ABSTRACT
Objective@#This study aimed to evaluate the effect of implementing the consensus statement from the Asian Society of Cardiovascular Imaging-Practical Tutorial 2020 (ASCI-PT 2020) on the reliability of cardiac MR with late gadolinium enhancement (CMR-LGE) myocardial viability scoring between observers in the context of ischemic cardiomyopathy. @*Materials and Methods@#A total of 17 cardiovascular imaging experts from five different countries evaluated CMR obtained in 26 patients (male:female, 23:3; median age [interquartile range], 55.5 years [50–61.8]) with ischemic cardiomyopathy. For LGE scoring, based on the 17 segments, the extent of LGE in each segment was graded using a five-point scoring system ranging from 0 to 4 before and after exposure according to the consensus statement. All scoring was performed via webbased review. Scores for slices, vascular territories, and total scores were obtained as the sum of the relevant segmental scores. Interobserver reliability for segment scores was assessed using Fleiss’ kappa, while the intraclass correlation coefficient (ICC) was used for slice score, vascular territory score, and total score. Inter-observer agreement was assessed using the limits of agreement from the mean (LoA). @*Results@#Interobserver reliability (Fleiss’ kappa) in each segment ranged 0.242–0.662 before the consensus and increased to 0.301–0.774 after the consensus. The interobserver reliability (ICC) for each slice, each vascular territory, and total score increased after the consensus (slice, 0.728–0.805 and 0.849–0.884; vascular territory, 0.756–0.902 and 0.852–0.941; total score, 0.847 and 0.913, before and after implementing the consensus statement, respectively. Interobserver agreement in scoring also improved with the implementation of the consensus for all slices, vascular territories, and total score. The LoA for the total score narrowed from ± 10.36 points to ± 7.12 points. @*Conclusion@#The interobserver reliability and agreement for CMR-LGE scoring for ischemic cardiomyopathy improved when following guidance from the ASCI-PT 2020 consensus statement.
ABSTRACT
Intravenous anesthesia is commonly used in pediatric cardiac catheterization. Objectives: (1) Define the efficiency of this method administered for pediatric cardiac cathterization; (2) Evaluate, analysis some anesthetic complications occurred during and after the producedure. Methods: Either Ketamin or Propofol was used for the induction. Anesthesia was maintained by Propofol infusion. 41 patients who underwent cardiac catheterization were included into the study. Heart rate, SpO2, respiratory rate of patient and the quality as well as the complications of anesthesia were evaluated. Results: The rate of good induction, good maintenance and good recovery were 95.2%, 97.6% and 100%, respectively. 82.3% of patients had a recovery time around 15 minutes. The complications of anesthesia were documented: apnea and transient drop of SpO2 occurred in the induction (4.8%), severe respiratory distress (2.4%), increasing secretor sputum (4.8%). Conclusions: Intravenous anesthesia has maitained the efficiency of sedation for pediatric cardiac catheterization.