New Cardiac Magnetic Resonance Reference Ranges for Right Ventricular Volumes and Systolic Function

Accurate quantitation of right ventricular (RV) volumes and systolic function provides important diagnostic and prognostic information in a wide range of conditions. In the case of heart failure, a preserved RV ejection fraction (RVEF) is associated with improved long-term survival.1 The most recent task force criteria for the diagnosis of arrhythmogenic RV cardiomyopathy require the presence of abnormal measurements of RV end-diastolic volume or RVEF to fulfil the major imaging criterion for diagnosis of the condition.2 In pulmonary arterial hypertension, increased RV end-diastolic volume and decreased RV stroke volume independently predict mortality3 and after myocardial infarction, RV function is an independent prognostic marker of clinical outcome.4See Article by Foppa et al Cardiac magnetic resonance (CMR) is considered the current reference standard for quantitation of RV volumes and systolic function5 because of its accuracy and reproducibility, and several previous studies have reported normal values for this method. So why then do we need new normal reference values?CMR methods have undergone considerable evolution and standardization during the past 2 decades. Today, balanced steady-state free precession (SSFP) is the standard for acquisition of cine CMR images because it provides much better endocardial border delimitation, shorter scan times, and higher signal:noise ratios than the formerly used spoiled gradient echo methods.6 The overall better image quality of balanced SSFP acquisition and the ability to more clearly differentiate trabeculation …