Key result
4D flow CMR reliably quantifies RV diastolic function noninvasively through intracavity flow energetics and vorticity.
Why the study?
The literature on 4D flow CMR methods used to determine right ventricular diastolic function had not been systematically summarised.
Can 4D flow cardiovascular magnetic resonance (CMR) methods quantify and assess right ventricular diastolic function in adult humans?
Systematic Review
No
Can 4D flow cardiovascular magnetic resonance (CMR) methods quantify and assess right ventricular diastolic function in adult humans?
This systematic review demonstrates that 4D flow CMR (particularly intracavity blood flow kinetic energy and vorticity analysis) is a promising noninvasive tool for quantifying right ventricular diastolic dysfunction, though larger multicenter validation studies are required before routine clinical adoption.
Answers are grounded in this paper and cite their sources.
Supports 4D flow CMR for noninvasive RV diastolic assessment; leaves open routine adoption pending larger validation studies.
Background . Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) is a noninvasive novel imaging technology that can be used to visualise and assess right ventricular function. The aim of this systematic review is to summarise the literature available on 4D flow CMR methods used to determine right ventricular diastolic function. Methods . A systematic review of current literature was carried out to ascertain what is known about right ventricular assessment by quantification of 4D flow CMR. Structured searches were carried out on Medline and EMBASE in December 2018. PG and NB screened the titles and abstracts for relevance. Results . Of the 20 articles screened, 5 studies met eligibility for systematic review. After a further search on pubmed 1 more relevant article was found and added to the review. Conclusions . These proposed methods using 4D flow CMR can quantify right ventricular diastolic assessment. The evidence gathered is mainly observational, featuring single-centred studies. Larger, multicentre studies are required to validate the proposed techniques, evaluate reproducibility, and investigate the clinical applicability that 4D flow CMR offers compared to standard practices. PROSPERO registration number is CRD42019121492 .
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Barker et al. (2019) conducted a systematic review in Right ventricular diastolic function / right ventricular diastolic dysfunction (RVDD). Four-dimensional flow cardiovascular magnetic resonance (4D flow CMR) vs. Standard imaging practices (e.g., echocardiography, 2D phase-contrast MRI) or healthy controls was evaluated on Quantification of right ventricular diastolic function via 4D flow CMR methods (intracavity blood flow kinetic energy, pathline visualization of direct flow, and vorticity). Four-dimensional flow CMR methods—primarily intracavity blood flow energetics and vorticity—can noninvasively quantify right ventricular diastolic function across 6 included observational studies.
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