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- Open Access
Vorticity for the assessment of right ventricular diastolic dysfunction using 4D flow CMR
© Fenster et al; licensee BioMed Central Ltd. 2013
- Published: 30 January 2013
- Pulmonary Hypertension
- Right Ventricular
- Ventricular Diastolic Dysfunction
- Right Ventricular Systolic Pressure
- Right Ventricular Diastolic Dysfunction
Thirteen subjects (10 females/3 males) with PH and 10 age-matched controls (7 females/3 males) underwent same-day echocardiography and 4D flow CMR. Echocardiography assessed RV diastolic function and RV systolic pressure (RVSP). PH subjects had to demonstrate RVDD on the day of CMR as defined by either Stage I RVDD (tricuspid E/A < .8, E/E' < 6, and deceleration time (DT) > 120 ms) or Stage II RVDD (E/A > 2.1, E/E' of > or =6, or DT > 120 ms). 4D flow CMR was performed with interleaved 3-directional velocity encoding (spatial resolution=3.5×2.6×3.0 mm3, α=15°, TE/TR=2.85/48.56 ms, venc=150 cm/s, temporal resolution=50 ms) on a 1.5 T MRI system (Avanto, Siemens, Germany) using ECG gating and respiratory navigation. Images were acquired in a sagittal oblique 3D volume covering the entire right heart. Datasets were corrected for noise and aliasing using a custom Matlab program (Jelena Bock, Northwestern University) and imported into Paraview (Kitware, Clifton, NY) for isolation of the right heart field of view. Right heart E wave vorticity was calculated using Paraview. Univariate and multivariate regression analysis were used to test the relationship between E wave vorticity and RVDD using JMP (SAS, Cary, NC). Heart rate and cardiac index were used to control for RV filling time and RV inflow, respectively.
Patient cohort characteristics
57 +/- 12
63 +/- 6
Gender (% Female)
58 +/- 17 mmHg
26 +/- 8 mmHg
p < .001
Decreased right heart vorticity identifies the presence and severity of RVDD in a small cohort of PH subjects when compared to controls. Vorticity analysis for the assessment of RVDD may represent a novel clinical application of 4D flow CMR. Future investigations will require improvements in 4D flow CMR spatial and temporal resolution, larger patient cohorts, and simultaneous 4D flow CMR and echocardiographic acquisition to validate this finding.
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