Classification of diastolic function with phase-contrast cardiac magnetic resonance imaging: validation with echocardiography and age-related reference values.
OBJECTIVE
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).


CONCLUSIONS
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.
Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany, sebastian.buss@med.uni-heidelberg.de.
Sebastian J
SJ
Buss
Birgit
B
Krautz
Bernhardt
B
Schnackenburg
Hassan
H
Abdel-Aty
Maria Fernanda Braggion
MF
Santos
Florian
F
Andre
Malte J
MJ
Maertens
Derliz
D
Mereles
Grigorios
G
Korosoglou
Evangelos
E
Giannitsis
Hugo A
HA
Katus
Henning
H
Steen
D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D003971:Diastole; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D016277:Ventricular Function, Left; D055815:Young Adult