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Functional cardiac MRI in preterm and term newborns
  1. Alan M Groves1,
  2. Gaia Chiesa1,
  3. Giuliana Durighel1,
  4. Stephen T Goldring1,
  5. Julie A Fitzpatrick1,
  6. Sergio Uribe2,3,
  7. Reza Razavi2,
  8. Jo V Hajnal1,
  9. A David Edwards1
  1. 1Institute of Clinical Sciences, Imperial College and MRC Clinical Sciences Centre, Hammersmith Hospital, London, UK
  2. 2Division of Imaging Sciences, British Heart Foundation (BHF) National Centre, National Institute for Health Research (NIHR) Comprehensive Biomedical Research Centre, Guy's and St Thomas' National Health Service (NHS) Foundation Trust, King's College London, London, UK
  3. 3Radiology Department and Center for Biomedical Imaging, Pontificia Universidad Catolica de Chile, Santiago, Chile
  1. Correspondence to Dr Alan Groves, Department of Paediatrics, Hammersmith House, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK; alan.groves{at}imperial.ac.uk

Abstract

Objective To use cardiac MRI techniques to assess ventricular function and systemic perfusion in preterm and term newborns, to compare techniques to echocardiographic methods, and to obtain initial reference data.

Design Observational magnetic resonance and echocardiographic imaging study.

Setting Neonatal Unit, Queen Charlotte's and Chelsea Hospital, London, UK.

Patients 108 newborn infants with median birth weight 1627 (580–4140) g, gestation 32 (25–42) weeks.

Results Mean (SD) flow volumes assessed by phase contrast (PC) imaging in 28 stable infants were left ventricular output (LVO) 222 (46), right ventricular output (RVO) 219 (47), superior vena cava (SVC) 95 (27) and descending aorta (DAo) 126 (32) ml/kg/min, with flow being higher at lower gestational age. Limits of agreement for repeated PC assessment of flow were LVO ±50.2, RVO ±55.5, SVC ±20.9 and DAo ±26.2 ml/kg/min. Mean (SD) LVO in 75 stable infants from three-dimensional models were 245 (47) ml/kg/min, with limits of agreement ±58.3 ml/kg/min. Limits of agreement for repeated echocardiographic assessment of LVO were ±108.9 ml/kg/min.

Conclusions Detailed magnetic resonance assessments of cardiac function and systemic perfusion are feasible in newborn infants, and provide more complete data with greater reproducibility than existing echocardiographic methods. Functional cardiac MRI could prove to be a useful research technique to study small numbers of newborn infants in specialist centres; providing insights into the pathophysiology of circulatory failure; acting as an outcome measure in clinical trials of inotropic intervention and so guiding clinical practice in the wider neonatal community.

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Footnotes

  • Funding This study was supported by the Garfield Weston Foundation, the Medical Research Council, the Wellcome Trust, the Imperial College Comprehensive Biomedical Research Centre and a Dorothy Hodgkins Postgraduate Award (S.U.).

  • Competing interests RR, JVH and ADE receive investigator-led research support from Philips.

  • Ethics approval This study was conducted with the approval of the Hammersmith Hospital REC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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