Non-invasive cardiac evaluation in heart failure patients using magnetic resonance imaging: a feasibility study.
BACKGROUND
To assess the feasibility of a fast, flow-insensitive magnetic resonance imaging (MRI) protocol in heart failure patients for the evaluation of cardiac function, cardiovascular anatomy, and myocardial viability.


RESULTS
Thirty-two consecutive patients with left ventricular (LV) systolic dysfunction and 13 control subjects were prospectively evaluated with MRI. The exam consisted of cine imaging with a steady-state free precession sequence, followed by time-resolved, three-dimensional angiography and delayed, contrast-enhanced imaging. Multiple LV parameters were evaluated, and the heart failure and control results were compared. In 12 patients, MRI-determined ejection fractions were compared to echocardiographic values. Additionally, a qualitative analysis of the cine images was performed. The cardiac MR evaluation yielded diagnostic-quality images in all subjects. Mean imaging time was 37 min. MRI demonstrated significant differences between the heart failure and control subjects in all parameters assessed (p < 0.05). MRI-determined ejection fractions correlated strongly with echocardiographic values (R = 0.75), although the limits of agreement were wide (-17.3%-18.3%).


CONCLUSIONS
Using fast, flow-insensitive imaging techniques, MRI is feasible in heart failure for the derivation of more independent indices of cardiac status than any other non-invasive test. Although further investigation is warranted, MRI may prove uniquely helpful in heart failure diagnosis and management.
Shors
Stephanie M
SM
Department of Radiology, Division of Cardiology, Feinberg School of Medicine, Northwestern University, 251 East Huron Street, Chicago, IL, 60611-3864, USA. sshors@yahoo.com
Cotts
William G
WG
Pavlovic-Surjancev
Biljana
B
Gheorghiade
Mihai
M
Carr
James C
JC
McCarthy
Richard M
RM
Pereles
Scott F
SF
Finn
Paul J
PJ
D000328:Adult; D000368:Aged; D004452:Echocardiography; D005240:Feasibility Studies; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000473:pathology