Stress increases intracardiac 4D flow cardiovascular magnetic resonance -derived energetics and vorticity and relates to VO2max in Fontan patients

• Published in: Journal of cardiovascular magnetic resonance 2019-07, Vol.21 (1), p.43-43, Article 43
• Main Authors: Kamphuis, Vivian P., Elbaz, Mohammed S.M., van den Boogaard, Pieter J., Kroft, Lucia J.M., Lamb, Hildo J., Hazekamp, Mark G., Jongbloed, Monique R.M., Blom, Nico A., Helbing, Willem A., Roest, Arno A.W., Westenberg, Jos J.M.
• Format: Article
• Language: English
• Subjects: 4D flow CMR; Flow; Fontan; Kinetic energy: energy loss; Vorticity
• ISSN: 1097-6647; 1532-429X
• DOI: 10.1186/s12968-019-0553-4

BACKGROUNDWe hypothesize that dobutamine-induced stress impacts intracardiac hemodynamic parameters and that this may be linked to decreased exercise capacity in Fontan patients. Therefore, the purpose of this study was to assess the effect of pharmacologic stress on intraventricular kinetic energy (KE), viscous energy loss (EL) and vorticity from four-dimensional (4D) Flow cardiovascular magnetic resonance (CMR) imaging in Fontan patients and to study the association between stress response and exercise capacity.METHODSTen Fontan patients underwent whole-heart 4D flow CMR before and during 7.5 μg/kg/min dobutamine infusion and cardiopulmonary exercise testing (CPET) on the same day. Average ventricular KE, EL and vorticity were computed over systole, diastole and the total cardiac cycle (vorticity_volavg cycle, KEavg cycle, ELavg cycle). The relation to maximum oxygen uptake (VO2 max) from CPET was tested by Pearson's correlation or Spearman's rank correlation in case of non-normality of the data.RESULTSDobutamine stress caused a significant 88 ± 52% increase in KE (KEavg cycle: 1.8 ± 0.5 vs 3.3 ± 0.9 mJ, P