Post-Processing and Workflow
Radu Tanacli, MD
Research Fellow
German Heart Center Berlin
Berlin, Berlin, Germany
Radu Tanacli, MD
Research Fellow
German Heart Center Berlin
Berlin, Berlin, Germany
Djawid Hashemi, MD
Physician / Clinician Scientist
Charité – Universitätsmedizin Berlin
Berlin, Berlin, Germany
Patrick Doeblin, MD
Cardiologist
German Heart Center Charité, Germany
Marthe Neye, MD
Research Fellow
German Heart Center Berlin, Germany
Laura Astrid A. Motzkus, MD
Research Fellow
German Heart Center Berlin
Berlin, Germany
Moritz Blum, MD
Resident
Charité – Universitätsmedizin Berlin, New York, Germany
Robin Kraft, MD
Cardiologist
German Heart Center Berlin, Germany
Seyedeh Mahsa Zamani, MD
Research Fellow
German Heart Center Berlin, Germany
Frank Edelmann, MD
Physician
Charité – Universitätsmedizin Berlin, Berlin, Germany
Burkert Pieske, MD
Head of Departement
Charité – Universitätsmedizin Berlin, Berlin, Germany
Hans-Dirk Duengen, MD
Physician
Charité – Universitätsmedizin Berlin, Berlin, Germany
Sebastian Kelle, MD, FSCMR
Cardiologist
German Heart Center Berlin
Berlin, Berlin, Germany
Feature tracking cardiac magnetic resonance imaging (FT-CMR) provides excellent tools to evaluate various aspects of cardiac mechanics, however its specific role in quantifying cardiac diastolic function is to date less well explored and defined. Echocardiography, currently representing the gold standard to assess diastolic impaired relaxation and filling, has a number of significant limitations which restrict its usage and is less reproducible than CMR.
Methods: We applied FT-CMR to a cohort of 56 patients including different types of heart failure (HF), according to the ESC guidelines (20 with HFpEF, 19 with HFmrEF and 17 with HFrEF) and a matched subgroup of 19 healthy controls. We derived the peak early diastolic longitudinal velocity (CMR Early Diast Longit Vel) and the ratio between peak early diastolic volume gradient curve and peak early diastolic longitudinal velocity (CMR Early Diast VolGrad/Longit Vel) as the main outcomes. We compared these parameters with the echo equivalents and then between the subgroups.
Results:
There was a satisfactory agreement between the echocardiography derived parameters and the CMR correspondents (Echo Average e’ Vel vs CMR Early Diast Longit Vel, R=-0.62, P< 0.001; Echo E/e’ Vel vs CMR Early Diast VolGrad/Longit Vel, R=-0.48, p< 0.001) (Figure 1.). Both CMR parameters were reliable in identifying diastolic dysfunction in all subgroups HFpEF, HFmrEF and HFrEF compared with Control (CMR Early Diast Longit Vel: -3.8±1.5 vs -2.5±1.1 vs -1.9±0.8 vs -1.5±0.9 cm/s, P<sub>ANOVA< 0.001; CMR Early Diast VolGrad/Longit Vel: -79.6±16.7 vs -119.3±48.4 vs -160.4±87.5 vs -280.7±142.8, P<sub>ANOVA< 0.001) (Figure 2.) A marked variability in CMR Early Diast Longit Vel in the Control subjects indicate that a certain degree of impaired relaxation may be common among healthy subjects and due to existing risk factors and aging.
Conclusion:
Feature tracking cardiac magnetic resonance imaging (FT-CMR) is a highly accessible option to estimate cardiac diastolic function in patients with heart failure and given its high sensitivity should be considered as a reliable option to detect early dysfunction such as lusitropic deficit.