Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance

Journal of Cardiovascular Magnetic Resonance

Research

Martin R Prince¹  Noel CF Codella¹  Yi Wang¹  Keigo Kawaji¹  Dorinna D Mendoza²  Troy M LaBounty²  Richard B Devereux²  Shant J Manoushagian²  Sonia Sethi²  Jonathan W Weinsaft³  James K Min³ 

[1] Department of Radiology, Weill Cornell Medical College, NY, NY, USA;Division of Cardiology, Department of Medicine, Weill Cornell Medical College, NY, NY, USA;Division of Cardiology, Department of Medicine, Weill Cornell Medical College, NY, NY, USA;Department of Radiology, Weill Cornell Medical College, NY, NY, USA;

关键词: Cardiovascular Magnetic Resonance;    Diastolic Dysfunction;    Filling Rate;    Left Ventricular Filling;    Diastolic Filling;   

DOI  :  10.1186/1532-429X-12-46

 received in 2010-03-31, accepted in 2010-07-31,  发布年份 2010

来源: Springer

【 摘 要 】

ObjectivesTo examine relationships between severity of echocardiography (echo) -evidenced diastolic dysfunction (DD) and volumetric filling by automated processing of routine cine cardiovascular magnetic resonance (CMR).BackgroundCine-CMR provides high-resolution assessment of left ventricular (LV) chamber volumes. Automated segmentation (LV-METRIC) yields LV filling curves by segmenting all short-axis images across all temporal phases. This study used cine-CMR to assess filling changes that occur with progressive DD.Methods115 post-MI patients underwent CMR and echo within 1 day. LV-METRIC yielded multiple diastolic indices - E:A ratio, peak filling rate (PFR), time to peak filling rate (TPFR), and diastolic volume recovery (DVR80 - proportion of diastole required to recover 80% stroke volume). Echo was the reference for DD.ResultsLV-METRIC successfully generated LV filling curves in all patients. CMR indices were reproducible (≤ 1% inter-reader differences) and required minimal processing time (175 ± 34 images/exam, 2:09 ± 0:51 minutes). CMR E:A ratio decreased with grade 1 and increased with grades 2-3 DD. Diastolic filling intervals, measured by DVR80 or TPFR, prolonged with grade 1 and shortened with grade 3 DD, paralleling echo deceleration time (p < 0.001). PFR by CMR increased with DD grade, similar to E/e' (p < 0.001). Prolonged DVR80 identified 71% of patients with echo-evidenced grade 1 but no patients with grade 3 DD, and stroke-volume adjusted PFR identified 67% with grade 3 but none with grade 1 DD (matched specificity = 83%). The combination of DVR80 and PFR identified 53% of patients with grade 2 DD. Prolonged DVR80 was associated with grade 1 (OR 2.79, CI 1.65-4.05, p = 0.001) with a similar trend for grade 2 (OR 1.35, CI 0.98-1.74, p = 0.06), whereas high PFR was associated with grade 3 (OR 1.14, CI 1.02-1.25, p = 0.02) DD.ConclusionsAutomated cine-CMR segmentation can discern LV filling changes that occur with increasing severity of echo-evidenced DD. Impaired relaxation is associated with prolonged filling intervals whereas restrictive filling is characterized by increased filling rates.

【 授权许可】

Unknown   
© Mendoza et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.