Volume 13 Supplement 1

Abstracts of the 2011 SCMR/Euro CMR Joint Scientific Sessions

Open Access

The clinical value of phase-contrast CMR mitral inflow diastolic parameters: comparison with echocardiography

  • Emilie Bollache1,
  • Alban Redheuil2,
  • Carine Defrance3,
  • Ludivine Perdrix3,
  • Benoît Diebold3,
  • Elie Mousseaux2 and
  • Nadjia Kachenoura1
Journal of Cardiovascular Magnetic Resonance201113(Suppl 1):P32

DOI: 10.1186/1532-429X-13-S1-P32

Published: 2 February 2011

Purpose

To evaluate the ability of phase-contrast cardiovascular magnetic resonance (PC-CMR) blood flow diastolic parameters to characterize left ventricular (LV) diastolic dysfunction.

Introduction

Early detection of LV diastolic dysfunction is crucial for the management of patients with heart disease. PC-CMR is increasingly used for this evaluation. However, its usefulness in clinical routine is not established yet because of technical issues such as the lack of automated post-processing tools. We hypothesized that the analysis of velocity and flow-rate curves extracted from an accurate segmentation of the transmitral flow would provide sensitive diastolic parameters.

Methods

We studied 35 healthy controls (21 women; age: 38±16 years) and 12 consecutive patients (8 women; age: 81±5 years) with a severe aortic stenosis (valve area/body surface=0.47±0.17 cm2/m2, ejection fraction=66±16%, end-diastolic volume=94±18 ml, end-systolic volume=33±19 ml). All subjects had an echocardiography (GE Vivid 7) and a transmitral flow PC-CMR acquisition (GE 1.5 T) on the same day. For PC-CMR images analysis, we used our custom software for semi-automated segmentation of transmitral flow and automated extraction of diastolic parameters from velocity and flow rate curves. Flow rate curves provided: 1) peak filling rate (EfMR, ml/s) and peak atrial filling rate (AfMR, ml/s) combined into EfMR/AfMR, 2) peak filling rate to filling volume ratio (EfMR/FVfMR, s-1), and 3) the deceleration time (DTfMR), while maximal velocity curves provided the early and late peak velocities EMR and AMR, combined into EMR/AMR. DTUS and EUS/AUS as well as the flow to tissue velocity ratio EUS/E’US were estimated from Doppler echocardiography.

Results

A stronger correlation and a slope closer to 1 was found for the comparison between the echocardiographic EUS/AUS and the flow rate-related EfMR/AfMR (r=0.80, EfMR/AfMR=0.89·EUS/AUS+0.09) than the velocity-related EMR/AMR (r=0.72, EMR/AMR=0.55·EUS/AUS+0.49). Results of receiver operating characteristic (ROC) analysis summarized in table 1 indicated the good sensitivity and specificity of the PC-CMR parameters to separate controls from patients.
Table 1

Summary of echocardiographic and CMR diastolic parameters for controls and patients and their ability to characterize pathological subjects. AUC=area under the ROC curve.

 

Controls

Patients

Sensitivity

Specificity

AUC

EUS/AUS

1.39 ± 0.60

0.82 ± 0.33

94

67

0.86

EUS/E’US

5.34 ± 1.83

14.3 ± 8.10

83

100

0.96

DTUS(ms)

180 ± 56

271 ± 58

77

92

0.86

EMR/AMR

1.34 ± 56

271 ± 58

77

92

0.86

EfMR/AfMR

1.44 ± 0.58

0.49 ± 0.20

91

92

0.95

DTfMR(ms)

187 ± 36

258 ± 45

86

83

0.88

EfMR/FVFMR (s-1)

4.26 ± 0.94

2.37 ± 0.55

91

100

0.97

Conclusions

Our automated method provided diastolic parameters in good agreement with Doppler echocardiography especially for our new EfMR/AfMR ratio estimated from flow rate analysis. In addition, our preliminary findings indicated their high sensitivity and specificity to determine patients from controls. The addition of tissue velocities analysis, which is under investigation, to our tool would increase this efficiency.

Authors’ Affiliations

(1)
1INSERM U678
(2)
2Radiology department, European Hospital Georges Pompidou
(3)
3Echocardiography department, European Hospital Georges Pompidou

Copyright

© Bollache et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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