Good agreement between cardiac magnetic imaging protocols using free-breathing and breath-holding techniques for flow quantification in valvular heart disease

Abstract Background Cardiac magnetic resonance (CMR) evaluation of valvular heart disease is an important diagnostic tool when echocardiography is inconclusive. Flow quantification is usually performed during breath hold, which can be challenging in valvular heart disease patients often suffering from dyspnea and heart failure. Purpose The purpose of the present study is to evaluate a free-breathing protocol of flow measurement in the aortic, pulmonary and tricuspid valves in healthy subjects (HS) and patients with tricuspid regurgitation (TR). Methods Phase contrast flow volume measurements were performed in 20 HS and 25 patients with TR using standard breath-holding (BH) and a free-breathing (FB) technique. Two venc-adjusted volume acquisition were acquired in the aortic, pulmonary and tricuspid valve during BH and one during FB. Mean, standard deviation (SD) and limits of agreement (LoA) for aortic forward flow volume (AoFF), pulmonary forward flow volume (PuFF) and tricuspid inflow volume (TrIF) were evaluated. Results Figure 1 presents flow volume (ml) of AoFF, PuFF and TrIF during BH (mean of 2 measurements) and FB. Conclusions The present study demonstrated good agreements between phase contrast flow measurements using FB and BH techniques. These parameters are used in the evaluation of aortic, mitral, pulmonary and tricuspid regurgitations using CMR imaging. Thus, free-breathing CMR acquisition can be an important complement in the assessment of valvular heart disease and may be applied in patients with difficulty to hold their breath.