Universidade Estadual Paulista (UNESP), Botucatu, SP - Brazil.
Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ - Brazil.
Arq Bras Cardiol. 2020 Feb;114(2):284-292. doi: 10.5935/abc.20190193.
Diastolic dysfunction, commonly evaluated by echocardiography, is an important early finding in many cardiomyopathies. Cardiac magnetic resonance (CMR) often requires specialized sequences that extends the test time. Recently, feature-tracking imaging has been made available, but still requires expensive software and lacks clinical validation.
To assess diastolic function in patients with aortic valve disease (AVD) and compare it with normal controls by evaluating left ventricular (LV) longitudinal displacement by CMR.
We compared 26 AVD patients with 19 normal controls. Diastolic function was evaluated as LV longitudinal displacement in 4-chamber view cine-CMR images using steady state free precession (SSFP) sequence during the entire cardiac cycle with temporal resolution < 50 ms. The resulting plot of atrioventricular junction (AVJ) position versus time generated variables of AVJ motion. Significance level of p < 0.05 was used.
Maximum longitudinal displacement (0.12 vs. 0.17 cm), maximum velocity during early diastole (MVED, 0.6 vs. 1.4s-1), slope of the best-fit line of displacement in diastasis (VDS, 0.22 vs. 0.03s-1), and VDS/MVED ratio (0.35 vs. 0.02) were significantly reduced in AVD patients compared with controls, respectively. Aortic regurgitation showed significantly worse longitudinal LV shortening compared with aortic stenosis. Higher LV mass indicated worse diastolic dysfunction.
A simple linear measurement detected significant differences on LV diastolic function between AVD patients and controls. LV mass was the only independent predictor of diastolic dysfunction in these patients. This method can help in the evaluation of diastolic dysfunction, improving cardiomyopathy detection by CMR, without prolonging exam time or depending on expensive software.
舒张功能障碍，通常通过超声心动图评估，是许多心肌病的重要早期发现。心脏磁共振（CMR）通常需要特殊的序列，这会延长测试时间。最近，特征跟踪成像已经可用，但仍然需要昂贵的软件，并且缺乏临床验证。
通过评估左心室（LV）纵向位移，用心脏磁共振（CMR）评估主动脉瓣疾病（AVD）患者的舒张功能，并与正常对照组进行比较。
我们比较了 26 例 AVD 患者和 19 例正常对照组。舒张功能通过 SSFP 序列在 4 腔心电影 CMR 图像中评估，在整个心动周期内时间分辨率<50ms。房室结（AVJ）位置与时间的关系生成 AVJ 运动的变量。使用 p<0.05 的显著性水平。
最大纵向位移（0.12 对 0.17cm）、早期舒张期最大速度（MVED，0.6 对 1.4s-1）、舒张期位移最佳拟合线斜率（VDS，0.22 对 0.03s-1）和 VDS/MVED 比值（0.35 对 0.02）在 AVD 患者中分别显著低于对照组。主动脉瓣反流患者的 LV 缩短纵向比主动脉瓣狭窄患者明显更差。LV 质量越高，舒张功能障碍越严重。
简单的线性测量发现 AVD 患者与对照组之间 LV 舒张功能存在显著差异。LV 质量是这些患者舒张功能障碍的唯一独立预测因子。这种方法可以帮助评估舒张功能障碍，通过 CMR 提高对心肌病的检测，而不会延长检查时间或依赖昂贵的软件。
