Noninvasive evaluation of global left ventricular function with use of cine nuclear magnetic resonance

Previous reports have validated the accuracy of nuclear magnetic resonance (NMR) imaging for quantitating ventricular volumes and myocardial mass. In this study, a new rapid NMR imaging method, cine NMR imaging, was used to compare left ventricular volumes determined from the transverse plane and short-axis plane in healthy volunteers and patients with dilated cardiomyopathy. With use of the short-axis plane, left ventricular mass at end-systole and end-diastole were determined and left ventricular systolic wall thickening at three different levels was assessed. For validation in the current study, cine NMR imaging and two-dimensional echocardiographic measurements of left ventricular volumes were correlated. Left ventricular volumes of the normal volunteers (end-systolic volume = 34 ± 3.8 ml, end-diastolic volume = 90.4 ± 7.2 ml) and patients with cardiomyopathy (end-systolic volume = 173 ± 28.3 ml, end-diastolic volume = 219.5 ± 29.6 ml) obtained in the transverse plane were nearly identical to those obtained in the short-axis plane (normal volunteers, end-systolic volume = 30.3 ± 3.5 ml, end diastolic volume = 84.7 ± 7.0 ml and patients with cardiomyopathy, end-systolic volume = 179.1 ± 27.8 ml, end-diastolic volume = 227 ± 30.9 ml) and correlated highly (r = 0.91) with volumes obtained by two-dimensional echocardiography. Assessment of left ventricular mass over a broad range using clue NMR imaging in a short-axis plane was identical at end-systole (normal volunteers, 117 ± 10 g; patients with cardiomyopathy, 202 ± 20 g) and end-diastole (normal volunteers, 115 ± 10 g; patients with cardiomyopathy, 194 ± 21 g). Normal hearts exhibited a gradient of wall thickening increasing progressively from the base to the apex, whereas cardiomyopahy ventricles showed no gradient in the extent of wall thickening. Thus, cine NMR imaging of the heart in a short-axis plane provides for the comprehensive geometric and functional evaluation of the normal and diseased left ventricle. The plane of imaging is not critical for the quantitation of ventricular volumes.