4D flow CMR can detect subtle right ventricular dysfunction in primary left ventricular disease

Background Right ventricular (RV) function holds important prognostic value in both rightand left-sided acquired and congenital heart diseases. However, assessment of RV function remains challenging due to its complex chamber geometry and physiology. 4D flow CMR permits assessment of multidimensional intraventricular flow. We hypothesized that 4D flow specific markers of RV function can detect subtle impairment of RV function in primary left ventricular (LV) disease. Methods Eighteen patients with mild ischemic heart disease and eleven healthy controls were enrolled. 4D flow CMR and standard morphological images were acquired on a 3T-scanner (Philips Ingenia). The patients were stratified into two groups (n=9 each) based on LV end-diastolic volume index (EDVI) from CMR: lower LVEDVI and higher LVEDVI, respectively. The RV volume was segmented from morphological images at end-diastole (ED) and end-systole (ES) and matched to the velocity