Undersampled free-breathing isotropic HR-LGE detected significantly more LGE-positive segments compared to conventional breath-held LR-LGE (101/391 vs 80/391, P<0.001).
Observational (n=43)
No
Does accelerated high-resolution free-breathing LGE CMR improve the detection of myocardial injuries compared to conventional breath-held low-resolution LGE in patients with structural heart disease or COVID-19 infection?
Accelerated high-resolution free-breathing LGE CMR improves the detection of myocardial injuries compared to conventional low-resolution LGE, particularly in patients with COVID-19 and troponin elevation.
Absolute Event Rate: 25.8% vs 20.5%
p-value: p=<0.001
PURPOSE: High-resolution free-breathing late gadolinium enhancement (HR-LGE) was shown valuable for the diagnosis of acute coronary syndromes with non-obstructed coronary arteries. The method may be useful to detect COVID-related myocardial injuries but is hampered by prolonged acquisition times. We aimed to introduce an accelerated HR-LGE technique for the diagnosis of COVID-related myocardial injuries. METHOD: ) sequence combined with advanced patch-based low-rank reconstruction was developed and validated in a phantom and in 23 patients with structural heart disease (test cohort; 15 men; 55 ± 16 years). Twenty patients with laboratory-confirmed COVID-19 infection associated with troponin rise (COVID cohort; 15 men; 46 ± 24 years) prospectively underwent cardiovascular magnetic resonance (CMR) with the proposed sequence in our center. Image sharpness, quality, signal intensity differences and diagnostic value of free-breathing HR-LGE were compared against conventional breath-held low-resolution LGE (LR-LGE, voxel size 1.8x1.4x6mm). RESULTS: resolution. Compared with LR-LGE, HR-LGE showed higher image quality (P = 0.03) and comparable signal intensity differences (P > 0.5). In patients with structural heart disease, all LGE-positive segments on LR-LGE were also detected on HR-LGE (80/391) with 21 additional enhanced segments visible only on HR-LGE (101/391, P < 0.001). In 4 patients with COVID-19 history, HR-LGE was definitely positive while LR-LGE was either definitely negative (1 microinfarction and 1 myocarditis) or inconclusive (2 myocarditis). CONCLUSIONS: Undersampled free-breathing isotropic HR-LGE can detect additional areas of late enhancement as compared to conventional breath-held LR-LGE. In patients with history of COVID-19 infection associated with troponin rise, the method allows for detailed characterization of myocardial injuries in acceptable scan times and without the need for repeated breath holds.
Bustin et al. (Mon,) conducted a observational in COVID-related myocardial injuries and structural heart disease (n=43). High-resolution free-breathing late gadolinium enhancement (HR-LGE) vs. Conventional breath-held low-resolution LGE (LR-LGE) was evaluated on Detection of LGE-positive segments (p=<0.001). Undersampled free-breathing isotropic HR-LGE detected significantly more LGE-positive segments compared to conventional breath-held LR-LGE (101/391 vs 80/391, P<0.001).