Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance

Objectives: Transthoracic echocardiography (TTE) remains the mainstay diagnostic imaging tool for the assessment of diastolic dysfunction.However, velocity-encoded phase-contrast imaging permits evaluation with cardiac magnetic resonance (CMR) with excellent capabilities to assess blood flow and m...

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Main Authors:	Mohd Shah, Azarisman Shah, Mitra, Shirazi, Bradley, Julie Andrew, Teo, Karen S.L, Worthley, Matthew Ian, Worthley, Stephen Grant
Format:	Article
Language:	English English English
Published:	Acta Cardiologica 2016
Subjects:	RC Internal medicine
Online Access:	http://irep.iium.edu.my/50699/ http://irep.iium.edu.my/50699/ http://irep.iium.edu.my/50699/ http://irep.iium.edu.my/50699/1/50699_Assessment%20of%20diastolic.pdf http://irep.iium.edu.my/50699/2/50699_Assessment%20of%20diastolic_WOS.pdf http://irep.iium.edu.my/50699/3/50699_Assessment%20of%20diastolic_SCOPUS.pdf

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spelling	iium-506992017-01-17T02:47:13Z http://irep.iium.edu.my/50699/ Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance Mohd Shah, Azarisman Shah Mitra, Shirazi Bradley, Julie Andrew Teo, Karen S.L Worthley, Matthew Ian Worthley, Stephen Grant RC Internal medicine Objectives: Transthoracic echocardiography (TTE) remains the mainstay diagnostic imaging tool for the assessment of diastolic dysfunction.However, velocity-encoded phase-contrast imaging permits evaluation with cardiac magnetic resonance (CMR) with excellent capabilities to assess blood flow and myocardial tissue motion. We evaluated the feasibility of measuring mitral blood flow, mitral annular velocity and pulmonary vein flow in assessing diastolic dysfunction in acute coronary syndrome (ACS) patients. Methods: Revascularized acute myocardial infarction patients with normal left ventricular (LV) systolic function on TTE were assessed by 1.5T CMR.Following acquisition of regular short-axis cine volumetry and 2-, 3- and 4-chamber views, we performed single-slice velocity-encoded phase-contrast imaging in short-axis plane at the level of the mitral leaflet tips and in a plane perpendicular to a pulmonary vein. Early, late diastolic mitral inflow velocities, peak systolic, diastolic pulmonary vein velocities and myocardial annular velocities were determined. These were then compared to comparable TTE parameters. Results: Fourty-six patients were analyzed. Mean LVEF was 61.1±8.9%. Peak E and A velocities underestimated by CMR, E/A ratio showed a significant correlation with TTE, R2 0.51. Peak S and D velocities also underestimated, S/D ratio significantly correlated with TTE, R2 0.58. Paradoxically, E’ is overestimated by CMR, with lower E/E’ ratio but still significantly correlated with TTE, R2 0.55. Bland-Altman analysis demonstrated excellent agreement with excellent reproducibility. Conclusion: CMR evaluation of diastolic dysfunction post-ACS has significant correlation with TTE. Although velocity-encoded phase-contrast imaging underestimates inflow velocities, and overestimates the mitral annular velocity, velocity ratios are consistently correlated with Doppler echocardiography. Acta Cardiologica 2016-08 Article NonPeerReviewed application/pdf en http://irep.iium.edu.my/50699/1/50699_Assessment%20of%20diastolic.pdf application/pdf en http://irep.iium.edu.my/50699/2/50699_Assessment%20of%20diastolic_WOS.pdf application/pdf en http://irep.iium.edu.my/50699/3/50699_Assessment%20of%20diastolic_SCOPUS.pdf Mohd Shah, Azarisman Shah and Mitra, Shirazi and Bradley, Julie Andrew and Teo, Karen S.L and Worthley, Matthew Ian and Worthley, Stephen Grant (2016) Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance. Acta Cardiologica, 71 (4). pp. 425-434. ISSN 0001-5385 E-ISSN 1784-973X https://www.ncbi.nlm.nih.gov/pubmed/27594358 10.2143/AC.71.4.3159695
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English English English
topic	RC Internal medicine
spellingShingle	RC Internal medicine Mohd Shah, Azarisman Shah Mitra, Shirazi Bradley, Julie Andrew Teo, Karen S.L Worthley, Matthew Ian Worthley, Stephen Grant Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance
description	Objectives: Transthoracic echocardiography (TTE) remains the mainstay diagnostic imaging tool for the assessment of diastolic dysfunction.However, velocity-encoded phase-contrast imaging permits evaluation with cardiac magnetic resonance (CMR) with excellent capabilities to assess blood flow and myocardial tissue motion. We evaluated the feasibility of measuring mitral blood flow, mitral annular velocity and pulmonary vein flow in assessing diastolic dysfunction in acute coronary syndrome (ACS) patients. Methods: Revascularized acute myocardial infarction patients with normal left ventricular (LV) systolic function on TTE were assessed by 1.5T CMR.Following acquisition of regular short-axis cine volumetry and 2-, 3- and 4-chamber views, we performed single-slice velocity-encoded phase-contrast imaging in short-axis plane at the level of the mitral leaflet tips and in a plane perpendicular to a pulmonary vein. Early, late diastolic mitral inflow velocities, peak systolic, diastolic pulmonary vein velocities and myocardial annular velocities were determined. These were then compared to comparable TTE parameters. Results: Fourty-six patients were analyzed. Mean LVEF was 61.1±8.9%. Peak E and A velocities underestimated by CMR, E/A ratio showed a significant correlation with TTE, R2 0.51. Peak S and D velocities also underestimated, S/D ratio significantly correlated with TTE, R2 0.58. Paradoxically, E’ is overestimated by CMR, with lower E/E’ ratio but still significantly correlated with TTE, R2 0.55. Bland-Altman analysis demonstrated excellent agreement with excellent reproducibility. Conclusion: CMR evaluation of diastolic dysfunction post-ACS has significant correlation with TTE. Although velocity-encoded phase-contrast imaging underestimates inflow velocities, and overestimates the mitral annular velocity, velocity ratios are consistently correlated with Doppler echocardiography.
format	Article
author	Mohd Shah, Azarisman Shah Mitra, Shirazi Bradley, Julie Andrew Teo, Karen S.L Worthley, Matthew Ian Worthley, Stephen Grant
author_facet	Mohd Shah, Azarisman Shah Mitra, Shirazi Bradley, Julie Andrew Teo, Karen S.L Worthley, Matthew Ian Worthley, Stephen Grant
author_sort	Mohd Shah, Azarisman Shah
title	Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance
title_short	Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance
title_full	Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance
title_fullStr	Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance
title_full_unstemmed	Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance
title_sort	assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance
publisher	Acta Cardiologica
publishDate	2016
url	http://irep.iium.edu.my/50699/ http://irep.iium.edu.my/50699/ http://irep.iium.edu.my/50699/ http://irep.iium.edu.my/50699/1/50699_Assessment%20of%20diastolic.pdf http://irep.iium.edu.my/50699/2/50699_Assessment%20of%20diastolic_WOS.pdf http://irep.iium.edu.my/50699/3/50699_Assessment%20of%20diastolic_SCOPUS.pdf
first_indexed	2023-09-18T21:11:41Z
last_indexed	2023-09-18T21:11:41Z
_version_	1777411295015862272

Assessment of diastolic dysfunction in patients with acute coronary syndrome and preserved systolic function: comparison between Doppler transthoracic echocardiography and velocity-encoded cardiac magnetic resonance

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