Key result
Patients with hypertensive heart disease, DCM, or LBBB had significantly increased systolic radial and diastolic long-axis dyssynchrony compared to healthy controls (P<0.01).
Why the study?
Does magnetic resonance tissue phase mapping detect differences in left ventricular radial and long-axis dyssynchrony between healthy volunteers and patients with hypertensive heart disease, DCM, or LBBB?
Observational (n=95)
Does magnetic resonance tissue phase mapping detect differences in left ventricular radial and long-axis dyssynchrony between healthy volunteers and patients with hypertensive heart disease, DCM, or LBBB?
p-value: p=<0.01
Magnetic resonance tissue phase mapping identifies radial systolic and long-axis diastolic dyssynchrony as sensitive markers for altered dyssynchrony in hypertensive heart disease and dilated cardiomyopathy.
TPM may quantify age- and disease-related LV dyssynchrony; leaves open clinical utility pending validation studies.
PURPOSE: To employ magnetic resonance tissue phase mapping (TPM) for the assessment of age-related left ventricular (LV) synchrony of radial and long-axis motion in healthy volunteers and in hypertensive heart disease, dilated cardiomyopathy (DCM), and left bundle branch block (LBBB). MATERIALS AND METHODS: TPM (spatial/temporal resolution = 1.3 × 2.6 mm(2)/13.8 msec) was employed to measure radial and long-axis myocardial velocities in 58 healthy volunteers of three age groups and 37 patients (hypertensive, n = 18; DCM, n = 12; DCM and LBBB n = 7). Regional times-to-peak velocities (TTP) in systole and diastole were derived for all LV segments. Four measures of dyssynchrony were defined as the standard deviation of systolic and diastolic TTP for radial and long-axis motion. RESULTS: Systolic radial and diastolic long-axis dyssynchrony was increased (P < 0.01) in all patient groups compared to controls. Multiple regressions revealed a significant relationship of dyssynchrony with LV ejection fraction and mass for systolic radial (P < 0.001 resp. P = 0.02), diastolic radial (P < 0.001 resp. P < 0.05), and long-axis (P < 0.001 resp. P = 0.001) motion. Diastolic dyssynchrony correlated with the LV remodeling index (P < 0.05) and increased with age (P < 0.03). Systolic long-axis dyssynchrony was not influenced by disease or LV function. CONCLUSION: Radial systolic and long-axis diastolic dyssynchrony were the most sensitive markers for altered dyssynchrony in hypertensive heart disease or DCM. Future studies are needed to evaluate the diagnostic value of TPM-derived dyssynchrony parameters.
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Föll et al. (2011) conducted an observational in Hypertensive heart disease, dilated cardiomyopathy, and left bundle branch block (n=95). Hypertensive heart disease, DCM, and LBBB vs. Healthy volunteers was evaluated on Systolic radial and diastolic long-axis dyssynchrony (p=<0.01). Patients with hypertensive heart disease, DCM, or LBBB had significantly increased systolic radial and diastolic long-axis dyssynchrony compared to healthy controls (P<0.01).
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