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10.01.2019 | Cardiac

Evaluation of elevated left ventricular end diastolic pressure in patients with preserved ejection fraction using cardiac magnetic resonance

verfasst von: Chengjie Gao, Yijing Tao, Jingwei Pan, Chengxing Shen, Jiayin Zhang, Zhili Xia, Qing Wan, Hao Wu, Yajie Gao, Hong Shen, Zhigang Lu, Meng Wei

Erschienen in: European Radiology | Ausgabe 5/2019

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Abstract

Objectives

This study aims to validate the reliability of cardiac magnetic resonance (CMR) parameters for estimating left ventricular end diastolic pressure (LVEDP) in heart failure patients with preserved ejection fraction (HFpEF) and compare their accuracy to conventional echocardiographic ones, with reference to left heart catheterisation.

Methods

Sixty patients with exertional dyspnoea (New York Heart Association function class II to III) were consecutively enrolled. CMR-derived time-volume curve and deformation parameters, conventional echocardiographic diastolic indices as well as LVEDP evaluated by left heart catheterisation were collected and analysed.

Results

Fifty-one patients, who accomplished all three examinations, were divided into HFpEF group and non-HFpEF group based on LVEDP measurements. Compared to the non-HFpEF group, CMR-derived time-volume curve showed lower peak filling rate adjusted for end diastolic volume (PFR/EDV, p = 0.027), longer time to peak filling rate (T-PFR, p < 0.001), and increased T-PFR in one cardiac cycle (%T-PFR, p < 0.001) in HFpEF group. In multivariable linear regression analysis, %T-PFR (β = 0.372, p = 0.024), left ventricular global peak longitudinal diastolic strain rate (LDSR, β = −0.471, p = 0.006), and E/e’ (β = 0.547, p = 0.001) were independently associated with invasively measured LVEDP. The sensitivity and specificity of E/e’ and LDSR for predicting the elevated LVEDP were 76%, 92% and 76%, 89%, respectively.

Conclusions

These findings suggest that CMR-derived time-volume curve and strain indices could predict HFpEF patients. Not only E/e’ assessed by echocardiography but also the CMR-derived %T-PFR and LDSR correlated well with LVEDP. These non-invasive parameters were validated to evaluate the left ventricular diastolic function.

Key Points

• The abnormal time-volume curve revealed insufficient early diastole in HFpEF patients.

• Non-invasive parameters including E/e’, %T-PFR, and LDSR correlated well with LVEDP.

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Titel: Evaluation of elevated left ventricular end diastolic pressure in patients with preserved ejection fraction using cardiac magnetic resonance
verfasst von: Chengjie Gao
Yijing Tao
Jingwei Pan
Chengxing Shen
Jiayin Zhang
Zhili Xia
Qing Wan
Hao Wu
Yajie Gao
Hong Shen
Zhigang Lu
Meng Wei
Publikationsdatum: 10.01.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 5/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5955-4

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Evaluation of elevated left ventricular end diastolic pressure in patients with preserved ejection fraction using cardiac magnetic resonance