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.
Department of Radiology, Division of Cardiology, Feinberg School of Medicine, Northwestern University, 251 East Huron Street, Chicago, IL, 60611-3864, USA. sshors@yahoo.com
Stephanie M
SM
Shors
William G
WG
Cotts
Biljana
B
Pavlovic-Surjancev
Mihai
M
Gheorghiade
James C
JC
Carr
Richard M
RM
McCarthy
Scott F
SF
Pereles
Paul J
PJ
Finn
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