Classification of diastolic function with phase-contrast cardiac magnetic resonance imaging: validation with echocardiography and age-related reference values
Classification of diastolic function with phase-contrast cardiac magnetic resonance imaging: validation with echocardiography and age-related reference values
复制标题
DOI：
10.1007/s00392-014-0669-3
复制
发表时间：
2014-06-01
影响因子：
5
通讯作者：
Steen, Henning
中科院分区：
文献类型：
--
作者：
Buss, Sebastian J.;Krautz, Birgit;Steen, Henning
目的 探讨与超声心动图 (EC) 相比，心脏磁共振相差成像 (PC-CMR) 是否可以确定左心室 (LV) 舒张功能。 背景 舒张功能的无创评估对于心肌病患者的诊断分类和风险分层具有重要意义。对于 EC，舒张功能根据二尖瓣血流量、左心室心肌组织多普勒速度和肺静脉流量进行分类。 PC-CMR 有潜力测量这些参数，并可能成为临床常规评估舒张功能的重要工具。 方法 在 36 名患有各种心血管疾病的患者和 6 名健康志愿者中，我们在二尖瓣叶尖和肺静脉流入水平进行单层短轴 PC-CMR，以产生 EC 可比的二尖瓣 E 和 A 波、间隔和外侧 e' 和 a' 组织速度以及 E/A 和 E/A 波。 E/e' 比率。在所有患者和六名志愿者的 PC-CMR 后进行 EC。对于这两种技术，患者被分为三组 DD。此外，我们评估了 120 名健康志愿者作为对照（3 个年龄组：1 = 20-35 岁；2 = 36-50 岁；3 >= 51 岁）作为参考值。 结果 PC-CMR 与 EC 在二尖瓣 E 和 A 速度关系方面的相关性良好（r = 0.83，p < 0.001）。平均间隔和横向 E/e' 比率的相关性很高，r = 0.90 (p < 0.001)。 40/42 的受试者 (95%) 被正确分类。 PC-CMR 的平均扫描时间为 189 +/- 16 秒，平均分析时间为 348 +/- 95 秒。 EC 图像采集时间稍长（201 +/- 37 s，p = n. s.），而 EC 图像分析时间明显较短（149 +/- 23 s，p < 0.001）。结论 PC-CMR 对 DD 进行分类是可行的，并且与广泛接受的 DD EC 分类具有良好的一致性。我们提出了一种利用 PC-CMR 对 DD 进行临床重要评估的实用方法，避免了复杂且耗时的 CMR 序列和专门设计的软件分析工具。
Objectives To investigate whether cardiac magnetic resonance phase-contrast imaging (PC-CMR) can determine left ventricular (LV) diastolic function in comparison to echocardiography (EC).Background Non-invasive evaluation of diastolic function is important for the diagnostic classification and risk stratification of patients with cardiomyopathies. With EC, diastolic function is classified based on the mitral blood flow, LV myocardial tissue Doppler velocities and pulmonary venous flow. PC-CMR has the potential to measure these parameters and may be an important tool to assess diastolic function in clinical routine.Methods In 36 patients with various cardiovascular diseases and 6 healthy volunteers, we performed single-slice short-axis PC-CMR at the level of the mitral leaflet tip and the inflow of the pulmonary veins to generate EC-comparable mitral E and A waves, septal and lateral e' and a' tissue velocities, and E/A and E/e' ratios. EC was performed after PC-CMR in all patients and six volunteers. Patients were classified into three groups of DD for both techniques. In addition, we evaluated 120 healthy volunteers as controls (3 age groups: 1 = 20-35 years; 2 = 36-50 years; 3 >= 51 years) for reference values.Results PC-CMR correlation with EC regarding the relation of mitral E and A velocities was good (r = 0.83, p < 0.001). The correlation for the mean septal and lateral E/e' ratio was high with r = 0.90 (p < 0.001). 40/42 subjects (95 %) were categorized correctly. The mean scan time for PC-CMR was 189 +/- 16 s and mean analysis time was 348 +/- 95 s. EC image acquisition time was slightly higher (201 +/- 37 s, p = n. s.), whereas EC image analysis time was significantly lower (149 +/- 23 s, p < 0.001).Conclusion The classification of DD with PC-CMR is feasible and shows good agreement with the widely accepted EC classification of DD. We present a practical approach for the clinically important assessment of DD with PC-CMR, circumventing sophisticated and time-consuming CMR sequences and specially designed software analysis tools.