Quantification of mitral regurgitation and biventricular assessment is feasible during continuous supine exercise cardiovascular magnetic resonance in primary mitral regurgitation patients
Autor: | Noor Sharrack, Sharmaine Thirunavukarasu, Arka Das, John P Greenwood, M Gorecka, Nicholas Jex, E Dall\\'armellina, Amrit Chowdhary, Thomas P. Craven, Peter P Swoboda, Eylem Levelt, David M. Higgins, Lae Brown, Sven Plein |
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Rok vydání: | 2021 |
Předmět: |
Mitral regurgitation
medicine.medical_specialty Supine position Ejection fraction medicine.diagnostic_test business.industry Diastole Magnetic resonance imaging General Medicine Stroke volume Internal medicine cardiovascular system Cardiology End-diastolic volume Medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Systole Cardiology and Cardiovascular Medicine business |
Zdroj: | European Heart Journal - Cardiovascular Imaging. 22 |
ISSN: | 2047-2412 2047-2404 |
DOI: | 10.1093/ehjci/jeab090.104 |
Popis: | Funding Acknowledgements Type of funding sources: None. Background Biventricular volume and great vessel flow assessment during continuous supine free-breathing exercise cardiovascular magnetic resonance (Ex-CMR) is feasible in healthy volunteers using Compressed SENSEx3 (CS3) sequences1. Exercise transthoracic echocardiography (TTE) provides prognostic information in primary mitral regurgitation (MR). Resting CMR offers reference standard biventricular assessment and MR quantification with superior reproducibility to TTE. Ex-CMR assessment of biventricular volumes and quantitated MR may offer additional prognostic information. Purpose Determine the feasibility of biventricular assessment and MR quantification in primary MR patients during continuous supine Ex-CMR using the recently validated protocol1. Methods 10 asymptomatic patients with at least moderate primary MR on TTE (8 male, median age 62, 55-67years interquartile range) underwent continuous in-scanner (1.5T Philips Ingenia) supine cycle ergometer (Lode BV) Ex-CMR. Target heart rates (THR) were individually prescribed using heart rate reserve (HRR) and age predicted maximal heart rate model. Participants exercised for 2-minutes at no resistance, then an increase of 25-Watts every 2-minutes until THR achieved at low (30-39% HRR), then moderate (40-59% HRR) stages. CMR imaging: free-breathing CS3 respiratory navigated short axis cine imaging and free-breathing CS3 aortic phase-contrast magnetic-resonance at rest, low and moderate exercise stages. MR was quantified indirectly from left ventricular (LV) and aortic stroke volumes. Intra/inter-observer reproducibility was assessed by coefficient of variance (CV). Results All patients completed the Ex-CMR protocol without complication. During exercise, no statistically significant changes occurred in LV volumes, global left ventricular ejection fraction (LVEF), right ventricular end-diastolic or systolic volumes (Table 1). From rest to low and moderate exercise: right ventricular ejection fraction increased (55 ± 5.4% to 60 ± 6.0% and 63 ± 6.6% respectively, p = 0.001) and MR fraction decreased (40 ± 14% to 36 ± 11% and 30 ± 15% respectively, p = 0.006) allowing effective forward LVEF (aortic stroke volume/ left ventricular end-diastolic volume) to increase (38 ± 9.3% to 43 ± 9.3% and 46 ± 11% respectively, p = 0.004). Intra-observer reproducibility (Table 2) was excellent (CV Conclusion Biventricular assessment and MR quantification during continuous supine Ex-CMR is feasible in asymptomatic primary MR patients, further research assessing the techniques prognostic ability is now warranted. |
Databáze: | OpenAIRE |
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