Clinical presentation, echocardiographic findings, treatment strategies, and prognosis of dogs with myxomatous mitral valve disease presented with pericardial effusion due to suspected left atrial tear: a retrospective case-control study.

INTRODUCTION/OBJECTIVES: Left atrial tear (LAT) is a life-threatening complication in dogs with myxomatous mitral valve disease (MMVD). The study objective was to describe clinical presentation, echocardiographic findings, treatment strategies, and survival in dogs with LAT compared to a control group of dogs with a similar stage of MMVD but no LAT. ANIMALS AND MATERIALS AND METHODS: Two-center retrospective case-controlled study including 15 dogs with and 15 dogs without LAT was conducted. Clinical and echocardiographic data were reviewed, and survival information were collected. RESULTS: Nine dogs in each group were in stage C of MMVD, while the remaining were in stage B2. No differences between groups were found regarding age, body weight, sex, kidney values, and echocardiography-derived cardiac dimensions. Most reported clinical signs associated with LAT included weakness, respiratory signs, and syncope. Treatment varied and was mainly focused on the management of congestive heart failure. Three dogs with LAT received a pericardiocentesis. All 15 dogs with LAT had died of cardiac causes, five dogs during the first seven days after admission. The median survival time for all 15 dogs with LAT was 52 days compared to 336 days in the control group (P=0.103). When excluding five dogs with LAT that died during the first seven days, the median survival increased to 407 days, not different compared to the control group (P=0.549). CONCLUSIONS: Dogs with MMVD and LAT have a high short-term mortality; however, when surviving the acute phase, the long-term prognosis may not differ from dogs with a similarly advanced degree of MMVD but without LAT.

Ventricular pre-excitation in cats: 17 cases.

OBJECTIVES: Atrioventricular accessory pathways are abnormal electrical connections between the atria and ventricles that predispose to ventricular pre-excitation (VPE) and tachycardias. ANIMALS: Seventeen cats with VPE and 15 healthy matched-control cats. MATERIAL AND METHODS: Multicenter case-control retrospective study. Clinical records were searched for cats with VPE, defined as preserved atrioventricular synchrony, reduced PQ interval, and increased QRS complex duration with a delta wave. Clinical, electrocardiography, echocardiographic, and outcome data were collated. RESULTS: Most cats with VPE were male (16/17 cats), non-pedigree cats (11/17 cats). Median age and mean body weight were 5.4 years (0.3-11.9 years) and 4.6 ± 0.8 kg, respectively. Clinical signs at presentation included lethargy (10/17 cats), tachypnea (6/17 cats), and/or syncope (3/17 cats). In two cats, VPE was an incidental finding. Congestive heart failure was uncommon (3/17 cats). Nine (9/17) cats had tachyarrhythmias: 7/9 cats had narrow QRS complex tachycardia and 2/9 cats had wide QRS complex tachycardia. Four cats had ventricular arrhythmias. Cats with VPE had larger left (P < 0.001) and right (P < 0.001) atria and thicker interventricular septum (P = 0.019) and left ventricular free wall (P = 0.028) than controls. Three cats had hypertrophic cardiomyopathy. Treatment included different combinations of sotalol (5/17 cats), diltiazem (5/17 cats), atenolol (4/17 cats), furosemide (4/17 cats), and platelet inhibitors (4/17 cats). Five cats died, all from cardiac death (median survival time 1882 days [2-1882 days]). CONCLUSIONS: Cats with VPE had a relatively long survival, albeit showing larger atria and thicker left ventricular walls than healthy cats.

Comparison of the diagnostic value of a small, single channel, electrocardiogram monitoring patch with a standard 3-lead Holter system over 24 hours in dogs.

INTRODUCTION/OBJECTIVES: The aim of this study was to compare a novel small event recorder device, the Carnation Ambulatory Monitor (CAM), with a standard Holter. ANIMALS: Nineteen adult dogs. MATERIAL AND METHODS: Comparative and explorative study. The two devices were simultaneously applied for approximately 24 h. RESULTS: Analysis time (P=0.013) and percentage of artefacts (P<0.001) were greater for the CAM (110 min [40-264]; and 9% [0-34], respectively) compared to a standard Holter (30 min [18-270]; and 0.3% [0-9], respectively). The total number of beats (P=0.017) and maximum (P=0.02) and mean (P=0.037) heart rates were lower for the CAM (113,806 ± 23,619 beats; 227 ± 35 bpm; and 88 ± 22 bpm, respectively) compared to the standard Holter (131,640 ± 40,037 beats; 260 ± 64 bpm; and 92 ± 26 bpm, respectively). The minimal heart rate (P=0.725), number of pauses (P=0.078), duration of the longest pause (P=0.087), number of ventricular ectopic complexes (P=0.55), ventricular couplets (P=0.186), ventricular triplets (P=0.203), ventricular tachycardia (P=0.05), Lown grade (P=0.233), presence or absence of ventricular bigeminy, trigeminy, supraventricular tachycardia, and atrial fibrillation (P=0.98) did not differ. The CAM missed some relevant events, like complex ventricular arrhythmias, and the Lown grade did not match in 5/19 dogs when comparing the devices. CONCLUSIONS: Cardiac Ambulatory Monitor can be used to record ECG traces in dogs over a prolonged period, allowing to detect arrhythmias. Due to some clinically relevant limitations, including a higher percentage of artefacts, a longer reading time (which precludes quantitative counts of >300ventricular premature complexes), and underestimation of complex ventricular arrhythmias, the CAM appears not suitable for quantitative arrhythmia analysis in dogs.

Presumptive vagally-mediated atrial flutter in a dog.

An asymptomatic nine-year-old Dobermann Pinscher underwent a screening for dilated cardiomyopathy. Echocardiography revealed left ventricular eccentric hypertrophy and systolic dysfunction; the rest of the echocardiographic parameters were within normal limits. Holter monitoring demonstrated sinus rhythm as the dominant cardiac rhythm during the first hours of the recording. Then, during a period of physiologically enhanced vagal tone (sleep), spontaneous development of atrial flutter (AFL) associated with variable ventricular response was documented. Alternation between AFL and paroxysmal atrial fibrillation was also observed. Subsequently, during a period of physiological increase of sympathetic tone (physical activity/excitement), spontaneous conversion of AFL to sinus rhythm occurred. In light of these findings, a presumptive diagnosis of vagal AFL was made. The images here described allow us to study the onset, behavior and termination of this intriguing electrocardiographic entity.

Effect of a single dose of pimobendan on right ventricular and right atrial function in 11 healthy cats.

OBJECTIVES: The objective of this study was to investigate the effect of pimobendan on echocardiographic parameters of right ventricular and atrial function in healthy cats. ANIMALS: Eleven privately owned, healthy adult cats. MATERIAL AND METHODS: Each cat underwent five echocardiographic examinations: the first and second examinations were performed 1 h apart on day 0. On day 1, the third examination served as baseline, whereas the fourth and fifth examinations were performed one and 6 h after administration of a single oral dose of pimobendan (1.25 mg/cat), respectively. Parameters of right ventricular and atrial morphology and function were collected and compared among time points. RESULTS: Pimobendan administration produced a change in some echocardiographic variables. Specifically, heart rate, right ventricular fractional shortening and peak velocity of systolic lateral tricuspid annular motion increased (P = 0.032, P = 0.002 and P < 0.001, respectively), whereas right ventricular end-systolic internal diameter and right atrial maximum and minimum internal diameters decreased (P = 0.004, P = 0.025 and P = 0.01, respectively). Right ventricular fractional area change and tricuspid annular plane systolic excursion did not change. CONCLUSIONS: This novel study showed that pimobendan had positive effects on right ventricular and right atrial function in healthy cats. Further studies are needed to determine whether pimobendan has similar effects in cats with cardiac diseases.

The predictive value of clinical, radiographic, echocardiographic variables and cardiac biomarkers for assessing risk of the onset of heart failure or cardiac death in dogs with preclinical myxomatous mitral valve disease enrolled in the DELAY study.

OBJECTIVES: To identify the predictive value on time to onset of heart failure (HF) or cardiac death of clinical, radiographic, and echocardiographic variables, as well as cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I in dogs with preclinical myxomatous mitral valve disease (MMVD). ANIMALS: One hundred sixty-eight dogs with preclinical MMVD and left atrium to aortic root ratio ≥1.6 (LA:Ao) and normalized left ventricular end-diastolic diameter ≥1.7 were included. METHODS: Prospective, randomized, multicenter, single-blinded, placebo-controlled study. Clinical, radiographic, echocardiographic variables and plasma cardiac biomarkers concentrations were compared at different time points. Using receiving operating curves analysis, best cutoff for selected variables was identified and the risk to develop the study endpoint at six-month intervals was calculated. RESULTS: Left atrial to aortic root ratio >2.1 (hazard ratio [HR] 3.2, 95% confidence interval [95% CI] 1.9-5.6), normalized left ventricular end-diastolic diameter > 1.9 (HR: 6.3; 95% CI: 3.3-11.8), early transmitral peak velocity (E peak) > 1 m/sec (HR: 3.9; 95% CI: 2.3-6.7), and NT-proBNP > 1500 ρmol/L (HR: 5.7; 95% CI: 3.3-9.5) were associated with increased risk of HF or cardiac death. The best fit model to predict the risk to reach the endpoint was represented by the plasma NT-proBNP concentrations adjusted for LA:Ao and E peak. CONCLUSIONS: Logistic and survival models including echocardiographic variables and NT-proBNP can be used to identify dogs with preclinical MMVD at higher risk to develop HF or cardiac death.

Echocardiographic assessment of right ventricular systolic function in healthy Beagle dogs compared to high field cardiac magnetic resonance imaging.

Ten healthy Beagle dogs were used to compare selected echocardiographic parameters of right ventricular (RV) systolic function with high field cardiac magnetic resonance imaging (MRI). All dogs underwent complete transthoracic echocardiography before and during anesthesia, as well as cardiac MRI with determination of morphology-based ejection fraction, and phase contrast angiography-derived stroke volume. A correlation analysis was carried out between echocardiographic and MRI parameters. The values of fractional area change, tricuspid annular plane systolic excursion, tissue Doppler imaging derived peak velocity of the isovolumic contraction wave and systolic wave of the lateral tricuspid valve annulus showed lower values under general anesthesia. Of all echocardiographic parameters of RV systolic function, only fractional area change (r = 0.671, P = 0.034) and tissue Doppler imaging derived peak velocity of the systolic wave of the lateral tricuspid valve annulus (r = 0.768; P = 0.01), showed a significant correlation with MRI derived stroke volume. None of the echocardiographic parameters correlated with MRI derived ejection fraction. When evaluating the RV echocardiographically, fractional area change and peak velocity of the systolic wave of the lateral tricuspid valve annulus appear to be the most reliable predictors of RV systolic function when compared to MRI under anesthesia.

Left atrial speckle tracking echocardiography in clinically healthy dogs: Variability and prediction intervals.

Left atrial (LA) speckle tracking echocardiography (STE) provides indices of LA deformation such as strain and strain rate. These variables offer useful clinical information in human and canine patients with cardiac disease. At present, reference ranges for LA STE variables in dogs are scarcely established and, due to variability among centers, they cannot be accepted worldwide. The present study aimed to provide normal ranges for LA strain and strain rate variables in clinically healthy dogs, and to evaluate the effect of clinical parameters such as bodyweight. Eighty clinically healthy dogs served as the study population. Left atrial STE was feasible in all dogs and agreement within and between observers was clinically acceptable for most of the variables, in particular strain variables. Age, sex, and heart rate did not affect LA STE. Bodyweight was negatively correlated with strain variables and positively correlated with diastolic strain rate variables and the relationship was allometric. Bodyweight-based vendor-dependent prediction intervals for LA STE variables in clinically healthy dogs could aid the evaluation of LA function in clinical practice.

Endocardial fibroelastosis in a dog with congestive heart failure.

In a 6-month-old, intact female, Japanese spitz presenting with severe dyspnea, lung ultrasonography revealed confluent B lines associated with severe echocardiographic left sided volume overload and systolic dysfunction. A congenital shunt or valvular dysplasia was not demonstrable. On electrocardiogram, there was a constant sinus rhythm, respectively sinus tachycardia. Cardiac troponin I was normal. Within 2 days of admission, the dog died of heart failure. On macroscopic postmortem examination, the left ventricle and atrium were markedly dilated, and the left ventricular endocardium had a mild diffuse whitish appearance. Histopathology revealed moderate to severe thickening of the left ventricular endocardium, composed mostly of abundant elastic fibers and fewer collagen fibers, diagnostic for endocardial fibroelastosis. In addition, there were mild degenerative changes of the atrioventricular valves. Endocardial fibroelastosis is a rare congenital disease and should be considered in a young dog if more common causes of echocardiographic dilated cardiomyopathy phenotype are ruled out.

Closure of an unusual morphology patent ductus arteriosus with a covered stent in a dog.

Patent ductus arteriosus (PDA) with unusual morphology was diagnosed in a 3-year-old German shepherd presented for exercise intolerance. Two interventional PDA closure procedures with various Amplatzer devices and one surgical ligation were attempted to close the PDA. However, PDA closure failed with both methods due to the unusual morphology and the severe enlarged ductus ampulla. Therefore, the patient underwent an aortic covered stent placement, and successful closure of the PDA was achieved. Eight months after the procedure, the dog was free of clinical signs and no residual flow was identified through the PDA on transthoracic echocardiography. Moreover, computed tomography angiography demonstrated correct stent positioning, with no evidence of thrombus formation, damage to the stent, nor any aortic wall abnormalities. Aortic covered stent placement is a viable option in dogs with unusual PDA morphology.

Effect of pimobendan on left atrial function: an echocardiographic pilot study in 11 healthy cats.

OBJECTIVES: - To evaluate the effect of a single dose of pimobendan on left atrial (LA) function in healthy cats. ANIMALS: - Eleven client owned healthy cats. MATERIAL AND METHODS: - Standardized and repeated echocardiographic examinations were performed on healthy and conscious cats before and after a single dose of orally administered pimobendan (1.25 mg/cat). Left atrial systolic functional parameters were assessed. RESULTS: - Some of the tested parameters of LA function showed significant improvement after pimobendan administration, whereas no significant effect on left ventricular function was observed. In particular, LA minimal diameters obtained from M-mode images in short (p=0.018) and long (p=0.009) axis reduced after pimobendan administration, whereas LA fractional shortening from short (p=0.027) and long (p=0.042) axis and LA appendage emptying velocity (p<0.001) significantly increased. A mild increase in heart rate (p=0.001), and a transient increase on the peak systolic wave pulmonary vein velocity (p=0.008) were also recorded as a possible effect. CONCLUSIONS: - A single dose of pimobendan appears to impact LA function in healthy cats. However, because of the small number of cats included, and the absence of a placebo group, these results cannot be definitively separated from the effect of time. Additional studies are needed to understand if similar effects are observed in cats with cardiomyopathy and LA dilatation.

Two-dimensional, M-mode, and Doppler echocardiography in 22 conscious and apparently healthy pet guinea pigs.

OBJECTIVES: The objective of this study was to report normal echocardiographic values in healthy guinea pigs. ANIMALS, MATERIALS, AND METHODS: Twenty-two privately owned, apparently healthy, conscious guinea pigs underwent complete transthoracic echocardiography. Left ventricular (LV), right ventricular, left atrial, and aortic root dimensions were measured, as were forward flow velocities across the mitral, aortic, and pulmonic valves. The effects of age, body weight, sex, and heart rate on these variables were also investigated. RESULTS: The median age (interquartile range) was 3.0 (1.8-4.0) years with a body weight of 902 (822-998) grams. Echocardiography was feasible in all conscious animals. Early and late diastolic transmitral flow waves were summated in 17 of 22 individuals. In the remaining five animals, the two waves were reversed (E wave-to-A wave velocity less than 1.0). A positive correlation was detected between body weight and LV internal diameter at end-diastole and end-systole and left atrial diameter (P < 0.05). Heart rate was negatively correlated with LV internal diameter at end-systole (r = -0.463, P = 0.035). Age was positively correlated with LV posterior wall thickness at end-diastole and aortic diameter (P < 0.05). LV internal diameter at end-systole was larger in males than in females (P = 0.012), while fractional shortening was lower (P = 0.008). CONCLUSIONS: Descriptive echocardiography ranges in apparently healthy awake guinea pigs have been provided and can be used for cardiac assessment in these pet animals.

DELay of Appearance of sYmptoms of Canine Degenerative Mitral Valve Disease Treated with Spironolactone and Benazepril: the DELAY Study.

INTRODUCTION: Efficacy of renin-angiotensin-aldosterone system (RAAS) blockade using angiotensin-converting enzyme inhibitors (ACEi) in dogs with preclinical myxomatous mitral valve disease (MMVD) is controversial. HYPOTHESIS: Administration of spironolactone (2-4 mg q 24 h) and benazepril (0.25-0.5 mg q 24 h) in dogs with preclinical MMVD, not receiving any other cardiac medications, delays the onset of heart failure (HF) and cardiac-related death. Moreover, it reduces the progression of the disease as indicated by echocardiographic parameters and level of cardiac biomarkers N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI). ANIMALS: 184 dogs with pre-clinical MMVD and left atrium-to-aortic root ratio (LA:Ao) ≥1.6 and normalized left ventricular end-diastolic diameter (LVEDDn) ≥1.7. METHODS: This is a prospective, randomized, multicenter, single-blinded, placebo-controlled study. Primary outcome variable was time-to-onset of first occurrence of HF or cardiac death. Secondary end points included effect of treatment on progression of the disease based on echocardiographic and radiographic parameters, as well as variations of NT-proBNP and cTnI concentrations. RESULTS: The median time to primary end point was 902 days (95% confidence interval (CI) 682-not available) for the treatment group and 1139 days (95% CI 732-NA) for the control group (p = 0.45). Vertebral heart score (p = 0.05), LA:Ao (p < 0.001), LVEDDn (p < 0.001), trans-mitral E peak velocity (p = 0.011), and NT-proBNP (p = 0.037) were lower at the end of study in the treatment group. CONCLUSIONS: This study failed in demonstrating that combined administration of spironolactone and benazepril delays onset of HF in dogs with preclinical MMVD. However, such treatment induces beneficial effects on cardiac remodeling and these results could be of clinical relevance.

[Extraction invasive minimale de Dirofilaria immitis chez un chien souffrant d'un syndrome cave supérieur]. / Minimal invasive Extraktion von adulten Dirofilaria immitis bei einem Hund mit Kavalsyndrom.

INTRODUCTION: Caval syndrome due to infection with Dirofilaria (D.) immitis is a life-threatening situation, needing immediate therapeutic intervention. Severe pulmonary hypertension due to dirofilariosis was diagnosed echocardiographically in a 3.6 kg dog with heart failure and moderate hemolytic anemia. A ball of adult worms was visualized in the tricuspid valve area. Using a modified pigtail catheter, these worms were removed under fluoroscopic guidance by a transvenous approach. Already intraoperatively the hemodynamic condition improved. Subsequently, additional routine adulticide treatment was performed without complications. Over the following weeks the severe pulmonary hypertension normalized slowly but steadily. Manual extraction of adult D. immitis can be achieved with relatively simple tools and allows rapid stabilization of a critically sick patient.

INTRODUCTION: Le syndrome cave supérieur dû à une infestation à ­Dirofilaria (D.) immitis est une situation potentiellement mortelle nécessitant un traitement immédiat. Une hypertension pulmonaire sévère due à la dirofilariose a été diagnostiquée par échocardiographie chez un chien de 3,6 kg présentant une insuffisance cardiaque et une anémie hémolytique modérée. Une boule de vers adultes a été visualisée dans la région de la valvule tricuspide. En utilisant un cathéter queue de cochon modifié, ces vers ont été retirés sous guidage fluoroscopique par une approche transveineuse. Déjà durant l'opération, l'état hémodynamique s'est amélioré. Par la suite, un traitement adulticide de routine supplémentaire a été réalisé sans complications. Au cours des semaines suivantes, l'hypertension artérielle pulmonaire sévère s'est normalisée lentement mais régulièrement. L'extraction manuelle de D. immitis adultes peut être réalisée avec des outils relativement simples et permet la stabilisation rapide d'un patient gravement atteint.

Preexcitation alternans in a dog.

Preexcitation alternans and orthodromic atrioventricular reciprocating tachycardia were diagnosed in a 3-month-old Boxer. The images described here show how conventional electrocardiographic techniques (12-lead surface electrocardiography, 24-hour Holter monitoring, and ladder diagram) can be interpreted to gain detailed information on presence of canine atrioventricular accessory pathways and their conduction properties.

Cor triatriatum sinister in a dog.

This report describes the transthoracic and transesophageal echocardiographic features of cor triatriatum sinister in an asymptomatic 6-year-old male French bulldog. Although cor triatriatum sinister represents a well-known and widely described cardiac malformation in humans, its description in the canine population is rare. In this clinical case, non-invasive echocardiographic techniques were helpful in visualizing and characterizing the lesion, allowing a valuable assessment of the malformation, and its hemodynamic consequences.

Holter monitoring demonstrates that ventricular arrhythmias are common in cats with decompensated and compensated hypertrophic cardiomyopathy.

Arrhythmias can complicate cardiac disease in cats and are a potential cause of sudden death. The aim of this study was to evaluate the presence and nature of cardiac arrhythmias, and the potential correlation between plasma serum troponin I (cTnI) concentrations and the presence or severity of arrhythmias in cats with decompensated (dHCM) and compensated hypertrophic cardiomyopathy (cHCM). Forty one client-owned cats were studied: 16 with cHCM, 15 with dHCM and 10 healthy control cats. Physical examination, echocardiography, cTnI and 24-h Holter recordings were obtained in all cats and thoracic radiographs in cats with dHCM. Cats in both HCM groups were followed for 1 year after their initial Holter examination. The median (range) number of ventricular premature complexes (VPCs) over 24h was 867 (1-35,160) in cats with dHCM, 431 (0-18,919) in cats with cHCM and 2 (0-13) in healthy control cats. The median number of episodes of ventricular tachycardia (VTach) was 0 (0-1497) in dHCM and 0.5 (0-91) in cats with cHCM. The number of VPCs, VTach episodes and heart rate was not different between the HCM groups. Plasma serum troponin I was highest in the cats with dHCM, but there was no correlation between cTnI concentration and the number of arrhythmias. Thirteen of 31 cats with HCM died, but an association with the presence and complexity of ventricular arrhythmias was not observed. Compared to healthy cats, ventricular arrhythmias were common in cats with cHCM and dHCM, but neither presence nor complexity of arrhythmias could be linked to prognosis.

Diagnostic and prognostic utility of surface electrocardiography in cats with left ventricular hypertrophy.

OBJECTIVES: To assess the ability of electrocardiography (ECG) to predict left ventricular hypertrophy (LVH) in the cat and to investigate the prognostic value of selected ECG variables in cats with LVH. ANIMALS: Fifty-seven privately owned cats: 22 clinically healthy cats and 35 cats with LVH. MATERIAL AND METHODS: This is a clinical cohort study. Echocardiographic diagnosis and surface ECG were available. Electrocardiography analysis included rhythm diagnosis and specific electrocardiographic measurements. In cats with LVH, cause of death and outcome data were recorded and analyzed using Kaplan-Meier curves. RESULTS: The presence of arrhythmia had sensitivity and specificity of 31% and 100%, respectively, for identifying LVH. Among ECG measurements, duration of QT interval (QT) and QT interval corrected for heart rate (QTc) was statistically different between healthy cats and cats with LVH (p = 0.007). Overall, the most accurate cutoffs to identify LVH were QT > 170 ms (sensitivity and specificity 48.3% and 91%, respectively) and QTc > 188 ms (sensitivity and specificity 62% and 77%, respectively). In healthy cats, the highest QT and QTc values were 180 ms and 200 ms, respectively. Mean survival time was 58 days and indeterminable for cats with QT > 180 ms and QT ≤ 180 ms, respectively (p = 0.042) and 125 days and indeterminable for cats with QTc > 200 ms and QTc ≤ 200 ms, respectively (p = 0.017). CONCLUSIONS: Arrhythmias as well as prolonged QT and QTc are useful ECG parameters in identifying LVH and predicting survival in affected cats.

Whole-heart 4D flow cardiac magnetic resonance in healthy dogs.

INTRODUCTION: In cardiac magnetic resonance imaging (CMR), accurate flow measurements rely on perpendicular plane-alignment with flow direction. For 2D phase contrast (PC) cardiac magnetic resonance measurements, planes have to be defined during the examination of the heart, which is time consuming and error-prone. Collection of flow information of the entire volume of the heart by a 4D flow CMR postpones plane alignment to post-processing. Sampling of such a large amount of data requires acceleration of data acquisition with techniques such as SENSitivity Encoding (k-t SENSE) or Broad-use Linear Acquisition Speed-up Technique (k-t BLAST). Objectives of the study were to compare 4D flow CMR, accelerated with two different acceleration methods with the established 2D PC CMR based on assessment of stroke volume at all four cardiac valves. The values of stroke volume acquired with the 4D flow CMR SENSE did not differ significantly when compared to the 2D PC CMR SENSE at the left side of the heart (aortic and mitral valve). Significant differences between the techniques were seen at the pulmonic and tricuspid valves. Acceleration with k-t BLAST revealed significantly lower values of stroke volume at all cardiac valves, except at the mitral valve.

INTRODUCTION: Lors d'examens cardiaques par résonnance magnétique (CMR), le plan pour des mesures de flux précises doit être défini perpendiculairement à la direction de flux sanguin. Dans la CMR en contraste de phases 2D (PC), le choix de ce plan se fait durant l'examen, ce qui prend du temps et peut être sujet à des problèmes. Avec la mesure de toutes les données relatives au flux sanguin dans l'ensemble du coeur au moyen d'un 4D flow CMR, on déplace le moment de ce choix dans la phase de traitement des données. La collecte d'une quantité aussi élevée de données nécessite une accélération de la technique de mesures comme par exemple SENSitivity Encoding (k-t SENSE) ou Broad-use Linear Acquisition Speed-up Technique (k-t BLAST). Le but de cette étude était de comparer la CMR 4D, accélérée avec deux méthodes différentes avec la CMR 2D bien établie, ceci sur la base de la détermination du volume d'éjection systolique au niveau des quatre valvules cardiaques. Les valeurs du volume d'éjection pour le coeur gauche (valvules aortiques et mitrales) obtenues par 4D flow CMR k-t SENSE n'étaient pas significativement différentes de celles obtenues par 2D PC CMR k-t SENSE. Par contre, des différences significatives entre les deux techniques étaient constatées au niveau des valvules pulmonaires et tricuspid. L'accélération par k-t-BLAST donnait de façon générale des valeurs du volume d'élection plus basses au niveau de toutes les valvules, à l'exception de la valvule mitrale.