Key result
Automated cine-CMR segmentation revealed that prolonged diastolic volume recovery was associated with grade 1 diastolic dysfunction, while high peak filling rate was associated with grade 3.
Why the study?
Can automated cine-CMR segmentation discern left ventricular filling changes associated with increasing severity of echocardiography-evidenced diastolic dysfunction in post-MI patients?
Observational (n=115)
Single-blind
No
Can automated cine-CMR segmentation discern left ventricular filling changes associated with increasing severity of echocardiography-evidenced diastolic dysfunction in post-MI patients?
Automated cine-CMR segmentation can effectively identify left ventricular filling changes corresponding to different grades of diastolic dysfunction, offering a reproducible method to assess diastolic function.
Answers are grounded in this paper and cite their sources.
Supports automated cine-CMR diastolic assessment in post-MI patients; hypothesis-generating pending prospective validation.
OBJECTIVES: To examine relationships between severity of echocardiography (echo) -evidenced diastolic dysfunction (DD) and volumetric filling by automated processing of routine cine cardiovascular magnetic resonance (CMR). BACKGROUND: Cine-CMR provides high-resolution assessment of left ventricular (LV) chamber volumes. Automated segmentation (LV-METRIC) yields LV filling curves by segmenting all short-axis images across all temporal phases. This study used cine-CMR to assess filling changes that occur with progressive DD. METHODS: 115 post-MI patients underwent CMR and echo within 1 day. LV-METRIC yielded multiple diastolic indices - E:A ratio, peak filling rate (PFR), time to peak filling rate (TPFR), and diastolic volume recovery (DVR80 - proportion of diastole required to recover 80% stroke volume). Echo was the reference for DD. RESULTS: LV-METRIC successfully generated LV filling curves in all patients. CMR indices were reproducible (< or = 1% inter-reader differences) and required minimal processing time (175 +/- 34 images/exam, 2:09 +/- 0:51 minutes). CMR E:A ratio decreased with grade 1 and increased with grades 2-3 DD. Diastolic filling intervals, measured by DVR80 or TPFR, prolonged with grade 1 and shortened with grade 3 DD, paralleling echo deceleration time (p < 0.001). PFR by CMR increased with DD grade, similar to E/e' (p < 0.001). Prolonged DVR80 identified 71% of patients with echo-evidenced grade 1 but no patients with grade 3 DD, and stroke-volume adjusted PFR identified 67% with grade 3 but none with grade 1 DD (matched specificity = 83%). The combination of DVR80 and PFR identified 53% of patients with grade 2 DD. Prolonged DVR80 was associated with grade 1 (OR 2.79, CI 1.65-4.05, p = 0.001) with a similar trend for grade 2 (OR 1.35, CI 0.98-1.74, p = 0.06), whereas high PFR was associated with grade 3 (OR 1.14, CI 1.02-1.25, p = 0.02) DD. CONCLUSIONS: Automated cine-CMR segmentation can discern LV filling changes that occur with increasing severity of echo-evidenced DD. Impaired relaxation is associated with prolonged filling intervals whereas restrictive filling is characterized by increased filling rates.
No takes yet. Share an insight, caveat, or question.
Mendoza et al. (2010) conducted an observational in Post-myocardial infarction with diastolic dysfunction (n=115). Automated cine-CMR segmentation (LV-METRIC) vs. Echocardiography was evaluated on Association of prolonged diastolic volume recovery (DVR80) with grade 1 diastolic dysfunction (OR 2.79, 95% CI 1.65-4.05, p=0.001). Automated cine-CMR segmentation revealed that prolonged diastolic volume recovery was associated with grade 1 diastolic dysfunction, while high peak filling rate was associated with grade 3.
Synapse has enriched 10 related papers. Consider them for comparative context: