What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Dilated cardiomyopathy (n=20). Intervention: Dilated cardiomyopathy vs. Healthy subjects. Primary outcome: Proportion of total left ventricular inflow passing directly to ejection (direct flow to total inflow ratio) (p=<0.001).

What does this research mean for the field?

Patients with dilated cardiomyopathy exhibit a significantly smaller proportion of left ventricular inflow passing directly to ejection compared to healthy subjects, despite having equivalent stroke volumes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

August 8, 2012European Heart Journal - Cardiovascular ImagingOpen Access

Four-dimensional blood flow-specific markers of LV dysfunction in dilated cardiomyopathy

Q: What are the key findings of this study?

Patients with clinically compensated dilated cardiomyopathy had a significantly smaller proportion of left ventricular inflow passing directly to ejection compared to healthy subjects (46% vs 70%, P<0.001).

Q: What does this research mean for the field?

Patients with dilated cardiomyopathy exhibit a significantly smaller proportion of left ventricular inflow passing directly to ejection compared to healthy subjects, despite having equivalent stroke volumes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Compensated dilated cardiomyopathy is linked to ~34% less LV direct flow vs healthy controls.

P<0.001
n=20

Why the study?

Does 4D flow MRI identify altered intra-ventricular flow patterns and kinetic energy in clinically compensated dilated cardiomyopathy patients compared to healthy subjects?

Population

20 subjects: 10 patients with clinically compensated dilated cardiomyopathy and 10 healthy subjects. Key…

Comparison

Four-dimensional time-resolved phase contrast… vs Healthy subjects with normal…

Design

Case-control

Authors

JEJonatan ErikssonLinköping University ABAnn F. BolgerCardiac Imaging TETino EbbersCardiac Imaging

Discussion

Member takes

Implication

4D MRI flow metrics may flag subclinical LV dysfunction in compensated DCM; case-control data leaves open marker utility pending validation.

Study Design

Type

Cross-Sectional (n=20)

Multicenter

Structured PICO

Does 4D flow MRI identify altered intra-ventricular flow patterns and kinetic energy in clinically compensated dilated cardiomyopathy patients compared to healthy subjects?

Population

20 subjects, including 10 patients with clinically compensated dilated cardiomyopathy and 10 healthy controls, underwent 4D flow MRI to assess left ventricular diastolic flow routes and energetics.

Exposure

Four-dimensional (4D) time-resolved phase contrast MRI to assess intra-ventricular flow components and kinetic energy (KE).

Comparator

Healthy subjects with normal electrocardiographic and echocardiographic examinations, no history of heart disease, and no cardiac medication.

Outcome

Left ventricular end-diastolic volume (EDV) separated into four flow components (direct flow, retained inflow, delayed ejection flow, and residual volume) and their respective kinetic energy (KE) over the cardiac cycle.surrogate

Main Result

Absolute Event Rate: 46% vs 70%

p-value: p=<0.001

4D flow MRI reveals that patients with compensated dilated cardiomyopathy have altered diastolic flow routes and impaired preservation of inflow kinetic energy despite having normal stroke volumes, suggesting its utility as a subclinical marker of LV dysfunction.

Limitations

Small sample size of only 10 patients and 10 healthy subjects.
Evaluations were performed only in the supine position at rest.
Included only patients in sinus rhythm with no significant valvular disorder.
Potential inaccuracies in assessing residual volume due to partial volume effects and imperfect segmentation.
Relatively long MRI scan times.
Risk of mismatch between morphological images and velocity data due to patient movement.
Small number of patients and healthy subjects
Evaluated only in supine position at rest
Included only patients in sinus rhythm with no significant valvular disorder
Potential mismatch due to patient movement between morphologic and velocity acquisitions
Residual volume likely inaccurately assessed due to partial volume effects and imperfect segmentation

Cite This Study

Eriksson et al. (2012) conducted a cross-sectional in Dilated cardiomyopathy (n=20). Dilated cardiomyopathy vs. Healthy subjects was evaluated on Proportion of total left ventricular inflow passing directly to ejection (direct flow to total inflow ratio) (p=<0.001). Patients with clinically compensated dilated cardiomyopathy had a significantly smaller proportion of left ventricular inflow passing directly to ejection compared to healthy subjects (46% vs 70%, P<0.001).

synapsesocial.com/papers/6a1913621d64db491ad31f0f https://doi.org/10.1093/ehjci/jes159

Topics

HFrEF treatment Heart failure Cardiac MRI

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Implication

4D MRI flow metrics may flag subclinical LV dysfunction in compensated DCM; case-control data leaves open marker utility pending validation.

Four-dimensional blood flow-specific markers of LV dysfunction in dilated cardiomyopathy

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Four-dimensional blood flow-specific markers of LV dysfunction in dilated cardiomyopathy

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider