Assessment of Left Ventricular Systolic Function by Cardiovascular Magnetic Resonance Compressed Sensing Real-Time Cine Imaging Combined With Area-Length Method in Normal Sinus Rhythm and Atrial Fibrillation.

The most-commonly used multi-slice Simpson's method employed with routine two-dimensional segmented cine images makes it difficult to evaluate left ventricular (LV) volume and function due to endocardial border blurring and beat-to-beat variation during atrial fibrillation (AF) status. To assess the feasibility of compressed sensing real-time (CSRT) cine imaging combined with an area-length method for quantification of LV systolic function in normal sinus rhythm (NSR) and AF. The CSRT cine sequence and routine segmented balanced Steady-State-Free-Precession cine sequence were performed in 71 patients with NSR (n = 36) or AF (n = 35). Image quality and edge sharpness for both sequences were assessed. The LV functional measurements in patients with NSR included end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), cardiac output (CO), cardiac index (CI), and LV mass (LVM); all were assessed using segmented cine with Simpson's rule in short axis (SegSA_Simpson, as a reference standard) and area-length (AL) method in the two chamber (Seg2CH_AL) or four chamber (Seg4CH_AL) and CSRT cine with AL method in the two chamber (CSRT2CH_AL) or four chamber (CSRT4CH_AL). Finally, the mean, maximum, and minimum values of each LV functional parameter [EDV/ESV/SV/EF/CO/CI/LVM/heart rate (HR)] from 4~5 consecutive heartbeats were measured using CSRT2CH_AL in patients with AF. In patients with NSR, measurements of EDV (p > 0.05), ESV (p > 0.05), SV (p > 0.05), EF (p > 0.05), and LVM (p > 0.05) assessed with CSRT2CH_AL did not differ significantly from those obtained with SegSA_Simpson. In patients with AF, CSRT image quality score (p < 0.001) and edge sharpness (p < 0.001) both were significantly higher than those obtained from segmented cine. The CSRT2CH_AL provided significantly different results among mean, maximum, and minimum values of each LV parameter from 4~5 consecutive heartbeats (all p < 0.001) with strong inter- and intra-observer agreement in AF. The CSRT cine sequence combined with two chamber area-length analysis accurately assessed LV systolic function in NSR. This approach is expected to permit the assessment of multiple parameters in consecutive heartbeats with good inter- and intra-observer reproducibility for beat-to-beat analysis of LV function in AF. Copyright © 2022 Yin, Cui, An, Zhao, Yang, Li, Yang, Wang, Dong, Yu, He, Chen, Lu and Zhao.

Citation

Gang Yin, Chen Cui, Jing An, Kankan Zhao, Kai Yang, Shuang Li, Xinling Yang, Jiaxin Wang, Zhixiang Dong, Shiqin Yu, Jian He, Xiuyu Chen, Minjie Lu, Shihua Zhao. Assessment of Left Ventricular Systolic Function by Cardiovascular Magnetic Resonance Compressed Sensing Real-Time Cine Imaging Combined With Area-Length Method in Normal Sinus Rhythm and Atrial Fibrillation. Frontiers in cardiovascular medicine. 2022;9:896816

PMID: 35711346

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