Cardiovascular magnetic resonance tagging of the right ventricular free wall for the assessment of long axis myocardial function in congenital heart disease

Sylvia S M Chen, Jennifer Keegan, Andrew W. Dowsey, Tevfik Ismail, Ricardo Wage, Wei Li, Guang Zhong Yang, David N. Firmin, Philip J. Kilner*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

18 Citations (Scopus)

Abstract

Background: Right ventricular ejection fraction (RV-EF) has traditionally been used to measure and compare RV function serially over time, but may be a relatively insensitive marker of change in RV myocardial contractile function. We developed a cardiovascular magnetic resonance (CMR) tagging-based technique with a view to rapid and reproducible measurement of RV long axis function and applied it in patients with congenital heart disease. Methods. We studied 84 patients: 56 with repaired Tetralogy of Fallot (rTOF); 28 with atrial septal defect (ASD): 13 with and 15 without pulmonary hypertension (RV pressure > 40 mmHG by echocardiography). For comparison, 20 healthy controls were studied. CMR acquisitions included an anatomically defined four chamber cine followed by a cine gradient echo-planar sequence in the same plane with a labelling pre-pulse giving a tag line across the basal myocardium. RV tag displacement was measured with automated registration and tracking of the tag line together with standard measurement of RV-EF. Results: Mean RV displacement was higher in the control (26 3 mm) than in rTOF (16 4 mm) and ASD with pulmonary hypertension (18 3 mm) groups, but lower than in the ASD group without (30 4 mm), P <0.001. The technique was reproducible with inter-study bias 95% limits of agreement of 0.7 2.7 mm. While RV-EF was lower in rTOF than in controls (49 9% versus 57 6%, P <0.001), it did not differ between either ASD group and controls. Conclusions: Measurements of RV long axis displacement by CMR tagging showed more differences between the groups studied than did RV-EF, and was reproducible, quick and easy to apply. Further work is needed to assess its potential use for the detection of longitudinal changes in RV myocardial function.

Original languageEnglish
Article number80
JournalJournal of Cardiovascular Magnetic Resonance
Volume13
Issue number1
DOIs
Publication statusPublished - 2011

Keywords

  • Cardiac MRI
  • Congenital Heart Disease
  • Ejection Fraction
  • Reproducibility
  • Right Ventricle
  • Tagging

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