The effects of breath-holding on pulmonary regurgitation measured by cardiovascular magnetic resonance velocity mapping
Why the study?
Does breath-holding during CMR affect the measurement of pulmonary regurgitant fraction in adult patients with repaired tetralogy of Fallot?
Population
43 adult patients with a previous repair of tetralogy of Fallot and residual pulmonary regurgitation
Comparison
Cardiovascular magnetic resonance phase contrast… vs CMR acquired during held inspiration…
Design
Cross-sectional
Authors
Discussion
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Implication
Breath-hold phase affects CMR pulmonary regurgitant fraction values; supports protocol standardization and leaves open impact on intervention thresholds.
Key Points
- To evaluate whether breath-holding conditions alter cardiovascular magnetic resonance measurements of pulmonary regurgitant fraction compared to free-breathing acquisitions.
- Investigated 43 adult patients with repaired tetralogy of Fallot and residual pulmonary regurgitation using cardiovascular magnetic resonance.
- Measured pulmonary regurgitant fraction via pulmonary trunk velocity mapping during held expiration, held inspiration, and non-breath-hold acquisitions, as well as from ventricular stroke volume differences.
- Pulmonary regurgitant fraction was significantly lower during held expiration (30.8%) than during held inspiration (37.0%, p=0.00017), non-breath-hold (35.6%, p=0.0035), or stroke volume difference (35.4%, p=0.026).
- Regurgitant volume was significantly lower during held expiration than held inspiration (41.9 vs. 48.3 ml, p=0.0018), while pulmonary forward flow was larger in held expiration than during non-breath-hold acquisition (132 vs. 124 ml, p=0.0024).
Structured PICO
Does breath-holding during CMR affect the measurement of pulmonary regurgitant fraction in adult patients with repaired tetralogy of Fallot?
P
Population
43 adult patients with a previous repair of tetralogy of Fallot and residual pulmonary regurgitation
I
Intervention
Cardiovascular magnetic resonance (CMR) phase contrast velocity mapping acquired during held expiration
C
Comparator
CMR acquired during held inspiration, non-breath-hold acquisition, and difference of right and left ventricular stroke volume measurements
O
Outcome
Pulmonary regurgitant fractionsurrogate
Breath-holding in expiration during CMR significantly underestimates pulmonary regurgitant fraction compared to free breathing or inspiration in patients with repaired tetralogy of Fallot, which may impact clinical decision-making for re-intervention.
Cite This Study
Johansson et al. (2009) studied this question.