Pulmonary Vein Flow Indices by MRI for Diastolic Function Evaluation

Area of Science:

• Cardiology
• Medical Imaging
• Physiology

Background:

• Transthoracic echocardiography (TTE) is the primary imaging method for diastolic dysfunction but has limitations in measuring pulmonary vein (PV) flow.
• Accurate PV flow assessment is vital for comprehensive diastolic function evaluation.

Purpose of the Study:

• To establish and evaluate Magnetic Resonance Imaging (MRI)-based pulmonary vein (PV) flow measurements for assessing diastolic dysfunction.
• To compare MRI-derived PV flow parameters with traditional TTE measurements.
• To assess the performance of MRI-based PV flow in patients with and without diastolic dysfunction.

Main Methods:

• Comparison of near same-day dedicated TTE and 3T MRI for PV flow measurements in a young cohort (N=12).
• Evaluation of PV flow in an older healthy cohort (N=11).
• Prospective enrollment of 21 patients (2019-2022) with recent TTE, imaged at 1.5T MRI using dedicated phase-contrast scans for PV flow assessment.

Main Results:

• Moderate agreement (r=0.72, p=0.03) between TTE and MRI for S/D ratio measured by total flow.
• High correlation (R=0.97, p<0.001) between MRI-based S/D using peak velocity and S/D by total flow.
• Prolonged D wave deceleration time (DT) in patients with diastolic dysfunction (253±42 ms) compared to those without (207±41 ms) (p<0.05).
• Receiver Operating Characteristic (ROC) analysis showed D wave DT > 241 ms predicted LV diastolic dysfunction with an Area Under the Curve (AUC) of 0.78.

Conclusions:

• MRI-based PV flow assessment demonstrates potential as a valuable tool for evaluating diastolic function.
• MRI-derived parameters, particularly D wave DT, show promise in differentiating patients with and without diastolic dysfunction.
• Further research can refine MRI techniques for more accurate and widespread clinical application in diastolic dysfunction assessment.