Diastolic Function in Patients with Hypertrophic Cardiomyopathy: Evaluation Using the Phase-contrast MRI Measurement of Mitral Valve and Pulmonary Vein Flow Velocities
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Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purposeof this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary veinflow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography wassuccessfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolicdysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients hadnormal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlationwith the same parameters measured by echocardiography (Pearson’s r values were 0.47, 0.60, and 0.75 for E, A,E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalizedpattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiacMRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysisof pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCMpatients.
Abstract
Purpose: Diastolic dysfunction is a common problem in patients with hypertrophic cardiomyopathy (HCM). The purposeof this study was to assess the role of MRI in the assessment of diastolic function using mitral valve and pulmonary veinflow velocities in HCM patients. Methods and Results: Phase-contrast MRI (mitral valve and pulmonary vein) and transthoracic echocardiography wassuccessfully performed for 59 HCM patients (44 men and 15 women; mean age, 51 years). Forty-nine patients had a diastolicdysfunction; grade 1 (n = 20), grade 2 (n = 27), and grade 3 (n = 2) using echocardiography, and ten patients hadnormal diastolic function. The transmitral inflow parameters (E, A, and E/A ratios) obtained by MRI showed positive correlationwith the same parameters measured by echocardiography (Pearson’s r values were 0.47, 0.60, and 0.75 for E, A,E/A, respectively, all P < 0.001). With the flow information of the pulmonary vein from cardiac MRI, pseudo-normalizedpattern (n = 8) could be distinguished from true normal filling pattern (n = 17), and the diastolic function grades by cardiacMRI showed moderate agreement with those of echocardiography (kappa value = 0.45, P < 0.001). Conclusions: Assessment of left ventricle diastolic function is feasible using phase-contrast MRI in HCM patients. Analysisof pulmonary vein flow velocity on MRI is useful for differentiating pseudo-normal from normal diastolic function in HCMpatients.
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