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Updated: Jul 20, 2025

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Diastology with Cardiac MRI: A Practical Guide.

Prabhakar Shantha Rajiah1, Alastair Moore1, Jordi Broncano1

  • 1From the Departments of Radiology (P.S.R., C.J.F.) and Cardiology (V.A., N.K.), Mayo Clinic, 200 1st St SW, Rochester, MN 55905; Department of Radiology, Baylor Health System, Dallas, Tex (A.M.); Department of Radiology, Hospital San Juan de Dios, Hospital de la Cruz Roja, HT-RESALTA, HT Médica, Córdoba, Spain (J.B.); Department of Cardiology, Houston Methodist Hospital, Houston, Tex (D.J.S.); and Cardiovascular Imaging Laboratory, Cleveland Clinic Foundation, Cleveland, Ohio (S.D.F.).

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|August 3, 2023
PubMed
Summary
This summary is machine-generated.

Cardiac MRI (CMR) is an emerging tool for evaluating diastolic dysfunction (DD), a key feature of heart failure with preserved ejection fraction (HFpEF). CMR offers accurate diagnosis, grading, and prognostic insights for DD, complementing echocardiography.

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Physiology

Background:

  • Diastolic filling relies on myocardial relaxation and stiffness.
  • Abnormal diastolic function characterizes heart failure with preserved ejection fraction (HFpEF), a prevalent condition.
  • Echocardiography is standard, but cardiac MRI (CMR) is gaining prominence.

Purpose of the Study:

  • To review the role of CMR in evaluating diastolic function and diastolic dysfunction (DD).
  • To highlight CMR's ability to differentiate HFpEF mimics and provide prognostic data.
  • To discuss advanced CMR techniques for assessing myocardial properties.

Main Methods:

  • Utilizing cine steady-state free-precession sequences for ventricular mass and filling curves.
  • Employing 2D/4D velocity-encoded phase-contrast sequences for flow and velocity analysis.
  • Incorporating MR strain imaging, elastography, and spectroscopy for mechanics, stiffness, and metabolism.

Main Results:

  • CMR can accurately diagnose and grade DD, traditionally an echocardiography role.
  • CMR distinguishes DD from infiltrative and pericardial disorders.
  • Late gadolinium enhancement and parametric mapping offer prognostic information.

Conclusions:

  • CMR is a powerful tool for assessing diastolic function and DD.
  • Advanced CMR techniques provide comprehensive insights into myocardial mechanics and properties.
  • CMR enhances the diagnosis, risk stratification, and understanding of HFpEF and related conditions.