Left ventricular quantification in heart failure by cardiovascular MR using prospective respiratory navigator gating: Comparison with breath-hold acquisition

Cardiovascular magnetic resonance (CMR) is the reference standard for the assessment of cardiac function. Faster sequences, such as breath-hold (BH) fast low-angle shot, have made CMR more clinically acceptable and cost effective. In a significantly large patient group, however, holding their breath is difficult, resulting in poor-quality images. We compared prospective navigator-echo respiratory gating (NE), which allows image acquisition during free breathing, and BH imaging in 14 patients with heart failure and 10 normal volunteers. There was good agreement between both NE and BH volumes, mass, and ejection fraction. The image quality of both NE basal and apical slices was significantly better than the corresponding BH slices in both the heart failure (P < 0.01) and normal groups (P < 0.05). The NE image acquisition was more time efficient than the BH acquisition in the heart failure group (P < 0. 01), with no difference in the normal group (P = 0.2). Thus, prospective navigator-echo gating, previously only described in coronary artery imaging, can be used in the assessment of cardiac function. It is particularly useful in patients who find it difficult to hold their breath in whom NE provides good-quality, time-efficient images.