Cardiac Magnetic Resonance Imaging to Determine Single Ventricle Function in a Pediatric Population is Feasible in a Large Trial Setting: Experience from the Single Ventricle Reconstruction Trial Longitudinal Follow up

Jon Detterich^#¹, Michael D Taylor^#², Timothy C Slesnick^{3

4}, Michael DiLorenzo⁵, Anthony Hlavacek⁶, Christopher Z Lam^{7

8}, Shagun Sachdeva⁹, Sean M Lang², M Jay Campbell¹⁰, Jennifer Gerardin¹¹, Kevin K Whitehead¹², Rahul H Rathod¹³, Mark Cartoski¹⁴, Shaji Menon¹⁵, Felicia Trachtenberg¹⁶, Russell Gongwer¹⁶, Jane Newburger¹³, Caren Goldberg¹⁷, Adam L Dorfman¹⁷; the Pediatric Heart Network Investigators

Affiliations

¹ Division of Cardiology, Children's Hospital Los Angeles and the University of Southern California, 4650 Sunset Blvd MS34, Los Angeles, CA, 90027, USA. jdetterich@chla.usc.edu.
² Department of Pediatrics, Heart Institute Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
³ Emory University School of Medicine, Atlanta, GA, USA.
⁴ Children's Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, GA, USA.
⁵ Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Irving Medical Center, New York, NY, USA.
⁶ Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
⁷ Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.
⁸ Division of Pediatric Imaging, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
⁹ The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
¹⁰ Duke University School of Medicine, Durham, NC, USA.
¹¹ Departments of Internal Medicine and Pediatrics, Children's Hospital Wisconsin-Herma Heart Institute, Medical College of Wiscosin, Milwaukee, WI, USA.
¹² Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
¹³ Department of Cardiology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁴ Division of Pediatric Cardiology, Nemours Cardiac Center, Nemours Children's Hospital, Wilmington, DE,, USA.
¹⁵ Division of Pediatric Cardiology, Primary Children's Hospital, University of Utah, Salt Lake City, UT, USA.
¹⁶ HealthCore Inc, Newton, MA, USA.
¹⁷ Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.

^# Contributed equally.

PMID: 37405456
PMCID: PMC10435402
DOI: 10.1007/s00246-023-03216-8

Randomized Controlled Trial

Cardiac Magnetic Resonance Imaging to Determine Single Ventricle Function in a Pediatric Population is Feasible in a Large Trial Setting: Experience from the Single Ventricle Reconstruction Trial Longitudinal Follow up

Jon Detterich et al. Pediatr Cardiol. 2023 Oct.

. 2023 Oct;44(7):1454-1461.

doi: 10.1007/s00246-023-03216-8. Epub 2023 Jul 5.

Authors

Affiliations

¹ Division of Cardiology, Children's Hospital Los Angeles and the University of Southern California, 4650 Sunset Blvd MS34, Los Angeles, CA, 90027, USA. jdetterich@chla.usc.edu.
² Department of Pediatrics, Heart Institute Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
³ Emory University School of Medicine, Atlanta, GA, USA.
⁴ Children's Healthcare of Atlanta, Sibley Heart Center Cardiology, Atlanta, GA, USA.
⁵ Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Irving Medical Center, New York, NY, USA.
⁶ Division of Pediatric Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
⁷ Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.
⁸ Division of Pediatric Imaging, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
⁹ The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
¹⁰ Duke University School of Medicine, Durham, NC, USA.
¹¹ Departments of Internal Medicine and Pediatrics, Children's Hospital Wisconsin-Herma Heart Institute, Medical College of Wiscosin, Milwaukee, WI, USA.
¹² Division of Cardiology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
¹³ Department of Cardiology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁴ Division of Pediatric Cardiology, Nemours Cardiac Center, Nemours Children's Hospital, Wilmington, DE,, USA.
¹⁵ Division of Pediatric Cardiology, Primary Children's Hospital, University of Utah, Salt Lake City, UT, USA.
¹⁶ HealthCore Inc, Newton, MA, USA.
¹⁷ Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.

^# Contributed equally.

PMID: 37405456
PMCID: PMC10435402
DOI: 10.1007/s00246-023-03216-8

Abstract

The Single Ventricle Reconstruction (SVR) Trial was a randomized prospective trial designed to determine survival advantage of the modified Blalock-Taussig-Thomas shunt (BTTS) vs the right ventricle to pulmonary artery conduit (RVPAS) for patients with hypoplastic left heart syndrome. The primary aim of the long-term follow-up (SVRIII) was to determine the impact of shunt type on RV function. In this work, we describe the use of CMR in a large cohort follow up from the SVR Trial as a focused study of single ventricle function. The SVRIII protocol included short axis steady-state free precession imaging to assess single ventricle systolic function and flow quantification. There were 313 eligible SVRIII participants and 237 enrolled, ages ranging from 10 to 12.5 years. 177/237 (75%) participants underwent CMR. The most common reasons for not undergoing CMR exam were requirement for anesthesia (n = 14) or ICD/pacemaker (n = 11). A total of 168/177 (94%) CMR studies were diagnostic for RVEF. Median exam time was 54 [IQR 40-74] minutes, cine function exam time 20 [IQR 14-27] minutes, and flow quantification time 18 [IQR 12-25] minutes. There were 69/177 (39%) studies noted to have intra-thoracic artifacts, most common being susceptibility artifact from intra-thoracic metal. Not all artifacts resulted in non-diagnostic exams. These data describe the use and limitations of CMR for the assessment of cardiac function in a prospective trial setting in a grade-school-aged pediatric population with congenital heart disease. Many of the limitations are expected to decrease with the continued advancement of CMR technology.

Keywords: Cardiac Magenetic Resonance Imaging; Clinical Trial; Fontan Circulation; Outcomes Research; Pediatrics.

PubMed Disclaimer

Conflict of interest statement

MC Consultant for Longeveron, JD Scientific Advisory Board for Alcor Scientific.

Figures

**Fig. 1**
This is a flow chart demonstrating the breakdown of eligible patients enrolled in SVR III and the total number of CMR exams with adequate imaging for measurement of right ventricular ejection fraction

**Fig. 2**
This figure demonstrates the distribution of study quality for all CMR exams performed in the SVR III study

See this image and copyright information in PMC

References

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Cardiac Magnetic Resonance Imaging to Determine Single Ventricle Function in a Pediatric Population is Feasible in a Large Trial Setting: Experience from the Single Ventricle Reconstruction Trial Longitudinal Follow up

Affiliations

Cardiac Magnetic Resonance Imaging to Determine Single Ventricle Function in a Pediatric Population is Feasible in a Large Trial Setting: Experience from the Single Ventricle Reconstruction Trial Longitudinal Follow up

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources