Introducing a free-breathing MRI method to assess peri-operative myocardial oxygenation and function: A volunteer cohort study.

Guensch, Dominik P; Utz, Christoph D; Jung, Bernd; Dozio, Scilla; Huettenmoser, Stefan P; Friess, Jan O; Terbeck, Sandra; Erdoes, Gabor; Huber, Adrian T; Eberle, Balthasar; Fischer, Kady (2024). Introducing a free-breathing MRI method to assess peri-operative myocardial oxygenation and function: A volunteer cohort study. European journal of anaesthesiology, 41(7), pp. 480-489. Lippincott Williams & Wilkins 10.1097/EJA.0000000000001964

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BACKGROUND

Induction of general anaesthesia has many potential triggers for peri-operative myocardial ischaemia including the acute disturbance of blood gases that frequently follows alterations in breathing and ventilation patterns. Free-breathing oxygenation-sensitive cardiovascular magnetic resonance (OS-CMR) imaging may provide the opportunity to continuously quantify the impact of such triggers on myocardial oxygenation.

OBJECTIVE

To investigate the impact of breathing patterns that simulate induction of general anaesthesia on myocardial oxygenation in awake healthy adults using continuous OS-CMR imaging.

DESIGN

Prospective observational study.

SETTING

Single-centre university hospital. Recruitment from August 2020 to January 2022.

PARTICIPANTS

Thirty-two healthy volunteers younger than 45 years old were recruited. Data were analysed from n = 29 (69% male individuals).

INTERVENTION

Participants performed a simulated induction breathing manoeuvre consisting of 2.5 min paced breathing with a respiration rate of 14 breaths per minute, followed by 5 deep breaths, then apnoea for up to 60s inside a magnetic resonance imaging scanner (MRI). Cardiac images were acquired with the traditional OS-CMR sequence (OSbh-cine), which requires apnoea for acquisition and with two free-breathing OS-CMR sequences: a high-resolution single-shot sequence (OSfb-ss) and a real-time cine sequence (OSfb-rtcine).

MAIN OUTCOME MEASURES

Myocardial oxygenation response at the end of the paced breathing period and at the 30 s timepoint during the subsequent apnoea, reflecting the time of successful intubation in a clinical setting.

RESULTS

The paced breathing followed by five deep breaths significantly reduced myocardial oxygenation, which was observed with all three techniques (OSbh-cine -6.0 ± 2.6%, OSfb-ss -12.0 ± 5.9%, OSfb-rtcine -5.4 ± 7.0%, all P < 0.05). The subsequent vasodilating stimulus of apnoea then significantly increased myocardial oxygenation (OSbh-cine 6.8 ± 3.1%, OSfb-ss 8.4 ± 5.6%, OSfb-rtcine 15.7 ± 10.0%, all P < 0.01). The free-breathing sequences were reproducible and were not inferior to the original sequence for any stage.

CONCLUSION

Breathing manoeuvres simulating induction of general anaesthesia cause dynamic alterations of myocardial oxygenation in young volunteers, which can be quantified continuously with free-breathing OS-CMR. Introducing these new imaging techniques into peri-operative studies may throw new light into the mechanisms of peri-operative perturbations of myocardial tissue oxygenation and ischaemia.

VISUALABSTRACT

http://links.lww.com/EJA/A922.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy > Partial clinic Insel
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Günsch, Dominik, Jung, Bernd, Friess, Jan-Oliver, Terbeck, Sandra, Erdoes, Gabor (B), Huber, Adrian Thomas, Eberle, Balthasar, Fischer, Kady Anne

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0265-0215

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Pubmed Import

Date Deposited:

08 Feb 2024 11:37

Last Modified:

08 Jun 2024 00:12

Publisher DOI:

10.1097/EJA.0000000000001964

PubMed ID:

38323332

BORIS DOI:

10.48350/192655

URI:

https://boris.unibe.ch/id/eprint/192655

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