Differences in left ventricular and left atrial function assessed during breath-holding and breathing

• Published in: European journal of radiology Vol. 141; p. 109756
• Main Authors: Reiter, Clemens, Reiter, Ursula, Kräuter, Corina, Nizhnikava, Volha, Greiser, Andreas, Scherr, Daniel, Schmidt, Albrecht, Fuchsjäger, Michael, Reiter, Gert
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.08.2021
• Subjects: Atrial function, left; Breath holding; Magnetic resonance imaging; Respiration; Ventricular function, left; PFRA; A; LAmax; MRI; E; bSSFP; LV; ECG-gated; PFRE; Ventricular function, left; GLS; SD; LAbc; EDV; EFtotal; EF; SV; EFpassive; ICC; ESV; Atrial function, left; r; Breath holding; EFactive; LAmin; Magnetic resonance imaging; LA; FA; PER; RR-interval; Respiration; FE
• ISSN: 0720-048X; 1872-7727; 1872-7727
• DOI: 10.1016/j.ejrad.2021.109756

•LV systolic and diastolic function parameters differ between inspiratory breath-holding and free breathing acquisition.•Left atrial volumetric function parameters differ between inspiratory breath-holding and free breathing acquisition.•Differences between inspiratory breath-holding and breathing functional parameters show considerable variations within individuals. To analyze differences in systolic and diastolic left ventricular (LV) as well as left atrial (LA) function parameters obtained from identical cardiac magnetic resonance (MR) imaging techniques during inspiratory breath-holding and breathing (breath-hold to breathing differences). 56 subjects without signs of heart failure (23/33 male/female, age 58 ± 14 years) underwent 3 T MR cine real-time and transmitral phase contrast imaging with the same spatial and temporal resolution during inspiratory breath-holding and free breathing. LV and LA volumetric function parameters were derived from segmentation of cine series, transmitral peak velocities and early-diastolic myocardial peak velocity from phase contrast series. Corresponding breath-hold and breathing parameters were compared by Bland-Altman analysis; repeatability of breath-hold and breathing measurements was quantified by variance component analysis. p < 0.05 was regarded as statistically significant. Mean differences between results obtained during inspiratory breath-holding vs. breathing were significant for LV volumetric function (end-diastolic volume=−7 mL, p = 0.002; end-systolic volume=−7 mL, p < 0.001; ejection fraction = 3 %, p < 0.001; peak ejection rate = 22 mL/s, p = 0.002; early-diastolic peak filling rate=−34 mL/s, p = 0.025), LA volumetric function (maximum volume=-6 mL, p < 0.001; total ejection fraction=-4%, p < 0.001; active ejection fraction=-2%, p = 0.013; before contraction ejection fraction=-4%, p < 0.001) and early-diastolic velocities (transmitral=-6 cm/s, p < 0.001; tissue velocity=-1.8 cm/s, p < 0.001). Standard deviations of breath-hold-to-breathing differences exceeded the corresponding repeatabilities of breath-hold and breathing measurements. Systolic and diastolic LV and LA function parameters acquired during inspiratory breath-holding and breathing differ, and large inter-individual breath-hold-to-breathing variations are possible. Thus, the breathing state should be taken into account, especially when comparing results in patient follow-up acquired in different respiratory states.