No CrossRef data available.
Article contents
MRI evaluation of right heart functions in children with mild cystic fibrosis
Published online by Cambridge University Press: 13 October 2022
Abstract
Background:
This study aimed to assess the ventricular anatomy, function of the right ventricle, and the haemodynamic findings of pulmonary artery in children with cystic fibrosis using cardiac MRI.
Patients:
This prospective study consisted of 32 children with mild cystic fibrosis and 30 age-matched healthy control participants.
Methods:
Cardiac MRI was used to assess right ventricular volumes, anatomy, and function and to assessment of haemodynamic findings of pulmonary artery in the control and study groups. Haemodynamic findings of pulmonary arteries were determined using pulmonary arteries peak velocity (cm/s), and pulmonary arteries time-to-peak velocity (ms) and pulmonary artery systolic pressure. All data of children with mild cystic fibrosis were compared with those of 30 age-matched healthy control group participants.
Results:
Our patients and their age-matched controls were aged from 6 to 17 years and from 7 to 15 years, respectively. We found that ejection fraction (%), cardiac output (L/ml), cardiac output (L/ml/m2), and systolic volume (ml/m2) were significantly lower in children with cystic fibrosis (p < 0.01). Right ventricular anterior wall thickness (mm) was significantly higher in children with cystic fibrosis (p = 0.01). No significant difference was observed between the haemodynamic parameters of pulmonary artery in the patient group.
Conclusion:
In our study, cardiac MRI was used to investigate whether the right ventricle was affected functionally and anatomically in children with mild cystic fibrosis. We detected a significant decrease in right ventricular systolic functions and notable alterations in the right ventricular geometry of children with mild cystic fibrosis. These alterations usually manifest themselves as hypertrophy of the right ventricle. Our study’s results demonstrate no relationship between the development of pulmonary hypertension in mild cystic fibrosis children.
- Type
- Original Article
- Information
- Copyright
- © The Author(s), 2022. Published by Cambridge University Press
References
Kosorok, MR, Wei, WH, Farrell, PM. The incidence of cystic fibrosis. Stat Med. 1996; 15: 449–462.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
Fraser, KL, Tullis, DE, Sasson, Z, Hyland, RH, Thornley, KS, Hanly, PJ. Pulmonary hypertension and cardiac function in adult cystic fibrosis: role of hypoxemia. Chest. 1999; 115: 1321–1328.CrossRefGoogle ScholarPubMed
Matthay, RA, Berger, HJ, Loke, J, et al. Right and left ventricular performance in ambulatory young adults with cystic fibrosis. Br Heart J. 1980; 43: 474–480.CrossRefGoogle ScholarPubMed
Allen, HD, Taussig, LM, Gaines, JA, Sahn, DJ, Goldberg, SJ. Echocardiographic profiles of the long-term cardiac changes in cystic fibrosis. Chest. 1979; 75: 428–433.CrossRefGoogle ScholarPubMed
Ionescu, AA, Ionescu, AA, Payne, N, Obieta-Fresnedo, I, Fraser, AG, Shale, DJ. Subclinical right ventricular dysfunction in cystic fibrosis. A study using tissue Doppler echocardiography. Am J Respir Crit Care Med. 2001; 163: 1212–1218.CrossRefGoogle ScholarPubMed
Bridges, RJ, Bradbury, NA. Cystic fibrosis, cystic fibrosis transmembrane conductance regulator and drugs: insights from cellular trafficking. Handb Exp Pharmacol. 2018; 245: 385–425.CrossRefGoogle ScholarPubMed
Hamutcu, R, Woo, MS. Advanced cystic fibrosis lung disease in children. Curr Opin Pulm Med. 2001; 7: 448–453.CrossRefGoogle ScholarPubMed
Geva, T. Is MRI the preferred method for evaluating right ventricular size and function in patients with congenital heart disease?: MRI is the preferred method for evaluating right ventricular size and function in patients with congenital heart disease. Circ Cardiovasc Imaging. 2014; 7: 190–197.CrossRefGoogle ScholarPubMed
Alfakih, K, Plein, S, Bloomer, T, Jones, T, Ridgway, J, Sivananthan, M. Comparison of right ventricular volume measurements between axial and short axis orientation using steady-state free precession magnetic resonance imaging. J Magn Reson Imaging. 2003; 18: 25–32.CrossRefGoogle ScholarPubMed
Grothues, F, Moon, JC, Bellenger, NG, et al. Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance. Am Heart J 2004; 147: 218–223.CrossRefGoogle ScholarPubMed
Nayler, GL, Firmin, DN, Longmore, DB. Blood flow imaging by cine magnetic resonance. J Comput Assist Tomogr 1986; 10: 715–722.CrossRefGoogle ScholarPubMed
Beerbaum, P, Korperich, H, Barth, P, et al. Noninvasive quantification of left-to-right shunt in pediatric patients: phase-contrast cine magnetic resonance imaging compared with invasive oximetry. Circulation 2001; 103: 2476–2482.CrossRefGoogle ScholarPubMed
Robertson, MB, Kohler, U, Hoskins, PR, et al. Quantitative analysis of PC MRI velocity maps: pulsatile flow in cylindrical vessels. Magn Reson Imaging 2001; 19: 685–695.CrossRefGoogle ScholarPubMed
Marchesseau, S, Ho, JXM, Totman, JJ. Influence of the short-axis cine acquisition protocol on the cardiac function evaluation: a reproducibility study. Eur J Radiol Open 2016-01-01; 3: 60–66.CrossRefGoogle ScholarPubMed
Fratz, S, Schuhbaeck, A, Buchner, C, et al. Comparison of accuracy of axial slices versus short-axis slices for measuring ventricular volumes by cardiac magnetic resonance in patients with corrected tetralogy of fallot. Am J Cardiol 2009 Jun 15; 103: 1764–1769.CrossRefGoogle Scholar
Jimenez-Juan, L, Joshi, SB, Wintersperger, BJ, et al. Assessment of right ventricular volumes and function using cardiovascular magnetic resonance cine imaging after atrial redirection surgery for complete transposition of the great arteries. Int J Cardiovasc Imaging 2013; 29: 335–342.CrossRefGoogle ScholarPubMed
Mooij, CF, de Wit, CJ, Graham, DA, Powell, AJ, Geva, T. Reproducibility of MRI measurements of right ventricular size and function in patients with normal and dilated ventricles. J Magn Reson Imaging. 2008; 28: 67–73.CrossRefGoogle ScholarPubMed
Sanam, V, Khoo, NS, Noga, ML, et al. Cardiac MRI volumetric assessment by short-axis has better reproducibility than the axial orientation in functionally single right ventricle hearts prior to bidirectional cavopulmonary anastomosis. Int J Cardiovasc Res 2016; 4: 1–10.Google Scholar
Buklioska-Ilievska, D, Minov, J, Kochovska-Kamchevska, N, et al. Cardiovascular comorbidity in patients with chronic obstructive pulmonary disease: echocardiography changes and their relation to the level of airflow limitation. Open Access Maced J Med Sci 2019; 7: 3568–3573.CrossRefGoogle Scholar
Vonk-Noordegraaf, A, Marcus, JT, Holverda, S, Roseboom, B, Postmus, PE. Early changes of cardiac structure and function in COPD patients with mild hypoxemia. Chest 2005; 127: 1898–1903.CrossRefGoogle ScholarPubMed
Kroft, LJM, Simons, P, van Laar, JM, de Roos, A. Patients with pulmonary fibrosis: cardiac function assessed with MR imaging. Radiology 2000; 216: 464–471.CrossRefGoogle ScholarPubMed
Lagan, J, Naish, JH, Bradley, J, et al. Cardiac involvement in cystic fibrosis evaluated using cardiopulmonary magnetic resonance. Int J Cardiovasc Imaging 2022; 38: 1121–1131.CrossRefGoogle ScholarPubMed
Pavlicek, M, Wahl, A, Rutz, T, et al. Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging. Eur J Echocardiogr. 2011; 12: 871–880.CrossRefGoogle ScholarPubMed
Rudski, LG, Lai, WW, Afilalo, J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010; 23: 685–788.CrossRefGoogle Scholar
Bogren, HG, Klipstein, RH, Mohiaddin, RH, et al. Pulmonary artery distensibility and blood flow patterns: a magnetic resonance study of normal subjects and of patients with pulmonary arterial hypertension. Am Heart J 1989; 118: 990–999.CrossRefGoogle ScholarPubMed
Kondo, C, Caputo, GR, Masui, T, et al. Pulmonary hypertension: pulmonary flow quantification and flow profile analysis with velocity-encoded cine MR imaging. Radiology. 1992; 183: 751–758.CrossRefGoogle ScholarPubMed
Mousseaux, E, Tasu, JP, Jolivet, O, et al. Pulmonary arterial resistance: noninvasive measurement with indexes of pulmonary flow estimated at velocity-encoded MR imaging – preliminary experience. Radiology 1999; 212: 896–902.CrossRefGoogle ScholarPubMed
Kreitner, KF, Ley, S, Kauczor, HU, et al. Chronic thromboembolic pulmonary hypertension: pre- and postoperative assessment with breath-hold MR imaging techniques. Radiology 2004; 232: 535–543.CrossRefGoogle ScholarPubMed
Ley, S, Puderbach, M, Fink, C, et al. Assessment of hemodynamic changes in the systemic and pulmonary arterial circulation in patients with cystic fibrosis using phase-contrast MRI. Eur Radiol 2005; 15: 1575–1580.CrossRefGoogle ScholarPubMed