HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2292020559v1 229/2/513    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van den Hout, R. J. Articles by de Roos, A. Search for Related Content PubMed PubMed Citation Articles by van den Hout, R. J. Articles by de Roos, A.

Real-Time MR Imaging of Aortic Flow: Influence of Breathing on Left Ventricular Stroke Volume in Chronic Obstructive Pulmonary Disease¹

Rik J. van den Hout, MD, Hildo J. Lamb, PhD, Joost G. van den Aardweg, MD, Robert Schot, BSc, Paul Steendijk, PhD, Ernst E. van der Wall, MD, Jeroen J. Bax, MD and Albert de Roos, MD

¹ From the Departments of Radiology (R.J.v.d.H., H.J.L., E.E.v.d.W., A.d.R.), Pulmonology (J.G.v.d.A., R.S.), and Cardiology (P.S., J.J.B.), Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands. From the 2001 RSNA scientific assembly. Received May 15, 2002; revision requested July 15; final revision received February 12, 2003; accepted March 28. Address correspondence to H.J.L. (e-mail: H.J.Lamb@lumc.nl).

PURPOSE: To assess real-time changes of left ventricular stroke volume (SV) in relation to the breathing pattern in healthy subjects and in patients with chronic obstructive pulmonary disease (COPD).

MATERIALS AND METHODS: Real-time magnetic resonance (MR) imaging flow measurements were performed in the ascending aorta of 10 healthy volunteers and nine patients with severe COPD. Breathing maneuvers were registered with an abdominal pressure belt, which was synchronized to the electrocardiographic signal and the flow measurement. Healthy subjects performed normal breathing, deep breathing, and the Valsalva maneuver. Patients with COPD performed spontaneous breathing. Paired two-tailed Student t tests were used in healthy volunteers to assess significant SV differences between normal breathing and deep breathing or the Valsalva maneuver. The results of measurements in the patients with COPD were compared with the results during normal breathing in healthy subjects with the unpaired two-tailed Student t test.

RESULTS: In healthy subjects, SV decreased during inspiration and increased during expiration (r² = 0.78, P < .05). When compared with the SV during normal breathing, mean SV did not change during deep breathing but declined during the Valsalva maneuver (P < .05). The difference between minimal and maximal SVs (ie, SV range) increased because of deep breathing or the Valsalva maneuver (P < .05). In normal and deep breathing, velocity of SV elevation and velocity of SV decrease were equal (which resulted in a ratio of 1), whereas during the Valsalva maneuver, this value increased (P < .05). Spontaneous breathing in COPD resulted in SV changes (P < .05) similar to those observed in healthy subjects who performed the Valsalva maneuver.

CONCLUSION: Real-time MR imaging of aortic flow reveals physiologic flow alterations, which are dependent on variations in the breathing pattern.

© RSNA, 2003

Index terms: Aorta, flow dynamics, 941.129416 • Aorta, MR, 941.129416 • Emphysema, 60.751 • Heart, function, 52.619, 52.719 • Heart, MR, 52.121416, 52.12144

This article has been cited by other articles:

				S. Ley, C. Fink, M. Puderbach, J. Zaporozhan, C. Plathow, M. Eichinger, W. Hosch, K.-F. Kreitner, and H.-U. Kauczor MRI Measurement of the hemodynamics of the pulmonary and systemic arterial circulation: influence of breathing maneuvers. Am. J. Roentgenol., August 1, 2006; 187(2): 439 - 444. [Abstract] [Full Text] [PDF]