Routine evaluation of left ventricular diastolic function by cardiovascular magnetic resonance: A practical approachReport as inadecuate




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Journal of Cardiovascular Magnetic Resonance

, 10:36

First Online: 08 July 2008Received: 12 May 2008Accepted: 08 July 2008

Abstract

BackgroundCardiovascular magnetic resonance CMR has excellent capabilities to assess ventricular systolic function. Current clinical scenarios warrant routine evaluation of ventricular diastolic function for complete evaluation, especially in congestive heart failure patients. To our knowledge, no systematic assessment of diastolic function over a range of lusitropy has been performed using CMR.

Methods and ResultsLeft ventricular diastolic function was assessed in 31 subjects 10 controls who underwent CMR and compared with Transthoracic echocardiogram TTE evaluation of mitral valve MV and pulmonary vein PV blood flow. Blood flow in the MV and PV were successfully imaged by CMR for all cases 31-31,100% while TTE evaluated flow in all MV 31-31,100% but only 21-31 PV 68% cases. Velocities of MV flow E and A measured by CMR correlated well with TTE r = 0.81, p < 0.001, but demonstrated a systematic underestimation by CMR compared to TTE slope = 0.77. Bland-Altman analysis of the E:A ratio and deceleration time DT calculated from each modality showed excellent agreement bias -0.29, and -10.3 ms for E:A and DT, respectively. When assessing morphology using TTE, CMR correctly identified patients as having normal or abnormal inflow conditions.

ConclusionWe have shown that there is homology between CMR and TTE for the assessment of diastolic inflow over a wide range of conditions, including normal, impaired relaxation and restrictive. There is excellent agreement of quantitative velocity measurements between CMR and TTE. Diastolic blood flow assessment by CMR can be performed in a single scan, with times ranging from 20 sec to 3 min, and we show that there is good indication for applying CMR to assess diastolic conditions, either as an adjunctive test when evaluating systolic function, or even as a primary test when TTE data cannot be obtained.

AbbreviationsCHFCongestive heart failure

CMRCardiovascular magnetic resonance

TTETransthoracic echocardiography

PCPhase contrast

LVLeft ventricle

MVMitral valve

PVPulmonary vein.

Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-10-36 contains supplementary material, which is available to authorized users.

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Author: Vikas K Rathi - Mark Doyle - June Yamrozik - Ronald B Williams - Ketheswaram Caruppannan - Craig Truman - Diane Vido - Ro

Source: https://link.springer.com/article/10.1186/1532-429X-10-36







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