Evaluation of diastolic function by three-dimensional volume tracking of the mitral annulus with cardiovascular magnetic resonance: Comparison with tissue Doppler imaging

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Abstract

© 2014 Wu et al.; licensee BioMed Central Ltd. Background: Measurement of mitral annulus (MA) dynamics is an important component of the evaluation of left ventricular (LV) diastolic function; MA velocities are commonly measured using tissue Doppler imaging (TDI). This study aimed to examine the clinical potential of a semi-automated cardiovascular magnetic resonance (CMR) technique for quantifying global LV diastolic function, using 3D volume tracking of the MA with conventional cine-CMR images. Methods. 124 consecutive patients with normal ejection fraction underwent both clinically indicated transthoracic echocardiography (TTE) and CMR within 2 months. Interpolated 3D reconstruction of the MA over time was performed with semi-automated atrioventricular junction (AVJ) tracking in long-axis cine-CMR images, producing an MA sweep volume over the cardiac cycle. CMR-based diastolic function was evaluated, using the following parameters: peak volume sweep rates in early diastole (PSR E ) and atrial systole (PSR A ), PSR E /PSR A ratio, deceleration time of sweep volume (DT SV ), and 50% diastolic sweep volume recovery time (DSVRT 50 ); these were compared with TTE diastolic measurements. Results: Patients with TTE-based diastolic dysfunction (n = 62) showed significantly different normalized MA sweep volume profiles compared to those with TTE-based normal diastolic function (n = 62), including a lower PSR E (5.25 ± 1.38 s -1 vs. 7.72 ± 1.7 s -1 ), a higher PSR A (6.56 ± 1.99 s -1 vs. 4.67 ± 1.38 s -1 ), a lower PSR E /PSR A ratio (0.9 ± 0.44 vs. 1.82 ± 0.69), a longer DT SV (144 ± 55 ms vs. 96 ± 37 ms), and a longer DSVRT 50 (25.0 ± 11.0% vs. 15.6 ± 4.0%) (all p < 0.05). CMR diastolic parameters were independent predictors of TTE-based diastolic dysfunction after adjusting for left ventricular hypertrophy, hypertension, and coronary artery disease. Good correlations were observed between CMR PSR E /PSR A and early-to-late diastolic annular velocity ratios (e′/a′) measured by TDI (r = 0.756 to 0.828, p < 0.001). Conclusions: 3D MA sweep volumes generated by semi-automated AVJ tracking in routinely acquired CMR images yielded diastolic parameters that were effective in identifying patients with diastolic dysfunction when correlated with TTE-based variables.

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Wu, V., Chyou, J. Y., Chung, S., Bhagavatula, S., & Axel, L. (2014). Evaluation of diastolic function by three-dimensional volume tracking of the mitral annulus with cardiovascular magnetic resonance: Comparison with tissue Doppler imaging. Journal of Cardiovascular Magnetic Resonance, 16(1). https://doi.org/10.1186/s12968-014-0071-3

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