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MR-Augmented Cardiopulmonary Exercise Testing- a proof of concept in Sickle Cell Disease (SCD). J Cardiovasc Magn Reson 2016. [PMCID: PMC5032132 DOI: 10.1186/1532-429x-18-s1-o69] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Magnetic Resonance–Augmented Cardiopulmonary Exercise Testing. Circ Cardiovasc Imaging 2016; 9:CIRCIMAGING.116.005282. [DOI: 10.1161/circimaging.116.005282] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 10/13/2016] [Indexed: 11/16/2022]
Abstract
Background—
Conventional cardiopulmonary exercise testing can objectively measure exercise intolerance but cannot provide comprehensive evaluation of physiology. This requires additional assessment of cardiac output and arteriovenous oxygen content difference. We developed magnetic resonance (MR)–augmented cardiopulmonary exercise testing to achieve this goal and assessed children with right heart disease.
Methods and Results—
Healthy controls (n=10) and children with pulmonary arterial hypertension (PAH; n=10) and repaired tetralogy of Fallot (n=10) underwent MR-augmented cardiopulmonary exercise testing. All exercises were performed on an MR-compatible ergometer, and oxygen uptake was continuously acquired using a modified metabolic cart. Simultaneous cardiac output was measured using a real-time MR flow sequence and combined with oxygen uptake to calculate arteriovenous oxygen content difference. Peak oxygen uptake was significantly lower in the PAH group (12.6±1.31 mL/kg per minute;
P
=0.01) and trended toward lower in the tetralogy of Fallot group (13.5±1.29 mL/kg per minute;
P
=0.06) compared with controls (16.7±1.37 mL/kg per minute). Although tetralogy of Fallot patients had the largest increase in cardiac output, they had lower resting (3±1.2 L/min per m
2
) and peak (5.3±1.2 L/min per m
2
) values compared with controls (resting 4.3±1.2 L/min per m
2
and peak 6.6±1.2 L/min per m
2
) and PAH patients (resting 4.5±1.1 L/min per m
2
and peak 5.9±1.1 L/min per m
2
). Both the PAH and tetralogy of Fallot patients had blunted exercise–induced increases in arteriovenous oxygen content difference. However, only the PAH patients had significantly reduced peak values (6.9±1.3 mlO2/100 mL) compared with controls (8.4±1.4 mlO2/100 mL;
P
=0.005).
Conclusions—
MR-augmented cardiopulmonary exercise testing is feasible in both healthy children and children with cardiac disease. Using this novel technique, we have demonstrated abnormal exercise patterns in oxygen uptake, cardiac output, and arteriovenous oxygen content difference.
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Ultrafast CMR to deliver high volume screening of an at risk thalassemia population in the developing world: preliminary results from the TIC-TOC study (Thailand and UK international collaboration in thalassaemia using an optimised ultrafast CMR protocol). THE JOURNAL OF HEART VALVE DISEASE 2016. [PMCID: PMC5032331 DOI: 10.1186/1532-429x-18-s1-o39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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MR augmented cardiopulmonary exercise testing - a novel method of assessing cardiovascular function. J Cardiovasc Magn Reson 2015. [PMCID: PMC4328955 DOI: 10.1186/1532-429x-17-s1-q2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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MR augmented cardiopulmonary exercise testing—a novel approach to assessing cardiovascular function. Physiol Meas 2015; 36:N85-94. [DOI: 10.1088/0967-3334/36/5/n85] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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