Heart Failure: Evaluation of Cardiopulmonary Transit Times with Time-resolved MR Angiography

Purpose: To measure cardiopulmonary transit times in patients with heart failure by using low-dose, time-resolved magnetic resonance (MR) angiography and to determine if transit curves reflect conventional MR indexes of cardiac function.

Materials And Methods: Twenty-six patients with heart failure and left ventricular (LV) systolic dysfunction (17 men and nine women; age range, 22-78 years) and thirteen control subjects (eight men and five women; age range, 23-59 years) were examined with MR imaging. The examination consisted of rapid cine MR imaging throughout the heart, followed by contrast material-enhanced time-resolved three-dimensional MR angiography of the cardiac chambers and pulmonary vasculature. Time-intensity curves for the pulmonary artery and ascending aorta were derived from the MR angiography images. Cardiopulmonary transit times and dispersions (full widths at half maximum [FWHM]) were determined from the curves. Transit times and FWHM values for the patients with heart failure were compared with control values by using two-tailed t tests, and transit time was correlated with standard LV functional parameters calculated from the cine MR images.

Results: Cardiopulmonary transit times and FWHM values were significantly prolonged in the patients with heart failure compared with those in the control patients (P <.001). Transit time correlated directly with LV end-diastolic and end-systolic volumes and inversely with LV ejection fraction (R > 0.60). However, transit time did not correlate strongly with age, body surface area, heart rate, LV mass, stroke volume, cardiac output, or sphericity index.

Conclusion: Time-resolved MR angiography allows determination of cardiopulmonary transit times that are significantly prolonged in heart failure and correlate directly with LV volumes and inversely with LV ejection fraction.