&#44; making it ideal for spectroscopy studies&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">12</span></a> However&#44; a little or no data are available on 3<span class="elsevierStyleHsp" style=""></span>T for the evaluation of LV function and WMA&#44; as compared to data analyzed by CT and other modalities&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">8&#8211;10</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Clinical scenarios where CMR is used can be diverse&#44; including research in normal volunteers&#44; in which no pathology is present and normal hemodynamics and breathing patterns are observed&#46; Imaging patients with pathology may pose some image acquisition problems when compared to normal subjects&#46; Therefore&#44; the limitations of this study include inherent variables due to pathologies&#44; the presence of increased intravascular volumes due to contrast injection during the acquisition of CT datasets&#44; where a non-significant increase in LV volumes was noted in those of CMR&#44; and the use of beta blockers&#44; which may affect stroke volume and exert a negative inotropic effect&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">We found a close correlation in the evaluation of global LV function systolic indices&#59; however&#44; in our study 64-slice VCT showed a non-significant tendency to underestimate LV mass&#46; Regional wall motion assessment had a highly significant correlation between both methods&#44; although 75&#37; of the segments analyzed were normal&#46; Interestingly&#44; wall motion of septal segments does not correlate as well as that of the rest of the LV segments&#46; Interobserver variability for wall motion assessed by 64-VCT goes beyond that expected by chance&#46; No significant difference was found in the presence of artifacts when assessing global and regional LV systolic function by 64-VCT&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conclusion</span><p id="par0105" class="elsevierStylePara elsevierViewall">In this study&#44; 3-T CMR was comparable to 64-VCT in the assessment of LVEF&#44; WMA&#44; volumes&#44; and LV mass without a significant incidence of artifacts&#46; This makes 3-T CMR an excellent option to evaluate these parameters&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Responsabilidades &#233;ticas</span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Protecci&#243;n de personas y animales</span><p id="par0110" class="elsevierStylePara elsevierViewall">Los autores declaran que para esta investigaci&#243;n no se han realizado experimentos en seres humanos ni en animales&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Confidencialidad de los datos</span><p id="par0115" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Derecho a la privacidad y consentimiento informado</span><p id="par0120" class="elsevierStylePara elsevierViewall">Los autores han obtenido el consentimiento informado de los pacientes y&#47;o sujetos referidos en el art&#237;culo&#46; Este documento obra en poder del autor de correspondencia&#46;</p></span></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Funding</span><p id="par0125" class="elsevierStylePara elsevierViewall">This work was partially supported by <span class="elsevierStyleGrantSponsor" id="gs1">Endowed Chair in Cardiology-Tec de Monterrey</span> 0020CAT131&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conflict of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To correlate the left ventricular parameters obtained with 64-slice Volumetric Computed Tomography &#40;VCT&#41; with those obtained with the reference standard&#44; cardiovascular magnetic resonance &#40;CMR&#41; imaging&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">VCT and a 3&#46;0<span class="elsevierStyleHsp" style=""></span>T MRI scanner were used&#46; Results from both studies were independently evaluated by two cardiologists&#46; A linear correlation and a paired Student&#39;s <span class="elsevierStyleItalic">t</span> test were used to analyze the data with a <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 being considered significant&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Thirty consecutive patients were evaluated with VCT and CMR&#46; The left ventricular indices for CMR and VCT were&#44; respectively&#44; mass 86&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;8 vs&#46; 82&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;6<span class="elsevierStyleHsp" style=""></span>g &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;31&#41;&#59; ESV 45&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;8 vs&#46; 48&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>40&#46;4<span class="elsevierStyleHsp" style=""></span>ml &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;405&#41;&#59; EDV 101&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#46;7 vs&#46; 105&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>44&#46;0<span class="elsevierStyleHsp" style=""></span>ml &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;475&#41;&#59; SV 55&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;1 vs&#46; 56&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;6<span class="elsevierStyleHsp" style=""></span>ml &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713&#41;&#59; LVEF 57&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;2&#37; vs&#46; 56&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;4&#37; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;630&#41;&#46; No differences in intraobserver variability for both methods were found&#44; CT <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;92 <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 and MR <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96 <span class="elsevierStyleItalic">r</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;93 <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#46; There was no significant statistical difference in the presence of artifacts&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">There is a close correlation between CMRI and VCT in the evaluation of LV function&#46; VCT is as useful as 3<span class="elsevierStyleHsp" style=""></span>T CMR&#44; and could be incorporated as another resource for evaluating LV function&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Correlacionar los par&#225;metros del ventr&#237;culo izquierdo obtenidos con la tomograf&#237;a computarizada volum&#233;trica &#40;TCV&#41; de 64 cortes con el est&#225;ndar de referencia&#44; la resonancia magn&#233;tica cardiaca &#40;RMC&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se us&#243; una TCV de 64 cortes y una RMC de 3&#46;0 Teslas&#46; Ambos estudios fueron interpretados de manera independiente por dos cardi&#243;logos&#46; Los datos se analizaron con la prueba t de Student y una correlaci&#243;n lineal&#44; resultando significativo valores de P<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Treinta pacientes consecutivos fueron evaluados con TCV y RMC&#46; Los &#237;ndices del ventr&#237;culo izquierdo mediante RMC y TCV fueron&#44; respectivamente&#44; masa 86&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;8 vs&#46; 82&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;6<span class="elsevierStyleHsp" style=""></span>g &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;31&#41;&#59; volumen telesist&#243;lico 45&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;8 vs&#46; 48&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>40&#46;4<span class="elsevierStyleHsp" style=""></span>ml &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;405&#41;&#59; volumen telediast&#243;lico 101&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#46;7 vs&#46; 105&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>44&#46;0<span class="elsevierStyleHsp" style=""></span>ml &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;475&#41;&#59; volumen latido 55&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;1 vs&#46; 56&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;6<span class="elsevierStyleHsp" style=""></span>ml &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;713&#41;&#59; fracci&#243;n de eyecci&#243;n de ventr&#237;culo izquierdo 57&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;2&#37; vs&#46; 56&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;4&#37; &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;630&#41;&#46; No hubo diferencias entre la variabilidad intraobservador para ambos m&#233;todos&#44; CT r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96 r<span class="elsevierStyleSup">2</span>&#61; 0&#46;92 P<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001 y MR r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;96 r<span class="elsevierStyleSup">2</span>r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;93&#44; P<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#46; No se encontraron diferencias significativas en la presencia de artefactos&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Hay correlaci&#243;n estrecha entre RMC y TCV en la evaluaci&#243;n de la funci&#243;n ventricular&#46; La TCV es tan &#250;til como la RMC y pudiera incorporarse como otro recurso para valorar la funci&#243;n ventricular&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1608
            "Ancho" => 3274
            "Tamanyo" => 252305
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A strong correlation between computed tomography &#40;CT&#41; and cardiovascular magnetic resonance &#40;CMR&#41; was seen when assessing left ventricular mass&#44; end systolic volume &#40;ESV&#41;&#44; end diastolic volume &#40;EDV&#41; and left ventricle ejection fraction &#40;LVEF&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">MDE<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MR&#44; myocardial delayed enhanced<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>magnetic resonance</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Total</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Male</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Mean time between scans</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;2 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Comorbidities&#58;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ischemic heart disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dilated cardiomyopathy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hyperthrophic cardiomyopathy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pericarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>MDE<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>MR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab994868.png"
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          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Patient demographics&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">CMR&#44; cardiovascular magnetic resonance&#59; VCT&#44; volumetric computed tomography&#59; EDV&#44; end diastolic volume&#59; ESV&#44; end systolic volume&#59; LVEF&#44; left ventricular ejection fraction&#59; SV&#44; stroke volume&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Parameter&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CT &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CMR &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Mass&#44; g&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;311&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ESV&#44; ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>40&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;405&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">EDV&#44; ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">101&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>44&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">SV&#44; ml&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">55&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>16&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;713&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">LVEF&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab994871.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Global left ventricular function assessed by cardiovascular magnetic resonance &#40;CMR&#41; and computed tomography&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CMR&#44; cardiovascular magnetic resonance&#59; VCT&#44; volumetric computed tomography&#59; WMA&#44; wall motion abnormalities&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">CMR-17 segments WMA</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non interpretable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hypokinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Akinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dyskinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">VCT-64&#8211;17 segments WMA</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non interpretable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">846&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hypokinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Akinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dyskinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">822&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab994872.png"
              ]
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          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Correlation between volumetric computed tomography and cardiovascular magnetic resonance when evaluating wall motion abnormalities&#46; Spearman <span class="elsevierStyleItalic">&#961;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;554&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001 Kendall <span class="elsevierStyleItalic">&#964;&#8211;c</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;211&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">CT&#44; volumetric computed tomography&#59; WMA&#44; wall motion abnormalities&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">WMA-VCT-64 Observer 1</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non interpretable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hypokinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Akinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dyskinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">WMA-VCT-64 Observer 2</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non interpretable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">382&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hypokinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Akinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dyskinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">427&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">510&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab994870.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Interobserver variability of wall motion abnormalities with volumetric computed tomography&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">CMR&#44; cardiovascular magnetic resonance&#59; WMA&#44; wall motion abnormalities&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">WMA CMR Observer 1</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Non interpretable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Hypokinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Akinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Dyskinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">WMA CMR Observer 2</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Non interpretable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">372&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">397&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hypokinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Akinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dyskinesis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">426&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
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Article information

ISSN: 14059940
Original language: English

DOI:10.1016/j.acmx.2015.05.006

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2023 October	51	9	60
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2023 July	21	28	49
2023 June	30	13	43
2023 May	34	7	41
2023 April	40	5	45
2023 March	37	4	41
2023 February	21	10	31
2023 January	29	5	34
2022 December	38	8	46
2022 November	22	16	38
2022 October	37	18	55
2022 September	29	40	69
2022 August	27	10	37
2022 July	33	12	45
2022 June	20	12	32
2022 May	38	14	52
2022 April	33	22	55
2022 March	43	9	52
2022 February	30	5	35
2022 January	34	8	42
2021 December	36	11	47
2021 November	38	12	50
2021 October	47	23	70
2021 September	37	14	51
2021 August	15	8	23
2021 July	31	9	40
2021 June	27	11	38
2021 May	23	9	32
2021 April	77	9	86
2021 March	31	10	41
2021 February	21	6	27
2021 January	15	7	22
2020 December	29	10	39
2020 November	13	5	18
2020 October	22	10	32
2020 September	20	11	31
2020 August	26	10	36
2020 July	15	12	27
2020 June	11	9	20
2020 May	17	14	31
2020 April	19	6	25
2020 March	18	9	27
2020 February	19	13	32
2020 January	12	22	34
2019 December	24	20	44
2019 November	14	13	27
2019 October	12	11	23
2019 September	15	10	25
2019 August	10	10	20
2019 July	14	21	35
2019 June	47	27	74
2019 May	154	68	222
2019 April	47	19	66
2019 March	15	7	22
2019 February	14	16	30
2019 January	11	7	18
2018 December	13	20	33
2018 November	17	8	25
2018 October	15	49	64
2018 September	13	3	16
2018 August	5	7	12
2018 July	8	9	17
2018 June	16	6	22
2018 May	11	1	12
2018 April	10	5	15
2018 March	5	2	7
2018 February	11	4	15
2018 January	4	1	5
2017 December	16	0	16
2017 November	14	0	14
2017 October	13	2	15
2017 September	10	10	20
2017 August	14	1	15
2017 July	16	1	17
2017 June	25	21	46
2017 May	17	6	23
2017 April	14	8	22
2017 March	21	20	41
2017 February	8	6	14
2017 January	10	4	14
2016 December	21	8	29
2016 November	31	9	40
2016 October	51	11	62
2016 September	36	12	48
2016 August	42	6	48
2016 July	28	5	33
2016 June	38	16	54
2016 May	35	26	61
2016 April	37	33	70
2016 March	48	39	87
2016 February	17	12	29

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