Magnetic resonance tissue phase mapping: Analysis of age‐related and pathologically altered left ventricular radial and long‐axis dyssynchrony

Abstract

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.

Increased myocardial dysfunction, dyssynchrony, and epicardial fat across the lifespan in healthy males

“…Previous studies of LV myocardial function and dyssynchrony in aging people have not observed individuals older than 89 years of age [8,9,11-13,17,18,28]. In the present study, our participants were aged up to 94 years.…”

“…Only two MRI studies have observed increasing myocardial dyssynchrony in healthy aging people [17,18], while no studies have previously examined age-related changes in EAT in healthy males. We found the combination of EAT, longitudinal, and circumferential LV-dyssynchrony at the base explained more than one-third of the variability in longitudinal strain and LV twist, respectively.…”

“…Previous studies have found increasing circumferential [17], longitudinal and radial [18] LV-dyssynchrony with age. Nonetheless, no studies have examined the association of both longitudinal and circumferential LV-dyssynchrony with STE-derived indices of myocardial mechanics, such as LV longitudinal and circumferential strain as well as twist, in a healthy aging population.…”

Volumetric motion quantification by 3D tissue phase mapped CMR

“…Parameters derived from velocity-time curves were introduced for tissue phase mapped imaging and include the standard deviation of the time to the systolic and diastolic peak [17] and the asynchrony correlation coefficient [18]. Reduced systolic and diastolic velocities have been reported in patients selected for cardiac resynchronization patients (CRT) and patients suffering from myocardial infarction [19,20].…”

“…The standard deviation of the time to systolic and diastolic peak (σ TTP ) has been assessed and increased σ TTP values have been found to be significantly increased in DCM patients [17]. …”