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Assessment of diastolic function and atrial remodeling by MRI – validation and correlation with echocardiography and filling pressure

Seemann, Felicia LU ; Baldassarre, Lauren A.; Llanos-Chea, Fiorella; Gonzales, Ricardo A.; Grunseich, Karl; Hu, Chenxi; Sugeng, Lissa; Meadows, Judith; Heiberg, Einar LU and Peters, Dana C. (2018) In Physiological Reports 6(17).
Abstract

Atrial fibrosis can be estimated noninvasively by magnetic resonance imaging (MRI) using late gadolinium enhancement (LGE), but diastolic dysfunction is clinically assessed by transthoracic echocardiography (TTE), and rarely by MRI. This study aimed to evaluate well-established diastolic parameters using MRI, and validate them with TTE and left ventricular (LV) filling pressures, and to study the relationship between left atrial (LA) remodeling and parameters of diastolic function. The study retrospectively included 105 patients (53 ± 16 years, 39 females) who underwent 3D LGE MRI between 2012 and 2016. Medical charts were reviewed for the echocardiographic diastolic parameters E, A, and e′ by TTE, and pressure catheterizations. E and A... (More)

Atrial fibrosis can be estimated noninvasively by magnetic resonance imaging (MRI) using late gadolinium enhancement (LGE), but diastolic dysfunction is clinically assessed by transthoracic echocardiography (TTE), and rarely by MRI. This study aimed to evaluate well-established diastolic parameters using MRI, and validate them with TTE and left ventricular (LV) filling pressures, and to study the relationship between left atrial (LA) remodeling and parameters of diastolic function. The study retrospectively included 105 patients (53 ± 16 years, 39 females) who underwent 3D LGE MRI between 2012 and 2016. Medical charts were reviewed for the echocardiographic diastolic parameters E, A, and e′ by TTE, and pressure catheterizations. E and A were measured from in-plane phase-contrast cardiac MRI images, and e′ by feature-tracking, and validated with TTE. Interobserver and intraobserver variability was examined. Furthermore, LA volumes, function, and atrial LGE was correlated with diastolic parameters. Evaluation of e′ in MRI had strong agreement with TTE (r = 0.75, P < 0.0001), and low interobserver and intraobserver variability. E and A by TTE showed strong agreement to MRI (r = 0.77, P = 0.001; r = 0.73, P = 0.003, for E and A, respectively). Agreement between E/e′ by TTE and MRI was strong (r = 0.85, P = 0.0004), and E/e′ by TTE correlated moderately to invasive pressures (r = 0.59, P = 0.03). There was a strong relationship between LA LGE and pulmonary capillary wedge pressure (r = 0.81, P = 0.01). In conclusion, diastolic parameters can be measured with good reproducibility by cardiovascular MRI. LA LGE exhibited a strong relationship with pulmonary capillary wedge pressure, an indicator of diastolic function.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular magnetic resonance imaging, diastolic function, echocardiography, left atrial late gadolinium enhancement, left ventricular filling pressure
in
Physiological Reports
volume
6
issue
17
publisher
John Wiley & Sons
external identifiers
  • scopus:85053359464
ISSN
2051-817X
DOI
10.14814/phy2.13828
language
English
LU publication?
yes
id
e58a6e87-a70c-44e1-b916-30d1732ec4cd
date added to LUP
2018-10-12 12:45:18
date last changed
2018-10-13 03:00:03
@article{e58a6e87-a70c-44e1-b916-30d1732ec4cd,
  abstract     = {<p>Atrial fibrosis can be estimated noninvasively by magnetic resonance imaging (MRI) using late gadolinium enhancement (LGE), but diastolic dysfunction is clinically assessed by transthoracic echocardiography (TTE), and rarely by MRI. This study aimed to evaluate well-established diastolic parameters using MRI, and validate them with TTE and left ventricular (LV) filling pressures, and to study the relationship between left atrial (LA) remodeling and parameters of diastolic function. The study retrospectively included 105 patients (53 ± 16 years, 39 females) who underwent 3D LGE MRI between 2012 and 2016. Medical charts were reviewed for the echocardiographic diastolic parameters E, A, and e′ by TTE, and pressure catheterizations. E and A were measured from in-plane phase-contrast cardiac MRI images, and e′ by feature-tracking, and validated with TTE. Interobserver and intraobserver variability was examined. Furthermore, LA volumes, function, and atrial LGE was correlated with diastolic parameters. Evaluation of e′ in MRI had strong agreement with TTE (r = 0.75, P &lt; 0.0001), and low interobserver and intraobserver variability. E and A by TTE showed strong agreement to MRI (r = 0.77, P = 0.001; r = 0.73, P = 0.003, for E and A, respectively). Agreement between E/e′ by TTE and MRI was strong (r = 0.85, P = 0.0004), and E/e′ by TTE correlated moderately to invasive pressures (r = 0.59, P = 0.03). There was a strong relationship between LA LGE and pulmonary capillary wedge pressure (r = 0.81, P = 0.01). In conclusion, diastolic parameters can be measured with good reproducibility by cardiovascular MRI. LA LGE exhibited a strong relationship with pulmonary capillary wedge pressure, an indicator of diastolic function.</p>},
  articleno    = {e13828},
  author       = {Seemann, Felicia and Baldassarre, Lauren A. and Llanos-Chea, Fiorella and Gonzales, Ricardo A. and Grunseich, Karl and Hu, Chenxi and Sugeng, Lissa and Meadows, Judith and Heiberg, Einar and Peters, Dana C.},
  issn         = {2051-817X},
  keyword      = {Cardiovascular magnetic resonance imaging,diastolic function,echocardiography,left atrial late gadolinium enhancement,left ventricular filling pressure},
  language     = {eng},
  number       = {17},
  publisher    = {John Wiley & Sons},
  series       = {Physiological Reports},
  title        = {Assessment of diastolic function and atrial remodeling by MRI – validation and correlation with echocardiography and filling pressure},
  url          = {http://dx.doi.org/10.14814/phy2.13828},
  volume       = {6},
  year         = {2018},
}