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- Open Access
Exercise cardiac MR assessment of diastolic function
© Francois et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Diastolic Function
- Motion Artifact
- Exercise Stress
- Left Ventricular Systolic Function
- Left Ventricular Diastolic Function
Dyspnea with exertion is a common symptom in patients with left ventricular (LV) systolic and diastolic dysfunction. Assessing changes in systolic and diastolic hemodynamic parameters with exercise is necessary to thoroughly characterize these patients. Evaluation of changes in LV systolic function with exercise stress cardiac magnetic resonance (MR) has been demonstrated previously [1, 2]. In this study we assessed the feasibility of assessing LV diastolic function with exercise cardiac magnetic resonance.
14 healthy subjects (26.1±4.7 years, 5 men/9 women) were prospectively recruited according to an IRB-approved and HIPAA-compliant protocol. Supine, exercise cardiac MR was performed on a 1.5T scanner (HDx and 450W, GE Healthcare, Waukesha, WI) using an MRI-compatible exercise device that enables exercise to be performed on the scanner table . Transmitral inflow was assessed with 2D phase-contrast (PC) MRI (FOV=370x260mm2; matrix=256x128; TR/TE=6.1/3.7ms; FA=30°; ASSET=2; VENC=100cm/s) acquired through the tips of the MV leaflets during diastole . Exercise was performed at a constant workload (36.1±7.5W) for >3 minutes. The flow measurements were acquired during a breath-hold immediately following cessation of exercise to minimize bulk motion artifacts. 2D PC MR images were analyzed with CV Flow (Version 3.3, Medis, Leiden, the Netherlands). Resting and exercise E and A velocities and E/A ratios were recorded for each subject from the transmitral inflow-time curves. The paired Student's t-test was used to determine if differences between exercise and baseline were statistically significant.
Summary of E- and A- velocities and E/A ratios at rest and following exercise.
<20bpm increase in HR (N=5)
>20bpm increase in HR (N=7)
Quantification of exercise stress transmitral flow with MRI was feasible in the majority of healthy subjects, enabling the evaluation of exercise-induced changes in diastolic function. The findings of higher E and A indices is concordant with previously published data using exercise-stress echocardiography [5, 6].
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