Introduction
Class diastolic dysfuntion | Description |
---|---|
Grade I | Reduced filling in the early phase |
Grade II | Pseudo-normal filling by increased atrial pressure |
Grade III | Reversible restrictive filling due to impaired relaxation |
Grade IV | Irreversible restrictive filling |
LV Time-Volume Relation and Left Atrial Size
Mitral Inflow Pattern
Isovolumic Relaxation Time
Pulmonary Venous Flow
Flow Propagation Velocity
LV Myocardial Wall Motion and Strain
Conclusions
CMR acquisition | Type of analysis | Indices for diastolic function testing |
---|---|---|
1) Radial stack of long-axis or parallel stack of short-axis covering whole LV | LV time-volume relation from planimetry | Early peak filling rate, time to peak filling rate, and atrial filling fraction |
2) Parallel stack covering left atrium or 2-chamber and 4-chamber view | Left atrial size from planimetry or biplane Simpson’s rule | Left atrial size |
3) 1-directional or 3-directional VE MRI at the mitral valve | Wave form analysis of mitral inflow pattern | Early peak filling rate (E) and atrial peak filling rate (A), E/A ratio, and deceleration time (DT) of early peak filling rate |
4) 1-directional or 3-directional VE MRI at the mitral and aortic valve | Wave form analysis of mitral inflow and aortic outflow pattern | Isovolumic relaxation time (IVRT) |
5) 1-directional or 3-directional VE MRI at the pulmonary veins | Wave form analysis of pulmonary venous flow pattern | Peak systolic velocity (S), peak anterograde diastolic velocity (D), S/D ratio, systolic filling fraction, peak atrial reversal velocity (Ar), and duration between Ar and A |
6) 3-directional VE MRI of the LV flow velocity field | Time-resolved flow velocity vector field during LV filling | Flow propagation velocity (Vp) and E/Vp ratio |
7) 1-directional VE MRI of longitudinal annular velocity | Wave form analysis of myocardial motion pattern | Early peak annular velocity (E′), E/E′ ratio, duration between E and E′ (TE-E′), and IVRT/TE-E′ ratio |
8) MR tissue tagging in long-axis or short-axis orientation | Strain analysis | LV and atrial relaxation characteristics from longitudinal, circumferential, and radial strain |