Diastolic dysfunction evaluation by cardiovascular magnetic resonance derived E, a, e': Comparison to echocardiography.

Abstract

Transthoracic echocardiography (TTE) is the first-line and most useful imaging modality for evaluating diastolic dysfunction (DD). Cardiovascular magnetic resonance (CMR) has not been fully evaluated for this task. We investigated the utility of CMR for DD evaluation.Thirty-one patients with a recent TTE (within 4 months) were prospectively enrolled, along with 12 healthy age-matched subjects. CMR imaging was performed at 1.5 T to assess diastolic function by quantifying mitral inflow velocities (E and A), mitral annular velocities (e'), and left atrial volume (LAVi). Measurements by TTE and CMR were compared using regression. The diagnostic accuracy of CMR for DD was determined.CMR derived E, A, E/A, e' and E/e' all correlated moderately to strongly with TTE, and more strongly when comparing studies performed closer in time (E: r = 0.68, E deceleration time: r = 0.82, A: r = 0.78, e' r = 0.75, E/e': r = 0.80, p = 0.001; LAVi: r = 0.79, p < 0.001; E/A: r = 0.82, p < 0.001, n = 14 within 45 days). Using CMR criteria analogous to TTE, there was 82% (23/28) agreement regarding the presence of DD (95% CI [63 to 93%]), with 100% sensitivity and 75% specificity, and 71% (20/28) agreement in the absolute DD grade.CMR can evaluate diastolic function, with overall strong agreement to TTE.