title: A novel and practical cardiovascular magnetic resonance method to quantify mitral annular excursion and recoil applied to hypertrophic cardiomyopathy.
abstract: BACKGROUND
  We have developed a novel and practical cardiovascular magnetic resonance (CMR) technique to evaluate left ventricular (LV) mitral annular motion by tracking the atrioventricular junction (AVJ). To test AVJ motion analysis as a metric for LV function, we compared AVJ motion variables between patients with hypertrophic cardiomyopathy (HCM), a group with recognized systolic and diastolic dysfunction, and healthy volunteers.
  
  
  METHODS
  We retrospectively evaluated 24 HCM patients with normal ejection fractions (EF) and 14 healthy volunteers. Using the 4-chamber view cine images, we tracked the longitudinal motion of the lateral and septal AVJ at 25 time points during the cardiac cycle. Based on AVJ displacement versus time, we calculated maximum AVJ displacement (MD) and velocity in early diastole (MVED), velocity in diastasis (VDS) and the composite index VDS/MVED.
  
  
  RESULTS
  Patients with HCM showed significantly slower median lateral and septal AVJ recoil velocities during early diastole, but faster velocities in diastasis. We observed a 16-fold difference in VDS/MVED at the lateral AVJ [median 0.141, interquartile range (IQR) 0.073, 0.166 versus 0.009 IQR -0.006, 0.037, P < 0.001]. Patients with HCM also demonstrated significantly less mitral annular excursion at both the septal and lateral AVJ. Performed offline, AVJ motion analysis took approximately 10 minutes per subject.
  
  
  CONCLUSIONS
  Atrioventricular junction motion analysis provides a practical and novel CMR method to assess mitral annular motion. In this proof of concept study we found highly statistically significant differences in mitral annular excursion and recoil between HCM patients and healthy volunteers.
authors.forename: Shahryar G
authors.initials: SG
authors.lastname: Saba
authors.forename: Sohae
authors.initials: S
authors.lastname: Chung
authors.forename: Sharath
authors.initials: S
authors.lastname: Bhagavatula
authors.forename: Robert
authors.initials: R
authors.lastname: Donnino
authors.forename: Monvadi B
authors.initials: MB
authors.lastname: Srichai
authors.forename: Muhamed
authors.initials: M
authors.lastname: Saric
authors.forename: Stuart D
authors.initials: SD
authors.lastname: Katz
authors.affiliation: Department of Medicine, Leon H, Charney Division of Cardiology, New York University Langone Medical Center, 550 First Avenue, New York, NY 10016, USA. leon.axel@nyumc.org.
authors.forename: Leon
authors.initials: L
authors.lastname: Axel
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D003287:Contrast Media; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D003287:Contrast Media