Oral Abstract
Jan Gröschel, MD
MD
Charite, Germany
Jan Gröschel, MD
MD
Charite, Germany
n/a Hausmann, MD
Doctoral Student
Charité - Universitätsmedizin Berlin, Germany
Leonhard Grassow
Medical student
Charité – Universitätsmedizin Berlin, Germany
Philine Reisdorf, MSc
PhD Student
Charité – Universitätsmedizin Berlin, Germany
Edyta Blaszczyk, MD
Cardiologist
Charité - Universitätsmedizin Berlin, Germany
Phillip van Dijck, MD
Physician
Charité – Universitätsmedizin Berlin, Germany
Jasmin Zernikow, MD
Physician
Charité - Universitätsmedizin Berlin, Germany
Robert Grimm, PhD
Employee
Siemens Healthcare GmbH, Germany
Andreas Voskrebenzev, PhD
Scientist
Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Hanover, Germany, Germany
Jeanette Schulz-Menger, MD
Head Working Group Cardiac MRI
Charité/ University Medicine Berlin and Helios, Germany
The cardiovascular and the pulmonary system are intertwined by a complex system of functional and vascular interdependencies (1). However, during a routine cardiovascular magnetic resonance (CMR) exam the pulmonary system is displayed only in anatomic overviews, not providing any functional pulmonary analysis. The PREFUL (Phase Resolved Functional Lung Imaging) technique allows for a contrast-free CMR analysis of lung function parameters, such as ventilation and perfusion (2). This study aims at providing insights into the hemodynamic relation of the cardiopulmonary system and identifying potential pulmonary function deficits providing targets for further diagnostic and therapy.
Methods:
We conducted a retrospective analysis of all patients referred for routine CMR who received a PREFUL sequence in September 2023. CMR was performed at a 1.5 Tesla scanner (Siemens). The scan was required to include at a minimum a two- and a four-chamber long axis view for analysis of atrial function and volumes as well as a short axis (SAX) cine stack for biventricular function assessment. PREFUL images were acquired in three coronal slices, with the middle being aligned at the bifurcation of the pulmonary artery (Figure 1A). CMR analysis was accomplished using cvi42 (version 5.13.7) and a prototype lung analysis tool provided by the vendor. Correlation between pulmonary and atrial as well as biventricular volume and function was assessed. In addition, a subgroup comparison based on the LVEF ( >60%, 60-50%, < 50%) was carried out.
Results:
Of N=100 scanned patients, N=12 had to be excluded due to missing SAX acquisitions and age < 18 years. The final cohort consisted of N=88 Patients (35 females, 53 males) with different pre-existing conditions (table 1). Biventricular and lung function parameters are presented in table 2. Significant negative correlations were found between QDP and: LVSV (correlation coefficient (cc) -0.42; p< 0.001), LVEDV (cc -0,246; p=0.021), RVSV (cc -0.33; p=0.001) and RVEDV (cc -0,266; p=0.012). For the atria significant correlations were found between QDP and LAEF (c -0,247; p=0.023) as well as RAEF (cc -0,306; p=0.005). Meanwhile no significant correlations could be found between VDP and atrial as well as biventricular function. Patients with a LVEF < 50% showed more total and exclusive QDP (Figure 1B). VDP did not differ significantly between the LVEF subgroups.
Conclusion:
Patients with a lower LVEF show more pulmonary perfusion defects in the absence of noticeable ventilation defects. In addition, we noticed a correlation between perfusion defects and left as well as right atrial and ventricular volumes. This underlines the hemodynamic interdependence of these two systems and provides potential targets for treatment. Further research applying the PREFUL technique is warranted to move from a dedicated CMR to cardiopulmonary magnetic resonance imaging.
