- Oral presentation
- Open Access
Assessment of right ventricular function by treadmill exercise stress cardiovascular magnetic resonance in patients with repaired tetralogy of Fallot
© da Silveira et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
- Right Ventricular
- Cardiovascular Magnetic Resonance
- Treadmill Exercise
- Right Ventricular Function
- Stress Cardiovascular Magnetic Resonance
Cardiac MR (CMR) is considered the gold standard to assess right ventricular (RV) function in different scenarios, including cases of congenital heart disease. Moreover, an MR-compatible treadmill coupled with Real Time (RT) CMR has been developed for stress testing, and may be an optimal choice in this setting. The aims of this study were to determine the feasibility and accuracy of a RT CMR protocol to evaluate RV function at rest and after treadmill exercise in adults with history of repaired Tetralogy of Fallot (ToF).
Ten young adults (median age 29 years, range 19-47) were prospectively enrolled, and imaging was performed using a 1.5T scanner (Avanto, Siemens) and 32-channel phased array coil. RV cavity was covered by 10 to 12 contiguous 8 mm transverse slices. ECG-Gated SSFP cine was performed at rest (TE 1.3 ms, TR 2.7 ms, temporal resolution 48 ms, α = 75°, BW 930 Hz/pixel), while non-triggered RT cine was executed both at rest and after stress (TE 1.0 msec, TR 2.3 msec, temporal resolution 46 ms, α = 65°, BW 1488 Hz/pixel). Patients underwent treadmill exercise with 12-lead ECG (Cardiosoft, GE) to achieve a goal of ≥ 85% age-predicted maximum heart rate (APMHR). RT cine imaging was performed immediately upon cessation of exercise. End-diastolic (EDV) and end-systolic (ESV) volumes were calculated by two different observers using Simpson's rule by manually tracing RV endocardial borders. Interobserver agreement was analyzed by the Pearson's correlation coefficient whereas differences were assessed with paired t-test (SPSS 22.0, IBM).
Right ventricular mean volumes and function obtained at rest and after stress, measured by ECG-Gated and Real-time sequences.
250.5 ± 72.2
253.8 ± 81.3
226.3 ± 85.2
131.8 ± 45.6
132.6 ± 52.8
109.4 ± 56.3
48.1 ± 6.2
48.9 ± 6.0
54.0 ± 10.2
The feasibility of RT CMR imaging coupled with treadmill exercise was demonstrated. The diagnostic value of this technique to assess RV function in patients with repaired ToF deserves further assessment in a larger patient cohort.
Partially funded by NIH: R01 HL102450.
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