Mitral regurgitation assessment by cardiovascular magnetic resonance imaging during continuous in-scanner exercise: a feasibility study.

Gorecka, M.; Craven, TP.; Jex, N.; Chew, PG.; Dobson, LE.; Brown, LAE.; Higgins, DM.; Thirunavukarasu, S.; Sharrack, N.; Javed, W.; Kotha, S.; Giannoudi, M.; Procter, H.; Parent, M.; Schlosshan, D.; Swoboda, PP.; Plein, S.; Levelt, E.; Greenwood, JP.

Mitral regurgitation assessment by cardiovascular magnetic resonance imaging during continuous in-scanner exercise: a feasibility study.

All Authors

Gorecka, M.

Craven, TP.

Jex, N.

Chew, PG.

Dobson, LE.

Brown, LAE.

Higgins, DM.

Thirunavukarasu, S.

Sharrack, N.

Javed, W.

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LTHT Author

Gorecka, Miroslawa
Craven, Thomas
Jex, Nick
Chew, Pei G
Thirunavukarasu, Sharmaine
Sharrack, Noor
Javed, Wasim
Kotha, Sindhoora
Giannoudi, Marilena
Procter, Henry
Parent, Martine
Schlosshan, Dominik
Swoboda, Peter
Plein, Sven
Levelt, Eylem
Greenwood, John

LTHT Department

Cardiology
Cardio-Respiratory

Publication Date

2024

Item Type

Journal Article

Abstract

PURPOSE: Exercise imaging using current modalities can be challenging. This was patient focused study to establish the feasibility and reproducibility of exercise-cardiovascular magnetic resonance imaging (EX-CMR) acquired during continuous in-scanner exercise in asymptomatic patients with primary mitral regurgitation (MR). METHODS: This was a prospective, feasibility study. Biventricular volumes/function, aortic flow volume, MR volume (MR-Rvol) and regurgitant fraction (MR-RF) were assessed at rest and during low- (Low-EX) and moderate-intensity exercise (Mod-EX) in asymptomatic patients with primary MR. RESULTS: Twenty-five patients completed EX-CMR without complications. Whilst there were no significant changes in the left ventricular (LV) volumes, there was a significant increase in the LVEF (rest 63 +/- 5% vs. Mod-EX 68 +/- 6%;p = 0.01). There was a significant reduction in the right ventricular (RV) end-systolic volume (rest 68 ml(60-75) vs. Mod-EX 46 ml(39-59);p < 0.001) and a significant increase in the RV ejection fraction (rest 55 +/- 5% vs. Mod-EX 65 +/- 8%;p < 0.001). Whilst overall, there were no significant group changes in the MR-Rvol and MR-RF, individual responses were variable, with MR-Rvol increasing by >= 15 ml in 4(16%) patients and decreasing by >= 15 ml in 9(36%) of patients. The intra- and inter-observer reproducibility of LV volumes and aortic flow measurements were excellent, including at Mod-EX. CONCLUSION: EX-CMR is feasible and reproducible in patients with primary MR. During exercise, there is an increase in the LV and RV ejection fraction, reduction in the RV end-systolic volume and a variable response of MR-Rvol and MR-RF. Understanding the individual variability in MR-Rvol and MR-RF during physiological exercise may be clinically important.