João G Ramos1, Alexander Fyrdahl1, Björn Wieslander1, Simon Thalén1, Gert Reiter2, Ursula Reiter3, Ning Jin4, Eva Maret1, Maria Eriksson1, Kenneth Caidahl5, Peder Sörensson6, Andreas Sigfridsson1, Martin Ugander7. 1. Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden. 2. Siemens Healthcare Diagnostics, Graz, Austria. 3. Department of Radiology, Graz Medical University, Graz, Austria. 4. Siemens Healthcare, Columbus, Ohio, USA. 5. Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden; Department of Clinical Physiology, Sahlgrenska University Hospital and Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 6. Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden. 7. Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden; Kolling Institute, Royal North Shore Hospital, Sydney, Australia; University of Sydney, Northern Clinical School, Sydney Medical School, Sydney, Australia. Electronic address: martin.ugander@gmail.com.
Abstract
OBJECTIVES: The aims of this study were to develop a comprehensive cardiovascular magnetic resonance (CMR) approach to diastolic dysfunction (DD) grading and to evaluate the accuracy of CMR in the diagnosis of DD compared with echocardiography. BACKGROUND: Left ventricular DD is routinely assessed using echocardiography. METHODS: Consecutive clinically referred patients (n = 46; median age 59 years; interquartile range: 46 to 68 years; 33% women) underwent both conventional echocardiography and CMR. CMR diastolic transmitral velocities (E and A) and myocardial tissue velocity (e') were measured during breath-hold using a validated high-temporal resolution radial sector-wise golden-angle velocity-encoded sequence. CMR pulmonary artery pressure was estimated from 4-dimensional flow analysis of blood flow vortex duration in the pulmonary artery. CMR left atrial volume was measured using the biplane long-axis area-length method. Both CMR and echocardiographic data were used to perform blinded grading of DD according to the 2016 joint American and European recommendations. RESULTS: Grading of DD by CMR agreed with that by echocardiography in 43 of 46 cases (93%), of which 9% were normal, 2% indeterminate, 63% grade 1 DD, 4% grade 2 DD, and 15% grade 3 DD. There was a very good categorical agreement, with a weighted Cohen kappa coefficient of 0.857 (95% confidence interval: 0.73 to 1.00; p < 0.001). CONCLUSIONS: A comprehensive CMR protocol for grading DD encompassing diastolic blood and myocardial velocities, estimated pulmonary artery pressure, and left atrial volume showed very good agreement with echocardiography.
OBJECTIVES: The aims of this study were to develop a comprehensive cardiovascular magnetic resonance (CMR) approach to diastolic dysfunction (DD) grading and to evaluate the accuracy of CMR in the diagnosis of DD compared with echocardiography. BACKGROUND:Left ventricular DD is routinely assessed using echocardiography. METHODS: Consecutive clinically referred patients (n = 46; median age 59 years; interquartile range: 46 to 68 years; 33% women) underwent both conventional echocardiography and CMR. CMR diastolic transmitral velocities (E and A) and myocardial tissue velocity (e') were measured during breath-hold using a validated high-temporal resolution radial sector-wise golden-angle velocity-encoded sequence. CMR pulmonary artery pressure was estimated from 4-dimensional flow analysis of blood flow vortex duration in the pulmonary artery. CMR left atrial volume was measured using the biplane long-axis area-length method. Both CMR and echocardiographic data were used to perform blinded grading of DD according to the 2016 joint American and European recommendations. RESULTS: Grading of DD by CMR agreed with that by echocardiography in 43 of 46 cases (93%), of which 9% were normal, 2% indeterminate, 63% grade 1 DD, 4% grade 2 DD, and 15% grade 3 DD. There was a very good categorical agreement, with a weighted Cohen kappa coefficient of 0.857 (95% confidence interval: 0.73 to 1.00; p < 0.001). CONCLUSIONS: A comprehensive CMR protocol for grading DD encompassing diastolic blood and myocardial velocities, estimated pulmonary artery pressure, and left atrial volume showed very good agreement with echocardiography.
Authors: Erica Qiao; Kathan Amin; Daniel S Hippe; Eric V Krieger; Theodore J Dubinsky Journal: Int J Cardiovasc Imaging Date: 2021-02-23 Impact factor: 2.357
Authors: Clement Lau; Mohamed M M Elshibly; Prathap Kanagala; Jeffrey P Khoo; Jayanth Ranjit Arnold; Sandeep Singh Hothi Journal: Front Cardiovasc Med Date: 2022-07-18