Cardiac compressed sensing real-time cine for the assessment of left ventricular function: a large sample size analysis.

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Segmented cine imaging using a balanced steady-state free precession sequence is the gold standard for accurately quantifying cardiac function and myocardial mass. However, this method suffers from inefficient K-space sampling, resulting in long scan times, and requires multiple breath holds that can be difficult for some patients. Real-time compressed sensing (CS) cine reduces image acquisition time through K-space undersampling and iterative reconstruction, enabling rapid magnetic resonance (MR) imaging. Further large-scale studies need to be conducted to validate its effectiveness. In this study, we assessed image quality and left ventricular (LV) function during the routine clinical use of CS imaging in cardiovascular MR (CMR) to determine the feasibility of using CS cine. From April 2022 to March 2023, 242 patients with various heart diseases, including arrhythmia, at outpatient, inpatient, and health examination centers, were consecutively enrolled in this prospective, cross-sectional study and underwent CMR. Two methods [real-time CS cine with free breathing (RTCSCineFB) and conventional breath-hold segmented cine (SegBH)] were used to acquire long- and short-axis cine images of the heart. The total scan time, image quality (Likert score; range, 1-5), LV function parameters, and image fidelity were evaluated for each method. The study cohort comprised 149 men and 75 women with a mean age of 56.2±15.1 years. The mean ± standard deviation (SD) total scan time was significantly shorter for RTCSCineFB than for SegBH (86.44±31.74 vs. 289.81±88.41 s, P<0.001). The overall image quality was slightly lower for RTCSCineFB than for SegBH (P<0.001). The correlations between cardiac function parameters were excellent (0.913-0.984), demonstrating good consistency between the two methods. Both methods were considered equivalent in evaluating LV function and image quality, and showed strong agreement in their diagnostic gradings of ejection fraction (EF) (κ=0.759) and high accuracy. CS cine assessed LV function with high diagnostic accuracy and enhanced image stability for individuals with arrhythmia while maintaining strong consistency in two methods for EF grading condition.