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Erschienen in:
20.08.2018 | Cardiac
Diastolic dysfunction evaluated by cardiac magnetic resonance: the value of the combined assessment of atrial and ventricular function
Erschienen in: European Radiology | Ausgabe 3/2019
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Objectives
We sought to evaluate the role of cardiac magnetic resonance imaging (CMR) in the evaluation of diastolic function by a combined assessment of left ventricular (LV) and left atrial (LA) function in a cohort of subjects with various degrees of diastolic dysfunction (DD) detected by echocardiography.
Methods
Forty patients with different stages of DD and 18 healthy controls underwent CMR. Short-axis cine steady-state free precession images covering the entire LA and LV were acquired. Parameters of diastolic function were measured by the analysis of the LV and LA volume/time (V/t) curves and the respective derivative dV/dt curves.
Results
At receiver operating characteristic (ROC) curve analysis, the peak of emptying rate A indexed by the LV filling volume with a cut-off of 3.8 was able to detect patients with grade I DD from other groups (area under the curve [AUC] 0.975, 95% confidence interval [CI] 0.86–1). ROC analysis showed that LA ejection fraction with a cut-off of ≤36% was able to distinguish controls and grade I DD patients from those with grade II and grade III DD (AUC 0.996, 95% CI 0.92–1, p < 0.001). The isovolumetric pulmonary vein transit ratio with a cut-off of 2.4 allowed class III DD to be distinguished from other groups (AUC 1.0, 95%CI 0.93–1, p < 0.001).
Conclusions
Analysis of LV and LA V/t curves by CMR may be useful for the evaluation of DD.
Key Points
• Combined atrial and ventricular volume/time curves allow evaluation of diastolic function.
• Atrial emptying fraction allows distinction between impaired relaxation and restrictive/pseudo-normal filling.
• Isovolumetric pulmonary vein transit ratio allows distinction between restrictive and pseudo-normal filling.