Diastolic dysfunction evaluated by cardiac magnetic resonance: the value of the combined assessment of atrial and ventricular function

被引:25
作者
Aquaro, Giovanni Donato [1 ]
Pizzino, Fausto [2 ]
Terrizzi, Anna [3 ]
Carerj, Scipione [3 ]
Khandheria, Bijoy K. [4 ]
Di Bella, Gianluca [3 ]
机构
[1] Fdn G Monasterio CNR Toscana, Via Giuseppe Moruzzi 1, I-56124 Pisa, Italy
[2] Scuola Super St Anna Univ Perfezionamento, Pisa, Italy
[3] Univ Messina, Dipartimento Med Clin & Sperimentale, Messina, Italy
[4] Univ Wisconsin, Sch Med & Publ Hlth, Aurora Cardiovasc Serv, Aurora Sinai Aurora St Lukes Med Ctr, Milwaukee, WI 53201 USA
关键词
Diastole; Magnetic resonance; Heart failure; Physiology: atrial function; Hypertrophic cardiomyopathy; PRESERVED EJECTION FRACTION; HEART-FAILURE; HOSPITALIZATION; FIBRILLATION; MORTALITY; EXERCISE; RISK;
D O I
10.1007/s00330-018-5571-3
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
ObjectivesWe 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.MethodsForty 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.ResultsAt 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).ConclusionsAnalysis of LV and LA V/t curves by CMR may be useful for the evaluation of DD.Key Points center dot Combined atrial and ventricular volume/time curves allow evaluation of diastolic function.center dot Atrial emptying fraction allows distinction between impaired relaxation and restrictive/pseudo-normal filling.center dot Isovolumetric pulmonary vein transit ratio allows distinction between restrictive and pseudo-normal filling.
引用
收藏
页码:1555 / 1564
页数:10
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