Cirener Lilly Charlotte, Körperich Hermann, Barth Peter, Racolta Anca, Piran Misagh, Burchert Wolfgang, Weber Oliver M, Eckstein Jan
Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany.
Clinic for Pediatric Cardiology, Center for Congenital Heart Defects, University Hospital RWTH Aachen, Aachen, Germany.
Clin Res Cardiol. 2024 Sep 30. doi: 10.1007/s00392-024-02553-9.
Impaired diastolic function is associated with a variety of diseases such as myocarditis or dilated cardiomyopathy. Currently, echocardiography is the standard method for assessing diastolic function. Recently, it has been postulated that cardiovascular magnetic resonance (CMR) is an at least equivalent or superior alternative to echocardiography. To assess CMR-based age- and gender-dependent diastolic functional normal reference values, pulmonary venous and transmitral blood-flow parameters were examined in heart-healthy test persons.
Flow-sensitive phase-contrast CMR imaging was performed in the right upper pulmonary vein (RUPV) and at the level of the mitral valve (MV) in 183 healthy subjects (age 10-70 years; 97 women, 86 men). The data was distributed as evenly as possible across all groups. Strong age-dependence was observed for PV S/D; r = 0.718, p < 0.001 (Pearson product-moment correlation) and for transmitral MV E/A; ρ = -0.736, p < 0.001 (Spearman's Rho correlation). Moderate age-dependence was found for PV slope D-wave; r = 0.394, p < 0.001. Except for MV slope E-wave (male -292 cm/s interquartile range (IQR) {-338; -243} vs. female -319 ± 82 cm/s; p = 0.047), no gender-related differences were observed. In a subgroup (N = 100), CMR data were compared with echocardiographic data. Strong correlation was found between CMR and echocardiography for PV S/D; r = 0.545, p < 0.001 and MV E/A; ρ = 0.692, p < 0.001.
Diastolic functional parameters change with age, while gender-differences are small. CMR and echocardiography showed similar PV S/D and MV E/A ratios, making CMR a promising alternative for assessing diastolic function.
舒张功能受损与多种疾病相关，如心肌炎或扩张型心肌病。目前，超声心动图是评估舒张功能的标准方法。最近，有人提出心血管磁共振成像（CMR）至少是与超声心动图等效或更优的替代方法。为了评估基于CMR的年龄和性别依赖性舒张功能正常参考值，对心脏健康的受试者的肺静脉和二尖瓣血流参数进行了检查。
对183名健康受试者（年龄10 - 70岁；97名女性，86名男性）的右上肺静脉（RUPV）和二尖瓣（MV）水平进行了流敏感相位对比CMR成像。数据在所有组中尽可能均匀分布。观察到肺静脉S/D有很强的年龄依赖性；r = 0.718，p < 0.001（Pearson积矩相关），二尖瓣MV E/A也有很强的年龄依赖性；ρ = -0.736，p < 0.001（Spearman秩相关）。肺静脉D波斜率有中度年龄依赖性；r = 0.394，p < 0.001。除了MV E波斜率（男性四分位间距（IQR）为 -292 cm/s {-338；-243}，女性为 -319±82 cm/s；p = 0.047）外，未观察到性别相关差异。在一个亚组（N = 100）中，将CMR数据与超声心动图数据进行了比较。CMR和超声心动图在肺静脉S/D方面有很强的相关性；r = 0.545，p < 0.001，在MV E/A方面也有很强的相关性；ρ = 0.692，p < 0.001。
舒张功能参数随年龄变化，而性别差异较小。CMR和超声心动图显示出相似的肺静脉S/D和二尖瓣MV E/A比值，使CMR成为评估舒张功能的有前景的替代方法。
