Marsan Nina Ajmone, Westenberg Jos J M, Tops Laurens F, Ypenburg Claudia, Holman Eduard R, Reiber Johannes H C, de Roos Albert, van der Wall Ernst E, Schalij Martin J, Roelandt Jos R, Bax Jeroen J
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Am J Cardiol. 2008 Nov 15;102(10):1366-72. doi: 10.1016/j.amjcard.2008.06.064. Epub 2008 Sep 6.
Velocity-encoded magnetic resonance imaging (VE-MRI), commonly used to perform flow measurements, can be applied for myocardial velocity analysis, similar to tissue Doppler imaging (TDI). In this study, a comparison between VE-MRI and TDI was performed for the assessment of left ventricular dyssynchrony and left ventricular filling pressures. Ten healthy volunteers and 22 patients with heart failure secondary to ischemic cardiomyopathy underwent both VE-MRI and TDI. Longitudinal myocardial peak systolic and diastolic velocities and time to peak systolic velocity (Ts) were measured with both techniques at the level of left ventricular septum and lateral wall. To quantify left ventricular dyssynchrony, the delay in Ts between basal septum and lateral wall was calculated (SLD) and patients were categorized into 3 groups: minimal (SLD <30 ms), intermediate (SLD = 30 to 60 ms) and extensive (SLD >60 ms) left ventricular dyssynchrony. The ratio of transmitral E wave velocity and mitral annulus septal early velocity (E/E' ratio) was also assessed, and patients were divided into 3 groups: normal (E/E' <8), probably abnormal (E/E' = 8 to 15), and elevated (E/E' >15) left ventricular filling pressures. Excellent correlations were observed for peak systolic velocity and peak diastolic velocity (r = 0.95, p <0.001) measured with TDI and VE-MRI. A small bias (p <0.001) of -1.1 +/- 1.1 cm/s for peak systolic velocity and of -0.45 +/- 1.03 cm/s for peak diastolic velocity was noted between the 2 techniques. A strong correlation was also noted between Ts measured with TDI and VE-MRI (r = 0.97, p <0.001) without a significant difference. TDI and VE-MRI showed an excellent agreement for left ventricular dyssynchrony and left ventricular filling pressures classification with a weighted kappa of 0.96 and 0.91, respectively. In conclusion, TDI and VE-MRI are highly concordant and can be used interchangeably for the assessment of left ventricular dyssynchrony and filling pressures.
速度编码磁共振成像（VE-MRI）通常用于进行血流测量，与组织多普勒成像（TDI）类似，也可用于心肌速度分析。在本研究中，对VE-MRI和TDI进行了比较，以评估左心室不同步性和左心室充盈压。10名健康志愿者和22名缺血性心肌病继发心力衰竭的患者接受了VE-MRI和TDI检查。使用这两种技术在左心室间隔和侧壁水平测量纵向心肌收缩期和舒张期峰值速度以及达到收缩期峰值速度的时间（Ts）。为了量化左心室不同步性，计算基底间隔和侧壁之间的Ts延迟（SLD），并将患者分为3组：最小（SLD<30毫秒）、中度（SLD = 30至60毫秒）和广泛（SLD>60毫秒）左心室不同步性。还评估了二尖瓣E波速度与二尖瓣环间隔早期速度之比（E/E'比值），并将患者分为3组：正常（E/E'<8）、可能异常（E/E' = 8至15）和升高（E/E'>15）左心室充盈压。观察到TDI和VE-MRI测量的收缩期峰值速度和舒张期峰值速度之间具有极好的相关性（r = 0.95，p<0.001）。两种技术之间收缩期峰值速度的小偏差（p<0.001）为-1.1±1.1厘米/秒，舒张期峰值速度的小偏差为-0.45±1.03厘米/秒。TDI和VE-MRI测量的Ts之间也存在强相关性（r = 0.97，p<0.001），且无显著差异。TDI和VE-MRI在左心室不同步性和左心室充盈压分类方面显示出极好的一致性，加权kappa分别为0.96和0.91。总之，TDI和VE-MRI高度一致，可互换用于评估左心室不同步性和充盈压。
