Abstract
Background and purposeConventional cardiac magnetic resonance (CCMR) imaging is usually performed with breath-holding (BH), which is adverse in patients with BH limitations. We explored the ability of a free-breathing CMR (fCMR) protocol to prognosticate in patients with coronary heart diseases (CHD) and limited BH ability.MethodsSixty-seven patients with CHD and limited BH abilities were prospectively enrolled in this study. All patients underwent comprehensive fCMR imaging at 3.0 T. The fCMR protocols included compressed sensing (CS) single-shot cine acceleration imaging, and motion-corrected (MOCO), single-shot late gadolinium enhancement (LGE) imaging. Image quality (IQ) of the cine and LGE images was evaluated based on the 5-point Likert scale. The value of fMRI in providing a prognosis in patients with CHD was assessed. Statistical methods included the T test, Mann–Whitney test, Kappa test, Kaplan–Meier curve, Log-rank test, Cox proportional hazard regression analysis, and receiver operating characteristic curves.ResultsAll IQ scores of the short axis CS-cine and both the short and long axes MOCO LGE images were ≥ 3 points. Over a median follow-up of 31 months (range 3.8–38.2), 25 major adverse cardiovascular events (MACE) occurred. In the univariate analysis, infarction size (IS), left ventricular ejection fraction (LVEF), 3D-Global peak longitudinal strain (3D-GPLS), heart failure classification were significantly associated with MACE. When the significantly univariate MACE predictors, added to the multivariate analysis, which showed IS (HR 1.02; 95% CI 1.00–1.05; p = 0.048) and heart failure with preserved EF (HR 0.20; 95% CI 0.04–0.98; p = 0.048) correlated positively with MACE. The optimal cutoff value for LVEF, 3D-GPLS, and IS in predicting MACE was 34.2%, − 5.7%, and 26.1% respectively, with a sensitivity of 90.5%, 64%, and 96.0% and specificity of 72%, 95.2%, and 85.7% respectively.ConclusionsThe fCMR protocol can be used to make prognostic assessments in patients with CHD and BH limitations by calculating IS and LVEF.
Highlights
Background and purposeConventional cardiac magnetic resonance (CCMR) imaging is usually performed with breath-holding (BH), which is adverse in patients with BH limitations
The free-breathing CMR (fCMR) protocol primarily included: (1) compressed sensing (CS) cine imaging with balanced steady-state free precession readout, featuring a two-dimensional, realtime, true fast imaging, steady-state precession, sparse data sampling and iterative reconstruction (SSIR). (2) MOCO late gadolinium enhancement (LGE) is characterized by respiratory motioncorrected, single-shot steady-state free procession, and averaged phase-sensitive inversion recovery (PSIR)
Patient characteristics Over two years, from February 1, 2017, to June 18, 2019, a total of 9256 patients underwent Cardiac magnetic resonance (CMR) imaging in our department; 67 (0.72%) patients were diagnosed with coronary heart diseases (CHD) by DSA and unable to meet the demands of multiple BH sessions and long examination times
Summary
Conventional cardiac magnetic resonance (CCMR) imaging is usually performed with breath-holding (BH), which is adverse in patients with BH limitations. We explored the ability of a free-breathing CMR (fCMR) protocol to prognosticate in patients with coronary heart diseases (CHD) and limited BH ability. Coronary heart disease (CHD) is primarily caused by coronary atherosclerosis, which causes coronary artery stenosis and myocardial ischemia. These changes lead to myocardial infarction (MI) or sudden. Cardiac magnetic resonance (CMR) imaging has been used to diagnose MI for a long time [1,2,3]. A few of patients with CHD quit CCMR examinations because it was difficult to perform BH in the time needed
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