Assessment of diastolic dysfunction: comparison of different cardiovascular magnetic resonance techniques

ESC Heart Failure

Wolfgang Utz¹  Edyta Blaszczyk¹  Jeanette Schulz‐Menger¹  Pierre Hennig¹  Florian vonKnobelsdorff‐Brenkenhoff¹  Josephine Kermer¹  Agnieszka Töpper¹  Julius Traber¹  Philipp Barckow²  Marius Menza³  Bernd Jung⁴  Andreas Greiser⁵ 

[1] Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health, Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max Delbrueck Center for Molecular Medicine Lindenberger Weg 80 Berlin 13125 Germany;Circle Cardiovascular Imaging Inc. Calgary Alberta Canada;Department of Radiology, Medical Physics, Medical Center—University of Freiburg, Faculty of Medicine University of Freiburg Freiburg Germany;Institute of Diagnostic, Interventional and Paediatric Radiology University Hospital Bern Bern Switzerland;Siemens Healthineers GmbH Erlangen Germany;

关键词: Diastolic dysfunction;    Cardiovascular magnetic resonance;    Tissue tracking;    Left atrium;    Myocardial deformation;    Heart failure with preserved ejection fraction;   

DOI  :  10.1002/ehf2.12846

来源: DOAJ

【 摘 要 】

Abstract Aims Heart failure with preserved ejection fraction is still a diagnostic and therapeutic challenge, and accurate non‐invasive diagnosis of left ventricular (LV) diastolic dysfunction (DD) remains difficult. The current study aimed at identifying the most informative cardiovascular magnetic resonance (CMR) parameters for the assessment of LVDD. Methods and results We prospectively included 50 patients and classified them into three groups: with DD (DD+, n = 15), without (DD−, n = 26), and uncertain (DD±, n = 9). Diagnosis of DD was based on echocardiographic E/E′, invasive LV end‐diastolic pressure, and N‐terminal pro‐brain natriuretic peptide. CMR was performed at 1.5 T to assess LV and left atrial (LA) morphology, LV diastolic strain rate (SR) by tissue tracking and tagging, myocardial peak velocities by tissue phase mapping, and transmitral inflow profile using phase contrast techniques. Statistics were performed only on definitive DD+ and DD− (total number 41). DD+ showed enlarged LA with LA end‐diastolic volume/height performing best to identify DD+ with a cut‐off value of ≥0.52 mL/cm (sensitivity = 0.71, specificity = 0.84, and area under the receiver operating characteristic curve = 0.75). DD+ showed significantly reduced radial (inferolateral E peak: DD−: −14.5 ± 6.5%/s vs. DD+: −10.9 ± 5.9%/s, P = 0.04; anterolateral A peak: DD−: −4.2 ± 1.6%/s vs. DD+: −3.1 ± 1.4%/s, P = 0.04) and circumferential (inferolateral A peak: DD−: 3.8 ± 1.2%/s vs. DD+: 2.8 ± 0.8%/s, P = 0.007; anterolateral A peak: DD−: 3.5 ± 1.2%/s vs. DD+: 2.5 ± 0.8%/s, P = 0.048) SR in the basal lateral wall assessed by tissue tracking. In the same segments, DD+ showed lower peak myocardial velocity by tissue phase mapping (inferolateral radial peak: DD−: −3.6 ± 0.7 ms vs. DD+: −2.8 ± 1.0 ms, P = 0.017; anterolateral longitudinal peak: DD−: −5.0 ± 1.8 ms vs. DD+: −3.4 ± 1.4 ms, P = 0.006). Tagging revealed reduced global longitudinal SR in DD+ (DD−: 45.8 ± 12.0%/s vs. DD+: 34.8 ± 9.2%/s, P = 0.022). Global circumferential and radial SR by tissue tracking and tagging, LV morphology, and transmitral flow did not differ between DD+ and DD−. Conclusions Left atrial size and regional quantitative myocardial deformation applying CMR identified best patients with DD.

【 授权许可】

Unknown