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We studied 100 consecutive patients who underwent clinically indicated cardiac MRI and TTE studies within 12\u00a0months between July 2017 and December 2020; 50 (28 females and 22 males; 54.5\u2009\u00b1\u200918.7\u00a0years) with normal body mass index (BMI) (18.5\u201325\u00a0kg\/m<jats:sup>2<\/jats:sup>) and 50 (21 females and 29 males; 47.2\u2009\u00b1\u200913.3\u00a0years) with severe obesity (BMI\u2009\u2265\u200940\u00a0kg\/m<jats:sup>2<\/jats:sup>). MRI and TTE image quality scores were compared within and across cohorts using a linear mixed model. Categorical left (LVF) and right (RVF) ventricular function were compared using Cohens Kappa statistic. Mean BMI for normal weight and obese cohorts were 22.2\u2009\u00b1\u20091.7\u00a0kg\/m<jats:sup>2<\/jats:sup> and 50.3\u2009\u00b1\u20095.9\u00a0kg\/m<jats:sup>2<\/jats:sup>, respectively. Out of a possible 93 points, mean MRI image quality score was 91.5\u2009\u00b1\u20092.5 for patients with normal BMI, and 88.4\u2009\u00b1\u20095.5 for patients with severe obesity; least square (LS) mean difference 3.1, p\u2009=\u20090.460. TTE scores were 64.2\u2009\u00b1\u200913.6 for patients with normal BMI and 46.0\u2009\u00b1\u200912.9 for patients with severe obesity, LS mean difference 18.2, p\u2009&lt;\u20090.001. Ventricular function agreement between modalities was worse in the obese cohort for both LVF (72% vs 80% agreement; kappa 0.53 vs 0.70, obese vs. normal BMI), and RVF (58% vs 72% agreement, kappa 0.18 vs 0.34, obese vs. normal BMI). Severe obesity had limited impact on cardiac MRI image quality, while obesity significantly degraded TTE image quality and ventricular function agreement with MRI.<\/jats:p>","DOI":"10.1007\/s10554-024-03078-y","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T11:14:15Z","timestamp":1713266055000},"page":"1081-1094","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The impact of severe obesity on image quality and ventricular function assessment in echocardiography and cardiac MRI"],"prefix":"10.1007","volume":"40","author":[{"given":"Akash","family":"Goyal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.","family":"Crabtree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan C.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thura T.","family":"Harfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Rajpal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat O.","family":"Yildiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orlando P.","family":"Simonetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S.","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"3078_CR1","first-page":"1","volume":"360","author":"CM Hales","year":"2020","unstructured":"Hales CM (2020) Prevalence of obesity and severe obesity among adults: United States. 2017\u20132018. 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