Abstract 10639: Abbreviated Cardiac Magnetic Resonance Imaging versus Echocardiography for Interval Assessment of Systolic Function in Duchenne Muscular Dystrophy: Patient Satisfaction, Clinical Utility and Image Quality

Abstract

Introduction: Interval assessment of systolic function in patients with Duchenne Muscular Dystrophy (DMD) is challenging by echocardiography (echo). Cardiac magnetic resonance imaging (CMR) has been limited due to study duration and patient experience. We developed an abbreviated CMR (aCMR) protocol which consisted only of cine acquisitions in the short axis, 4 chamber and vertical long axis planes, and compared it to echo in regard to: exam duration, patient satisfaction, clinical utility and image quality scores. Methods: DMD patients were recruited prospectively to undergo simultaneous echo and aCMR. Exclusion criteria included need for continuous positive pressure ventilation (PPV) and inability to lay supine ≥ 30 minutes. Subjects completed a patient satisfaction survey (PSS) comparing modalities. The clinical cardiologist completed a survey (CUS) assessing the clinical utility of each modality. A blinded expert reviewer completed an image quality survey (GQAS) for each modality. Results were compared using the Wilcoxon signed-rank test and Spearman correlation. Results: 19 DMD patients participated. PSS scores and exam duration were equivalent between modalities, while CUS and GQAS scores favored aCMR. ACMR scored particularly higher than echo in RV visualization and judgement of atrial size. Older age had a statistically significant negative correlation with echo GQAS and CUS scores, as well as aCMR PSS scores. Nighttime PPV requirement and non-ambulatory status were associated with worse echo CUS scores. Poor image quality precluding quantification existed in 4 (21%) echo and 0 aCMR studies. Conclusions: The aCMR protocol resulted in improved clinical utility and quality scores relative to echocardiography, without detriment in patient satisfaction or exam duration. For DMD patients known to have challenging echo acoustic windows, aCMR should be considered in lieu of echocardiography for interval assessment of systolic function.