title: Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities.
abstract: The assessment of atrioventricular junction (AVJ) deformation plays an important role in evaluating left ventricular systolic and diastolic function in clinical practice. This study aims to demonstrate the effectiveness and consistency of cardiovascular magnetic resonance (CMR) for quantitative assessment of AVJ velocity compared with tissue Doppler echocardiography (TDE). A group of 145 human subjects comprising 21 healthy volunteers, 8 patients with heart failure, 17 patients with hypertrophic cardiomyopathy, 52 patients with myocardial infarction, and 47 patients with repaired Tetralogy of Fallot were prospectively enrolled and underwent TDE and CMR scan. Six AVJ points were tracked with three CMR views. The peak systolic velocity (Sm1), diastolic velocity during early diastolic filling (Em), and late diastolic velocity during atrial contraction (Am) were extracted and analyzed. All CMR-derived septal and lateral AVJ velocities correlated well with TDE measurements (Sm1: r = 0.736; Em: r = 0.835; Am: r = 0.701; Em/Am: r = 0.691; all p < 0.001) and demonstrated excellent reproducibility [intrastudy: r = 0.921-0.991, intraclass correlation coefficient (ICC): 0.918-0.991; interstudy: r = 0.900-0.970, ICC: 0.887-0.957; all p < 0.001]. The evaluation of three-dimensional AVJ motion incorporating measurements from all views better differentiated normal and diseased states [area under the curve (AUC) = 0.918] and provided further insights into mechanical dyssynchrony diagnosis in HF patients (AUC = 0.987). These findings suggest that the CMR-based method is feasible, accurate, and consistent in quantifying the AVJ deformation, and subsequently in diagnosing systolic and diastolic cardiac dysfunction.
authors.affiliation: National Heart Centre Singapore, Singapore;
authors.forename: Shuang
authors.initials: S
authors.lastname: Leng
authors.affiliation: National Heart Centre Singapore, Singapore;
authors.forename: Xiao-Dan
authors.initials: XD
authors.lastname: Zhao
authors.affiliation: National Heart Centre Singapore, Singapore; Duke-NUS Graduate Medical School Singapore, Singapore; and.
authors.forename: Fei-Qiong
authors.initials: FQ
authors.lastname: Huang
authors.affiliation: National Heart Centre Singapore, Singapore;
authors.forename: Jia-Ing
authors.initials: JI
authors.lastname: Wong
authors.affiliation: National Heart Centre Singapore, Singapore;
authors.forename: Bo-Yang
authors.initials: BY
authors.lastname: Su
authors.affiliation: Duke-NUS Graduate Medical School Singapore, Singapore; and.
authors.forename: John Carson
authors.initials: JC
authors.lastname: Allen
authors.affiliation: California Medical Innovations Institute, San Diego, California.
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab
authors.affiliation: National Heart Centre Singapore, Singapore; Duke-NUS Graduate Medical School Singapore, Singapore; and.
authors.forename: Ru-San
authors.initials: RS
authors.lastname: Tan
authors.affiliation: National Heart Centre Singapore, Singapore; Duke-NUS Graduate Medical School Singapore, Singapore; and zhong.liang@nhcs.com.sg.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhong
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D001283:Atrioventricular Node / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D001331:Automation; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013599:Systole; D013997:Time Factors; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: atrioventricular junction deformation; cardiovascular magnetic resonance tissue doppler echocardiography; feature tracking