Feasibility of tissue magnetic resonance imaging: a pilot study in comparison with tissue Doppler imaging and invasive measurement.
OBJECTIVE
This research was intended to determine the feasibility of tissue magnetic resonance (MR) imaging in comparison with tissue Doppler imaging and its potential implications for the estimation of filling pressure, in comparison with invasive measurement.


BACKGROUND
Evaluation of diastolic function using MR imaging is commonly confined to the study of transmitral flow. However, transmitral flow is unreliable for the estimation of left ventricular (LV) filling pressures in hypertrophy and normal systolic function. Normalizing early mitral velocity (E) for the influence of myocardial relaxation by combining E with early diastolic mitral septal tissue velocity (Ea) provides better Doppler estimates of filling pressures.


METHODS
Eighteen patients with hypertensive heart disease (LV mass index: 114 +/- 21 g/m(2)), absence of valvular regurgitation, and with normal or mildly reduced systolic function (LV ejection fraction: 57.6 +/- 6.5%) referred for cardiac catheterization, underwent consecutive measurement of mitral flow and septal tissue velocities with phase-contrast MR and Doppler. These data were compared with mean pulmonary capillary wedge pressure (PCWP).


RESULTS
There was a strong relation between MR (11.6 +/- 4.3) and Doppler-assessed (12.1 +/- 3.5) E/Ea (95% confidence interval of -1.5 to 0.5) (r = 0.89, p < 0.0001). In addition, E/Ea related strongly to invasively measured PCWP (MR: r = 0.80, p < 0.0001 and Doppler: r = 0.85, p < 0.0001).


CONCLUSIONS
Tissue MR imaging is a feasible method to assess Ea. Combining E and Ea allowed similar estimation of filling pressure by MR and Doppler, in good agreement with invasive measurement. The potential confounding effect of valvular regurgitation needs further study.
Paelinck
Bernard P
BP
Department of Cardiology, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium. Bernard.Paelinck@uza.be
de Roos
Albert
A
Bax
Jeroen J
JJ
Bosmans
Johan M
JM
van Der Geest
Rob J
RJ
Dhondt
Dominique
D
Parizel
Paul M
PM
Vrints
Christiaan J
CJ
Lamb
Hildo J
HJ
D001783:Blood Flow Velocity; D006328:Cardiac Catheterization; D003326:Coronary Circulation; D015150:Echocardiography, Doppler / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000502:physiology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011669:Pulmonary Wedge Pressure; D011673:Pulsatile Flow; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology