Diastolic dysfunction evaluation by cardiovascular magnetic resonance derived E, a, e': Comparison to
Jérôme Lamy1,2, Jie Xiang3, Nimish Shah4
1Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut, USA.
Insights
Cardiovascular magnetic resonance (CMR) shows strong agreement with transthoracic echocardiography (TTE) for evaluating diastolic dysfunction (DD). This study demonstrates CMR
Area of Science:
- Cardiology
- Medical Imaging
- Diagnostic Tools
Background:
- Transthoracic echocardiography (TTE) is the primary imaging method for assessing diastolic dysfunction (DD).
- The role of Cardiovascular Magnetic Resonance (CMR) in evaluating DD remains under-investigated.
- Diastolic dysfunction affects the heart's ability to relax and fill, impacting overall cardiac function.
Purpose of the Study:
- To investigate the diagnostic utility of CMR for evaluating diastolic dysfunction.
- To compare CMR-derived diastolic function parameters with those obtained from TTE.
- To determine the accuracy of CMR in diagnosing and grading DD.
Main Methods:
- Prospective enrollment of 31 patients with recent TTE and 12 healthy controls.
- CMR imaging at 1.5T to quantify mitral inflow velocities (E, A), mitral annular velocities (e'), and left atrial volume index (LAVi).
- Comparison of CMR measurements with TTE using regression analysis and assessment of diagnostic accuracy for DD.
Main Results:
- CMR-derived parameters (E, A, E/A, e', E/e', LAVi) showed moderate to strong correlations with TTE findings.
- Higher correlations were observed for studies performed closer in time, particularly for E/A (r=0.82) and LAVi (r=0.79).
- CMR demonstrated 82% agreement with TTE for DD presence (100% sensitivity, 75% specificity) and 71% agreement for DD grade.
Conclusions:
- Cardiovascular magnetic resonance is a viable tool for assessing diastolic function.
- CMR exhibits strong agreement with transthoracic echocardiography in the evaluation of diastolic dysfunction.
- CMR offers a valuable alternative or complementary imaging modality for DD assessment.
Abstract:
Transthoracic echocardiography (TTE) is the first-line and most useful imaging modality for evaluating diastolic dysfunction (DD). Cardiovascular magnetic resonance (CMR) has not been fully evaluated for this task. We investigated the utility of CMR for DD evaluation.Thirty-one patients with a recent TTE (within 4 months) were prospectively enrolled, along with 12 healthy age-matched subjects. CMR imaging was performed at 1.5 T to assess diastolic function by quantifying mitral inflow velocities (E and A), mitral annular velocities (e'), and left atrial volume (LAVi). Measurements by TTE and CMR were compared using regression. The diagnostic accuracy of CMR for DD was determined.CMR derived E, A, E/A, e' and E/e' all correlated moderately to strongly with TTE, and more strongly when comparing studies performed closer in time (E: r = 0.68, E deceleration time: r = 0.82, A: r = 0.78, e' r = 0.75, E/e': r = 0.80, p = 0.001; LAVi: r = 0.79, p < 0.001; E/A: r = 0.82, p < 0.001, n = 14 within 45 days). Using CMR criteria analogous to TTE, there was 82% (23/28) agreement regarding the presence of DD (95% CI [63 to 93%]), with 100% sensitivity and 75% specificity, and 71% (20/28) agreement in the absolute DD grade.CMR can evaluate diastolic function, with overall strong agreement to TTE.
More Related Videos
Related Concept Videos
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...