Diastolic Cardiac Function by MRI-Imaging Capabilities and Clinical Applications
El-Sayed H Ibrahim1, Jennifer Dennison2, Luba Frank1
1Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Insights
Assessing diastolic cardiac function using cardiac MRI is crucial for detecting heart failure with preserved ejection fraction (HFpEF). MRI offers advanced insights into myocardial relaxation and filling patterns, aiding early diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
- Biophysics
Background:
- Left ventricular (LV) systolic function is commonly studied, but diastolic function assessment is gaining importance due to rising heart failure with preserved ejection fraction (HFpEF) prevalence.
- Diastolic dysfunction, marked by impaired myocardial relaxation and filling, is linked to aging and cardiovascular risks like hypertension and diabetes.
- Early detection of diastolic dysfunction is critical for managing cardiovascular health.
Purpose of the Study:
- To review cardiac magnetic resonance imaging (MRI) techniques for evaluating diastolic cardiac function.
- To explore the clinical applications and findings of MRI in various heart diseases.
- To highlight MRI's potential in detecting subtle changes in cardiac function related to patient demographics.
Main Methods:
- Cardiac MRI techniques for assessing myocardial relaxation and LV filling patterns.
- Analysis of diastolic parameters beyond the traditional E/A ratio.
- Review of existing literature on MRI in diastolic dysfunction.
Main Results:
- Cardiac MRI can differentiate normal from abnormal myocardial relaxation, enabling early diastolic dysfunction detection.
- MRI allows detailed spatial and temporal assessment of cardiac contractility during diastole.
- Specific MRI parameters can reveal subtle functional changes associated with age, gender, and comorbidities.
Conclusions:
- Cardiac MRI is a powerful tool for comprehensive diastolic function assessment.
- MRI facilitates early diagnosis and characterization of diastolic dysfunction, particularly in HFpEF.
- The review underscores MRI's value in understanding diverse patient populations and heart conditions.
Abstract:
Most cardiac studies focus on evaluating left ventricular (LV) systolic function. However, the assessment of diastolic cardiac function is becoming more appreciated, especially with the increasing prevalence of pathologies associated with diastolic dysfunction like heart failure with preserved ejection fraction (HFpEF). Diastolic dysfunction is an indication of abnormal mechanical properties of the myocardium, characterized by slow or delayed myocardial relaxation, abnormal LV distensibility, and/or impaired LV filling. Diastolic dysfunction has been shown to be associated with age and other cardiovascular risk factors such as hypertension and diabetes mellitus. In this context, cardiac magnetic resonance imaging (MRI) has the capability for differentiating between normal and abnormal myocardial relaxation patterns, and therefore offers the prospect of early detection of diastolic dysfunction. Although diastolic cardiac function can be assessed from the ratio between early and atrial filling peaks (E/A ratio), measuring different parameters of heart contractility during diastole allows for evaluating spatial and temporal patterns of cardiac function with the potential for illustrating subtle changes related to age, gender, or other differences among different patient populations. In this article, we review different MRI techniques for evaluating diastolic function along with clinical applications and findings in different heart diseases.
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