Diagnosis of Left Ventricular Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging: Comparison of Volume-Time Curves Derived from Long- and Short-Axis Cine Steady-State Free Precession Datasets

Schaafs, Lars-Arne; Wyschkon, Sebastian; Elgeti, Matthias; Nagel, Sebastian N.; Knebel, Fabian; Steffen, Ingo G.; Makowski, Marcus R.; Hamm, Bernd; Elgeti, Thomas

doi:10.1055/a-1108-1892

Cited by 8 publications

(8 citation statements)

References 33 publications

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“…These suggest that peak filling time and peak filling rate can be used as useful CMR indicators for diastolic dysfunction. This is consistent with multiple studies that have found that a lower peak filling rate and a longer time to peak filling rate are useful indicators of diastolic dysfunction on CMR [5,6].…”

Section: Discussionsupporting

confidence: 92%

Role of 3 Tesla Magnetic Resonance Imaging in the Assessment of Infiltrative Cardiomyopathies

Kalekar¹,

Gupta²,

Kumar³

2023

Cureus

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Background: The aim of the present study was to assess the role of 3 Tesla (3T) magnetic resonance imaging (MRI) in the assessment of infiltrative cardiomyopathy (ICM). Methods: Cardiac MRI was performed on a 3T MRI machine for 15 patients who had clinical or echocardiographic signs of infiltrative cardiomyopathy. Each scan was assessed on a set of anatomical and functional parameters. The patterns of left ventricular (LV) late gadolinium enhancement (LGE) were also analyzed.Results: Bi-atrial dilatation was noted in 14 patients, consistent with a restrictive phenotype. All 15 patients had diastolic dysfunction with reduced LV diastolic ventricular filling and prolonged peak filling times. Eleven patients had a decreased peak filling rate. Twelve patients had systolic dysfunction with reduced ejection fraction (EF). Ten patients had contractile dysfunction in the form of global LV hypokinesia. On delayed contrast imaging, four patients showed no abnormal LGE. Two patients showed diffuse subendocardial enhancement. Two patients showed patchy subendocardial enhancement. Six patients showed patchy mid-myocardial enhancement. One patient showed diffuse mid-myocardial enhancement. Three patients showed patchy subepicardial enhancement. Two patients showed patchy transmural enhancement. Three patients showed reversed myocardial nulling. All 15 patients received a provisional diagnosis of infiltrative cardiomyopathy on the basis of cardiac MRI findings. Sarcoidosis was given as a probable cause in four patients, amyloidosis in three patients, an infectious cause in two patients, and druginduced cardiomyopathy in one patient. In five patients, no obvious cause could be identified. Conclusion: Infiltrative cardiomyopathies, although relatively uncommon, pose significant challenges in diagnosis and treatment. Cardiac MRI has become the gold standard for non-invasive diagnosis of all infiltrative cardiomyopathies.

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Section: Discussionsupporting

confidence: 92%

Role of 3 Tesla Magnetic Resonance Imaging in the Assessment of Infiltrative Cardiomyopathies

Kalekar¹,

Gupta²,

Kumar³

2023

Cureus

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“…This could be attributed to several reasons as follows: (1) TTPF across different stages of diastolic dysfunction should be considered. Schaafs, L. A et al 20 established that, in time/volume curves analysis, TTPR increased with the progression of diastolic dysfunction, whereas it decreased in healthy participants suffering from severe diastolic dysfunction when restrictive LV lling occurs; (2) TTPF cut-off differs depending on the data 17,[20][21][22] since choosing a TTPF cut-off value to assess for the dynamic change of left ventricular relaxation remains challenging.…”

Section: Discussionmentioning

confidence: 99%

Stress-induced Worsening Diastolic Function in Patients with Coronary Slow Flow: A Study from G-SPECT Imaging

Wang,

Meng,

Wang

et al. 2023

Preprint

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Background Gated 99m Tc-sestamibi myocardial perfusion single-photon emission computed tomography (G-SPECT) is a non-invasive imaging technique that offers accurate evaluation of myocardial perfusion and resting left ventricular diastolic function in patients with coronary slow flow (CSF). However, it’s uses to estimate the diastolic function during stress is still not well determined.Objective To evaluate the left ventricular diastolic function at rest and during stress in CSF patients using G-SPECT and to determine the association between the clinical variables and the rest-stress changes in diastolic function.Methods We identified 18 angiographically proven CSF patients (56 ± 8.9 years, 12 male), from January 2017 through October 2018, who underwent a 2-day 99mTc-t sestamibi adenosine/exercise stress test along with rest protocols. The cardiac diastolic function parameters, including peak filling rate (PFR), time to peak filling (TTPF), and peak filling rate normalized to EDV (end diastolic volume) (PFR/EDV) were obtained using G‑SPECT. Then, the association between the diastolic function parameter changes (Δ stress-rest) and cardiovascular risk factors were analyzed.Results Compared with rest, summed stress scores were significantly higher (P = 0.01). TTPF, PFR, and PFR adjusted by EDV(PFR/EDV) alone showed no significant difference between rest and stress as diastolic dysfunction was present in both states. There was progressive decrease in TTPF, PFR and PFR/EDV with stress. In stepwise regression model, total cholesterol was significantly associated with the difference of summed scores (ΔStress-Rest) (β = 0.518, P = 0.028). In the same model, uric acid was found inversely associated with the difference in TTPF (ΔStress-Rest) and PFR/EDV (ΔStress-Rest) (β= -0.516, P = 0.028 and β= -0.560, P = 0.015, respectively).Conclusion Uric acid is significantly associated with the diastolic function worsening during stress in CSF patients. It may be a potential predictor and possible therapeutic target to attenuate the early diastolic function deterioration in these patients.

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“…VTCs and their first derivative were subsequently analysed using a semi-automated script in MATLAB® (MathWorks, Natick, Massachusetts, USA, version R2009a) in accordance with prior publications. 21 A spline algorithm was implemented to generate a smoothed VTC with a time interval of 1 ms. 22 All curves were normalized to the maximal end-diastolic volume (EDV) at t = 0. Figure 1 shows VTC and first derivative from segmented as well as CRT sequences of a patient with normal diastolic function as well as of a patient with grade 1 diastolic dysfunction.…”

Section: Quantitative Analysis Of Volume-time Curvesmentioning

confidence: 99%

Evaluation of left ventricular function in patients with acute ischaemic stroke using cine cardiovascular magnetic resonance imaging

et al. 2020

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Aims Heart failure (HF) is frequent in patients with acute ischaemic stroke (AIS) and associated with higher morbidity and mortality. Assessment of cardiac function in AIS patients using cardiovascular MRI (CMR) may help to detect HF. We report the rate of systolic and diastolic dysfunction in a cohort of patients with AIS using CMR and compare cine real-time (CRT) sequences with the reference of segmented cine steady-state free precession sequences. Methods and results Patients with AIS without known atrial fibrillation were prospectively enrolled in the HEart and BRain Interfaces in Acute Ischemic Stroke (HEBRAS) study (NCT 02142413) and underwent CMR at 3 Tesla within 7 days after AIS. Validity of CRT sequences was determined in 50 patients. A total of 229 patients were included in the analysis (mean age 66 years; 35% women; HF 2%). Evaluation of cardiac function was successful in 172 (75%) patients. Median time from stroke onset to CMR was 82 h (interquartile range 56-111) and 54 h (interquartile range 31-78) from cerebral MRI to CMR. Systolic dysfunction was observed in 43 (25%) and diastolic dysfunction in 102 (59%) patients. Diagnostic yield was similar using CRT or segmented cine imaging (no significant difference in left ventricular ejection fraction, myocardial mass, time to peak filling rate, and peak filling rate ratio E/A). Intraobserver and interobserver agreement was high (κ = 0.78-1.0 for all modalities). Conclusions Cardiovascular MRI at 3 Tesla is an appropriate method for the evaluation of cardiac function in a selected cohort of patients with AIS. Systolic and diastolic dysfunction is frequent in these patients. CRT imaging allows reliable assessment of systolic and diastolic function.

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Diagnosis of Left Ventricular Diastolic Dysfunction Using Cardiac Magnetic Resonance Imaging: Comparison of Volume-Time Curves Derived from Long- and Short-Axis Cine Steady-State Free Precession Datasets

Cited by 8 publications

References 33 publications

Role of 3 Tesla Magnetic Resonance Imaging in the Assessment of Infiltrative Cardiomyopathies

Role of 3 Tesla Magnetic Resonance Imaging in the Assessment of Infiltrative Cardiomyopathies

Stress-induced Worsening Diastolic Function in Patients with Coronary Slow Flow: A Study from G-SPECT Imaging

Evaluation of left ventricular function in patients with acute ischaemic stroke using cine cardiovascular magnetic resonance imaging

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