• Walter R T Witschey, Francisco Contijoch, Jeremy R McGarvey, Victor A Ferrari, Michael S Hansen, Madonna E Lee, Satoshi Takebayashi, Chikashi Aoki, Julio A Chirinos, Paul A Yushkevich, Joseph H Gorman, James J Pilla, and Robert C Gorman.
• Gorman Cardiovascular Research Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
• Ann. Thorac. Surg. 2014 May 1; 97 (5): 1597-603.

BackgroundRapid determination of the left ventricular (LV) pressure-volume (PV) relationship as loading conditions are varied is the gold standard for assessment of LV function. Cine magnetic resonance imaging (MRI) does not have sufficient spatiotemporal resolution to assess beat-to-beat changes of the LV PV relationship required to measure the LV end-systolic elastance (EES) or preload-recruitable stroke work (PRSW). Our aim was to investigate real-time MRI and semiautomated LV measurement of LV volume to measure PV relations in large animals under normal and inotropically stressed physiologic conditions.MethodsWe determined that PV relationships could be accurately measured using an image exposure time Tex less than 100 ms and frame rate Tfr less than 50 ms at elevated heart rates (∼140 beats per minute) using a golden angle radial MRI k-space trajectory and active contour segmentation.ResultsWith an optimized exposure time (Tex=95 ms and frame rate Tfr=2.8 ms), we found that there was no significant difference between cine and real-time MRI at rest in end-diastolic volume, end-systolic volume, ejection fraction, stroke volume, or cardiac output (n=5, p<0.05) at either normal or elevated heart rates. We found EES increased from 1.9±0.7 to 3.1±0.3 mm Hg/mL and PRSW increased from 6.2±1.2 to 9.1±0.9 mm Hg during continuous intravenous dobutamine infusion (n=5, p<0.05).ConclusionsReal-time MRI can assess LV volumes, EES, and PRSW at baseline and elevated inotropic states.Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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