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Global diastolic function in endurance athletes: three-dimensional volume tracking of the mitral annulus with cine-CMR
© Wu et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Diastolic Function
- Hypertrophic Cardiomyopathy
- Tissue Doppler Imaging
- Mitral Annular
- Endurance Athlete
CMR can be used to assess the structure and function of athletes' hearts. However, diastolic function is not routinely measured with CMR. Mitral annular (MA) motion, commonly assessed by tissue Doppler imaging, is an important element of diastole that may help to distinguish physiological remodeling from pathological processes of the heart. CMR has been shown to play a useful role in evaluating MA motion. This study aims to characterize the global left ventricular diastolic function in endurance athletes by 3D volume tracking of the MA, using conventional cine-CMR images.
CMR studies of 24 high-level endurance athletes (age 22 ± 3) were retrospectively selected from a database. Routine CMR studies from 39 patients with normal hearts (age 42 ± 16) and 29 hypertrophic cardiomyopathy (HCM) patients (age 52 ± 17) with normal ejection fractions were included for comparison. Using normalized cross-correlation, feature-tracking of the atrioventricular junctions was performed over the cardiac cycle, in routine long-axis 2-, 3-, and 4-chamber cine-CMR views. This resulted in 6 spatial MA points per cardiac phase, which were interpolated with a spline for 3D MA reconstruction. The 3D volume swept out by the MA was then calculated; the net sweep volume at a given cardiac phase was derived from the sum of the incremental volumes starting from end-diastole.
3D MA sweep volumes derived from cine-CMR demonstrated that athletes had significantly faster early diastolic relaxation, followed by reduced MA motion in atrial systole, and faster diastolic MA sweep volume recovery, when compared to normal subjects and HCM patients.
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