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Evaluation of left ventricular diastolic function by fractional area change using cine cardiovascular magnetic resonance: a feasibility study.

Okayama S, Nakano T, Uemura S, Fujimoto S, Somekawa S, Watanabe M, Nakajima T, Saito Y - J Cardiovasc Magn Reson (2013)

Bottom Line: Normal, impaired relaxation, pseudonormal, and restrictive LV filling were observed in 15, 28, 11, and 5 patients, respectively.The diastolic index was significantly lower (p < 0.0001) in patients with impaired relaxation (32.4 ± 7.5), pseudonormal filling (25.4 ± 5.6), and restrictive filling (9.5 ± 1.5) compared to those with normal diastolic function (67.7 ± 10.8), and the index decreased significantly with worsening of diastolic dysfunction.The diastolic index correlated positively with early diastolic mitral annular velocity measured by tissue Doppler imaging (r = 0.75, p < 0.0001), respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: First Department of Internal Medicine, Nara Medical University, Nara, Japan. satosi01@naramed-u.ac.jp.

ABSTRACT

Background: Evaluation of left ventricular (LV) diastolic function is essential for the management of heart failure. We verified whether LV diastolic function could be evaluated by measuring the fractional area change (FAC) using cine cardiovascular magnetic resonance (CMR).

Methods: We collected clinical data from 59 patients who underwent echocardiography and cine CMR. Normal, impaired relaxation, pseudonormal, and restrictive LV filling were observed in 15, 28, 11, and 5 patients, respectively. We calculated FAC during the first 30% of diastole (diastolic-index%) in the short-axis view, by tracing the contours on only three MR cine images.

Results: The diastolic index was significantly lower (p < 0.0001) in patients with impaired relaxation (32.4 ± 7.5), pseudonormal filling (25.4 ± 5.6), and restrictive filling (9.5 ± 1.5) compared to those with normal diastolic function (67.7 ± 10.8), and the index decreased significantly with worsening of diastolic dysfunction. The diastolic index correlated positively with early diastolic mitral annular velocity measured by tissue Doppler imaging (r = 0.75, p < 0.0001), respectively.

Conclusions: Measurement of FAC can be useful for the evaluation of LV diastolic function using cine CMR.

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Related in: MedlinePlus

Evaluation of left ventricular systolic and diastolic function by fractional area change in cine CMR. End-diastolic and end-systolic phase are visually determined in datasets from short-axis cine images at mid papillary muscle, and phase number during 30% of diastole is calculated by multiplying total phase number during diastole by 0.3 and rounding up values. Left ventricular (LV) endocardial contours are then manually traced only on cine images of end-diastolic phase, end-systolic phase, and phase at 30% of diastole. The LV systolic fractional area change (systolic-index,%) and fractional area change during the first 30% of diastole (diastolic-index %) are calculated.
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Figure 1: Evaluation of left ventricular systolic and diastolic function by fractional area change in cine CMR. End-diastolic and end-systolic phase are visually determined in datasets from short-axis cine images at mid papillary muscle, and phase number during 30% of diastole is calculated by multiplying total phase number during diastole by 0.3 and rounding up values. Left ventricular (LV) endocardial contours are then manually traced only on cine images of end-diastolic phase, end-systolic phase, and phase at 30% of diastole. The LV systolic fractional area change (systolic-index,%) and fractional area change during the first 30% of diastole (diastolic-index %) are calculated.

Mentions: CMR data were analyzed by two experienced observers who were blinded to the clinical backgrounds of the participants, using integral software (Argus; Siemens). The concepts of Echo-CK were applied to short-axis cine image datasets at the level of the mid-papillary muscle. We visually determined the end-diastolic and end-systolic phases and calculated the phase number during 30% of diastole by multiplying the total phase number during diastole by 0.3 and rounding up the values. We manually traced LV endocardial contours on only cine images of the end-diastolic phase, end-systolic phase, and the phase at 30% of diastole and then calculated the systolic fractional area change (systolic-index, percent) and fractional area change during the first 30% of diastole (diastolic-index, percent) (Figure 1).


Evaluation of left ventricular diastolic function by fractional area change using cine cardiovascular magnetic resonance: a feasibility study.

Okayama S, Nakano T, Uemura S, Fujimoto S, Somekawa S, Watanabe M, Nakajima T, Saito Y - J Cardiovasc Magn Reson (2013)

Evaluation of left ventricular systolic and diastolic function by fractional area change in cine CMR. End-diastolic and end-systolic phase are visually determined in datasets from short-axis cine images at mid papillary muscle, and phase number during 30% of diastole is calculated by multiplying total phase number during diastole by 0.3 and rounding up values. Left ventricular (LV) endocardial contours are then manually traced only on cine images of end-diastolic phase, end-systolic phase, and phase at 30% of diastole. The LV systolic fractional area change (systolic-index,%) and fractional area change during the first 30% of diastole (diastolic-index %) are calculated.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3815234&req=5

Figure 1: Evaluation of left ventricular systolic and diastolic function by fractional area change in cine CMR. End-diastolic and end-systolic phase are visually determined in datasets from short-axis cine images at mid papillary muscle, and phase number during 30% of diastole is calculated by multiplying total phase number during diastole by 0.3 and rounding up values. Left ventricular (LV) endocardial contours are then manually traced only on cine images of end-diastolic phase, end-systolic phase, and phase at 30% of diastole. The LV systolic fractional area change (systolic-index,%) and fractional area change during the first 30% of diastole (diastolic-index %) are calculated.
Mentions: CMR data were analyzed by two experienced observers who were blinded to the clinical backgrounds of the participants, using integral software (Argus; Siemens). The concepts of Echo-CK were applied to short-axis cine image datasets at the level of the mid-papillary muscle. We visually determined the end-diastolic and end-systolic phases and calculated the phase number during 30% of diastole by multiplying the total phase number during diastole by 0.3 and rounding up the values. We manually traced LV endocardial contours on only cine images of the end-diastolic phase, end-systolic phase, and the phase at 30% of diastole and then calculated the systolic fractional area change (systolic-index, percent) and fractional area change during the first 30% of diastole (diastolic-index, percent) (Figure 1).

Bottom Line: Normal, impaired relaxation, pseudonormal, and restrictive LV filling were observed in 15, 28, 11, and 5 patients, respectively.The diastolic index was significantly lower (p < 0.0001) in patients with impaired relaxation (32.4 ± 7.5), pseudonormal filling (25.4 ± 5.6), and restrictive filling (9.5 ± 1.5) compared to those with normal diastolic function (67.7 ± 10.8), and the index decreased significantly with worsening of diastolic dysfunction.The diastolic index correlated positively with early diastolic mitral annular velocity measured by tissue Doppler imaging (r = 0.75, p < 0.0001), respectively.

View Article: PubMed Central - HTML - PubMed

Affiliation: First Department of Internal Medicine, Nara Medical University, Nara, Japan. satosi01@naramed-u.ac.jp.

ABSTRACT

Background: Evaluation of left ventricular (LV) diastolic function is essential for the management of heart failure. We verified whether LV diastolic function could be evaluated by measuring the fractional area change (FAC) using cine cardiovascular magnetic resonance (CMR).

Methods: We collected clinical data from 59 patients who underwent echocardiography and cine CMR. Normal, impaired relaxation, pseudonormal, and restrictive LV filling were observed in 15, 28, 11, and 5 patients, respectively. We calculated FAC during the first 30% of diastole (diastolic-index%) in the short-axis view, by tracing the contours on only three MR cine images.

Results: The diastolic index was significantly lower (p < 0.0001) in patients with impaired relaxation (32.4 ± 7.5), pseudonormal filling (25.4 ± 5.6), and restrictive filling (9.5 ± 1.5) compared to those with normal diastolic function (67.7 ± 10.8), and the index decreased significantly with worsening of diastolic dysfunction. The diastolic index correlated positively with early diastolic mitral annular velocity measured by tissue Doppler imaging (r = 0.75, p < 0.0001), respectively.

Conclusions: Measurement of FAC can be useful for the evaluation of LV diastolic function using cine CMR.

Show MeSH
Related in: MedlinePlus