Comprehensive Cardiovascular Magnetic Resonance Diastolic Dysfunction Grading Shows Very Good Agreement Compared With Echocardiography

Ramos, Joao G; Fyrdahl, Alexander; Wieslander, Björn; Thalén, Simon; Reiter, Gert; Reiter, Ursula; Jin, Ning; Maret, Eva; Eriksson, Maria; Caidahl, Kenneth; Sörensson, Peder; Sigfridsson, Andreas

doi:10.1016/j.jcmg.2020.06.027

Cited by 23 publications

(17 citation statements)

References 27 publications

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“…Very little has been written about the use of cardiac MR to evaluate left diastolic function. Recently, Ramos et al [23,24] concluded good agreement and diagnostic yield for pulmonary hypertension and diastolic dysfunction between cardiac MR and echocardiography. This contributes to expanding the diagnostic capabilities of cardiac MR in patients with cardiac dysfunction.…”

Section: Discussionmentioning

confidence: 99%

The heart as a spring, the measurement of myocardial bounce to assess left ventricular function on cardiac MR

Qiao

Amin

Hippe

et al. 2021

Int J Cardiovasc Imaging

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Little has been reported on the left ventricular myocardial distension (bounce) and its utility to assess cardiac function. The purpose of this study is to determine whether myocardial bounce at end diastole is reproducibly visualized by blinded observers and to determine whether it corresponds to systolic and diastolic function. 144 Consecutive cardiac MR exams between September and December 2017 were selected for analysis. The bounce was graded by two blinded observers, and the change in LV diameter pre and post bounce was measured. The bounce was defined as the rapid change in LV volume that occurs at the end of diastole during atrial contraction just prior to systolic ejection. Inter-reader agreement was summarized using Cohen's kappa. Spearman's rank correlation coefficient was used to evaluate associations between bounce grade and cardiac physiology parameters. Overall agreement was good with unweighted kappa = 0.69 (95% CI 0.60-0.79). Bounce grade was significantly correlated with the average change in LV diameter before and after the bounce (Spearman's rho = 0.76, p < 0.001). Median diameter changes were 0.0, 1.9, and 4.2 mm in grades 0 (no bounce), 1 (small bounce), and 2 (normal), respectively. The bounce lasted 8 to 12 ms in all patients. Bounce grade was significantly correlated with LV EF (Spearman's rho = 0.43, p < 0.001).

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Section: Discussionmentioning

confidence: 99%

The heart as a spring, the measurement of myocardial bounce to assess left ventricular function on cardiac MR

Qiao

Amin

Hippe

et al. 2021

Int J Cardiovasc Imaging

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“…In terms of assessment of LV diastolic function, 4D flow techniques such as retrospective valve tracking, can be used to accurately measure conventional flow parameters of LV diastolic function such as mitral inflow velocities with good correlation with echocardiographic measurements (21,23,24). More recently, novel and more complex flow patternbased parameters have also been used to study diastolic flow hemodynamics.…”

Section: Four-dimensional Flow Cardiac Magnetic Resonance Imagingmentioning

confidence: 99%

Four-dimensional flow cardiac magnetic resonance assessment of left ventricular diastolic function

Ashkir

Myerson

Neubauer

et al. 2022

Front. Cardiovasc. Med.

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Left ventricular diastolic dysfunction is a major cause of heart failure and carries a poor prognosis. Assessment of left ventricular diastolic function however remains challenging for both echocardiography and conventional phase contrast cardiac magnetic resonance. Amongst other limitations, both are restricted to measuring velocity in a single direction or plane, thereby compromising their ability to capture complex diastolic hemodynamics in health and disease. Time-resolved three-dimensional phase contrast cardiac magnetic resonance imaging with three-directional velocity encoding known as ‘4D flow CMR’ is an emerging technology which allows retrospective measurement of velocity and by extension flow at any point in the acquired 3D data volume. With 4D flow CMR, complex aspects of blood flow and ventricular function can be studied throughout the cardiac cycle. 4D flow CMR can facilitate the visualization of functional blood flow components and flow vortices as well as the quantification of novel hemodynamic and functional parameters such as kinetic energy, relative pressure, energy loss and vorticity. In this review, we examine key concepts and novel markers of diastolic function obtained by flow pattern analysis using 4D flow CMR. We consolidate the existing evidence base to highlight the strengths and limitations of 4D flow CMR techniques in the surveillance and diagnosis of left ventricular diastolic dysfunction.

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“…Kanagala et al ( 9 ) found that CMR diagnosed new, significant clinical cardiac pathologies such as myocardial infarction, HCM and constrictive pericarditis in 27% of 154 patients with HFpEF and these patients were at higher risk of death and HF hospitalization at 6 months. Recent data further suggests integration of different CMR measures of diastolic function into a novel diagnostic algorithm ( 10 ) in a similar vein to echocardiography but further validation and consensus agreement is required before putting such algorithms into routine clinical practice.…”

Section: Diagnosing Hfpef With Cmrmentioning

confidence: 99%

The role of cardiac magnetic resonance imaging in the assessment of heart failure with preserved ejection fraction

Lau

Elshibly

Kanagala

et al. 2022

Front. Cardiovasc. Med.

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Heart failure (HF) is a major cause of morbidity and mortality worldwide. Current classifications of HF categorize patients with a left ventricular ejection fraction of 50% or greater as HF with preserved ejection fraction or HFpEF. Echocardiography is the first line imaging modality in assessing diastolic function given its practicality, low cost and the utilization of Doppler imaging. However, the last decade has seen cardiac magnetic resonance (CMR) emerge as a valuable test for the sometimes challenging diagnosis of HFpEF. The unique ability of CMR for myocardial tissue characterization coupled with high resolution imaging provides additional information to echocardiography that may help in phenotyping HFpEF and provide prognostication for patients with HF. The precision and accuracy of CMR underlies its use in clinical trials for the assessment of novel and repurposed drugs in HFpEF. Importantly, CMR has powerful diagnostic utility in differentiating acquired and inherited heart muscle diseases presenting as HFpEF such as Fabry disease and amyloidosis with specific treatment options to reverse or halt disease progression. This state of the art review will outline established CMR techniques such as transmitral velocities and strain imaging of the left ventricle and left atrium in assessing diastolic function and their clinical application to HFpEF. Furthermore, it will include a discussion on novel methods and future developments such as stress CMR and MR spectroscopy to assess myocardial energetics, which show promise in unraveling the mechanisms behind HFpEF that may provide targets for much needed therapeutic interventions.

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Comprehensive Cardiovascular Magnetic Resonance Diastolic Dysfunction Grading Shows Very Good Agreement Compared With Echocardiography

Cited by 23 publications

References 27 publications

The heart as a spring, the measurement of myocardial bounce to assess left ventricular function on cardiac MR

The heart as a spring, the measurement of myocardial bounce to assess left ventricular function on cardiac MR

Four-dimensional flow cardiac magnetic resonance assessment of left ventricular diastolic function

The role of cardiac magnetic resonance imaging in the assessment of heart failure with preserved ejection fraction

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