Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance
<p>Abstract</p> <p>Objectives</p> <p>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).</p> <p>Bac...
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doaj-8a6b7dce65cd4e1e8baeff4f04f32eb12020-11-25T00:38:52ZengBMCJournal of Cardiovascular Magnetic Resonance1097-66471532-429X2010-07-011214610.1186/1532-429X-12-46Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonanceMendoza Dorinna DCodella Noel CFWang YiPrince Martin RSethi SoniaManoushagian Shant JKawaji KeigoMin James KLaBounty Troy MDevereux Richard BWeinsaft Jonathan W<p>Abstract</p> <p>Objectives</p> <p>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).</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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 (DVR<sub>80 </sub>- proportion of diastole required to recover 80% stroke volume). Echo was the reference for DD.</p> <p>Results</p> <p>LV-METRIC successfully generated LV filling curves in all patients. CMR indices were reproducible (≤ 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 DVR<sub>80 </sub>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 DVR<sub>80 </sub>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 DVR<sub>80 </sub>and PFR identified 53% of patients with grade 2 DD. Prolonged DVR<sub>80 </sub>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.</p> <p>Conclusions</p> <p>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.</p> http://www.jcmr-online.com/content/12/1/46 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mendoza Dorinna D Codella Noel CF Wang Yi Prince Martin R Sethi Sonia Manoushagian Shant J Kawaji Keigo Min James K LaBounty Troy M Devereux Richard B Weinsaft Jonathan W |
spellingShingle |
Mendoza Dorinna D Codella Noel CF Wang Yi Prince Martin R Sethi Sonia Manoushagian Shant J Kawaji Keigo Min James K LaBounty Troy M Devereux Richard B Weinsaft Jonathan W Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance Journal of Cardiovascular Magnetic Resonance |
author_facet |
Mendoza Dorinna D Codella Noel CF Wang Yi Prince Martin R Sethi Sonia Manoushagian Shant J Kawaji Keigo Min James K LaBounty Troy M Devereux Richard B Weinsaft Jonathan W |
author_sort |
Mendoza Dorinna D |
title |
Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance |
title_short |
Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance |
title_full |
Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance |
title_fullStr |
Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance |
title_full_unstemmed |
Impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance |
title_sort |
impact of diastolic dysfunction severity on global left ventricular volumetric filling - assessment by automated segmentation of routine cine cardiovascular magnetic resonance |
publisher |
BMC |
series |
Journal of Cardiovascular Magnetic Resonance |
issn |
1097-6647 1532-429X |
publishDate |
2010-07-01 |
description |
<p>Abstract</p> <p>Objectives</p> <p>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).</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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 (DVR<sub>80 </sub>- proportion of diastole required to recover 80% stroke volume). Echo was the reference for DD.</p> <p>Results</p> <p>LV-METRIC successfully generated LV filling curves in all patients. CMR indices were reproducible (≤ 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 DVR<sub>80 </sub>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 DVR<sub>80 </sub>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 DVR<sub>80 </sub>and PFR identified 53% of patients with grade 2 DD. Prolonged DVR<sub>80 </sub>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.</p> <p>Conclusions</p> <p>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.</p> |
url |
http://www.jcmr-online.com/content/12/1/46 |
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