Patients with hypertensive heart disease demonstrated alterations in systolic long-axis motion, basal rotation and dyssynchrony. Longitudinal studies are needed to investigate the value of regional wall motion abnormalities regarding disease progression and outcome.
Purpose: To employ magnetic resonance tissue phase mapping (TPM) for the assessment of age-related left ventricular (LV) synchrony of radial and long-axis motion in healthy volunteers and in hypertensive heart disease, dilated cardiomyopathy (DCM), and left bundle branch block (LBBB).Materials and Methods: TPM (spatial/temporal resolution ¼ 1.3 Â 2.6 mm 2 /13.8 msec) was employed to measure radial and long-axis myocardial velocities in 58 healthy volunteers of three age groups and 37 patients (hypertensive, n ¼ 18; DCM, n ¼ 12; DCM and LBBB n ¼ 7). Regional times-to-peak velocities (TTP) in systole and diastole were derived for all LV segments. Four measures of dyssynchrony were defined as the standard deviation of systolic and diastolic TTP for radial and long-axis motion.Results: Systolic radial and diastolic long-axis dyssynchrony was increased (P < 0.01) in all patient groups compared to controls. Multiple regressions revealed a significant relationship of dyssynchrony with LV ejection fraction and mass for systolic radial (P < 0.001 resp. P ¼ 0.02), diastolic radial (P < 0.001 resp. P < 0.05), and long-axis (P < 0.001 resp. P ¼ 0.001) motion. Diastolic dyssynchrony correlated with the LV remodeling index (P < 0.05) and increased with age (P < 0.03). Systolic long-axis dyssynchrony was not influenced by disease or LV function.
Conclusion:Radial systolic and long-axis diastolic dyssynchrony were the most sensitive markers for altered dyssynchrony in hypertensive heart disease or DCM. Future studies are needed to evaluate the diagnostic value of TPM-derived dyssynchrony parameters.
TPM identified previously not described alterations of the spatial distribution and timing of all myocardial velocities in patients with DCM and LBBB. This may help to optimize therapy management in future.
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