Correlation between velocity encoded cine magnetic resonance imaging and Doppler echocardiography for the evaluation of diastolic dysfunction

Background

Doppler echocardiographic (Echo) measurements of the mitral and pulmonary venous flow have been used to assess diastolic dysfunction (DD). Velocity-encoded cardiac magnetic resonance (Ve-CMR) can measure similar parameters and may potentially be used for the assessment of DD.

Objective

To assess the correlation of Ve-CMR with Echo in assessing mitral inflow E/A ratio, left atrial (LA) size, and pulmonary vein (PV) flow.

Methods

We prospectively enrolled 22 outpatients with a mitral inflow pattern by Echo that was normal (8), impaired relaxation (7), pseudo-normal (2), or restrictive (5). The mean left ventricular ejection fraction (LVEF) was 60.8 and two patients had left ventricular hypertrophy on echo. Ve-CMR was performed within 2 hours of the Echo. The following indices were measured: LA size, mitral inflow E-velocity (E), A-velocity (A), E/A ratio, PV waves (S, D and A).

Results

The mean age of the patients was 51 years. The average Echo mitral inflow absolute velocities were close to double the Ve-CMR {Echo E-velocity = 85.8 cm/sec vs. Ve-CMR E velocity = 41.4 cm/sec, Echo A-velocity 70 cm/sec vs. Ve-CMR A-velocity 32.5 cm/sec}. The average E/A ratio was 1.41 by echocardiogram and 1.48 by Ve-CMR. There was a significant correlation in LA size and Mitral inflow E/A ratio between Ve-CMR and Echo (Rho = 0.9, p < 0.01; Rho = 0.88, p < 0.01, respectively). There were no significant correlations in PV waves (Rho = 0.12, p = 0.58). Figure 1

Figure 1

Correlation between Ve-CMR and Doppler echo derived values was tested using Spearman's rank correlation coefficients. There was significant correlation between left atrial size and E/A ratio. A: LA size (R = 0.9, p-value < 0.05), B: E/A ratio (R = 0.88, p-value < 0.05), but not C: (R = 0.12, p = 0.58). LA; left atrium, PV, pulmonary vein.

Conclusion

Ve-CMR has a very high correlation with Echo in the assessment of mitral inflow E/A ratio and LA size. Ve-CMR maybe useful for the assessment of diastolic dysfunction.