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.
This paper is freely available online under the BMJ Journals unlocked scheme, see http://adc.bmj.com/info/unlocked.dtl
Statistics from Altmetric.com
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.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.