Insights into diastolic function analyses using cardiac magnetic resonance imaging: impact of trabeculae and papillary muscles

Insights into Imaging

Kai Müllerleile¹  Bjoern P. Schoennagel²  Gerhard Adam²  Enver Tahir²  Peter Bannas²  Jitka Starekova²  Jin Yamamura²  Roland Fischer³  Regine Grosse⁴ 

[1] Department of Cardiology, University Heart and Vascular Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 22609, Hamburg, Germany;Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 22609, Hamburg, Germany;Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 22609, Hamburg, Germany;UCSF Benioff Children’s Hospital, Oakland, USA;Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 22609, Hamburg, Germany;

关键词: Diastolic function;    Trabeculae and papillary muscles;    Cardiovascular magnetic resonance;   

DOI  :  10.1186/s13244-021-01104-4

来源: Springer

【 摘 要 】

BackgroundThis cardiovascular magnetic resonance (CMR) study investigates the impact of trabeculae and papillary muscles (TPM) on diastolic function parameters by differentiation of the time-volume curve. Differentiation causes additional problems, which is overcome by standardization.MethodsCine steady-state free-precession imaging at 1.5 T was performed in 40 healthy volunteers stratified for age (age range 7–78y). LV time-volume curves were assessed by software-assisted delineation of endocardial contours from short axis slices applying two different methods: (1) inclusion of TPM into the myocardium and (2) inclusion of TPM into the LV cavity blood volume. Diastolic function was assessed from the differentiated time-volume curves defining the early and atrial peaks, their filling rates, filling volumes, and further dedicated diastolic measures, respectively.ResultsOnly inclusion of TPM into the myocardium allowed precise assessment of early and atrial peak filling rates (EPFR, APFR) with clear distinction of EPFR and APFR expressed by the minimum between the early and atrial peak (EAmin) (100% vs. 36% for EAmin < 0.8). Prediction of peak filling rate ratios (PFRR) and filling volume ratios (FVR) by age was superior with inclusion of TPM into the myocardium compared to inclusion into the blood pool (r2 = 0.85 vs. r2 = 0.56 and r2 = 0.89 vs. r2 = 0.66). Standardization problems were overcome by the introduction of a third phase (mid-diastole, apart from diastole and systole) and fitting of the early and atrial peaks in the differentiated time-volume curve.ConclusionsOnly LV volumetry with inclusion of TPM into the myocardium allows precise determination of diastolic measures and prevents methodological artifacts.

【 授权许可】

CC BY