Young Jin Kim MD, Abstract Co-Author: Nothing to Disclose

Eun Jeong Choi MD, Presenter: Nothing to Disclose

Jae Seung Seo, Abstract Co-Author: Nothing to Disclose

Byoung Wook Choi MD, Abstract Co-Author: Nothing to Disclose

Tae Hoon Kim, Abstract Co-Author: Nothing to Disclose

Kyu Ok Choe MD, Abstract Co-Author: Nothing to Disclose

Ji-Eun Nam MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

In the assessment of diastolic dysfunction, mitral flow velocity data by velocity encoded magnetic resonance (VE-MR) is comparable to echocardiography(Echo). However, it is difficult to differentiate pseudonormalization from normal pattern by mitral flow velocity, because mitral flow velocity is preload-dependent. We hypothesized that VE-MR during Valsalva maneuver and tissue velocity MR could discriminate pseudonormalization from normal pattern.

A total 53 subjects (42 male, 57 ±13 years) underwent VE-MR after Echo. Routine breath-hold VE-MR for mitral flow velocity was obtained at the level of tip of mitral valve (TR/TE/FA=5.3/3.0/15,128x256, 40 phase/cardiac cycle, VENC=100cm/sec. SENSE factor=2). Valsalva VE-MR was acquired at the same level during Valsalva maneuver. Tissue velocity MR was obtained at the same level (VENC=50cm/sec) and tissue velocity was measured in the posterior basal septum. Peak E, A, E', and A’ wave velocities were measured. Pattern of diastolic dysfunction (normal, relaxation abnormality, pseudonormalization, and restrictive physiology) was analyzed by VE-MR and compared with echocardiography as a gold standard.

Image acquisition time was less than 25 seconds in each sequence (routine, Valsalva, tissue). E and A velocities by VE-MR were somewhat lower than Echo, but well correlated (E, r=0.67, p<0.0001; A, r= 0.58, p<0.0001; E/A, r=0.58, p<0.0001). Based on routine VE-MR data, 30 patients were normal pattern, 21 were relaxation abnormality and 2 were restrictive physiology. Among the 30 patients showing normal pattern on routine VE-MR, conclusion of 21 patients was changed from normal pattern to pseudonormalization, who demonstrated reversal of E/A ratio on Valsalva VE-MR or reversed pattern of E’ and A’ on tissue velocity. Pattern of diastolic dysfunction by VE-MR was mismatched with Echo in 8 patients, however, 5 of whom were pseudonormalization pattern by VE-MR and relaxation abnormality by Echo.

In the evaluation of diastolic dysfunction, VE-MR during Valsalva and tissue velocity MR are useful methods to differentiate pseudonormalization from normal pattern.

In the assessment of diastolic dysfunction, mitral flow velocity data by velocity encoded magnetic resonance (VE-MR) is comparable to echocardiography(Echo). However, it is difficult to differentiate pseudonormalization from normal pattern by mitral flow velocity, because mitral flow velocity is preload-dependent. We hypothesized that VE-MR during Valsalva maneuver and tissue velocity MR could discriminate pseudonormalization from normal pattern.

A total 53 subjects (42 male, 57 ±13 years) underwent VE-MR after Echo. Routine breath-hold VE-MR for mitral flow velocity was obtained at the level of tip of mitral valve (TR/TE/FA=5.3/3.0/15,128x256, 40 phase/cardiac cycle, VENC=100cm/sec. SENSE factor=2). Valsalva VE-MR was acquired at the same level during Valsalva maneuver. Tissue velocity MR was obtained at the same level (VENC=50cm/sec) and tissue velocity was measured in the posterior basal septum. Peak E, A, E', and A’ wave velocities were measured. Pattern of diastolic dysfunction (normal, relaxation abnormality, pseudonormalization, and restrictive physiology) was analyzed by VE-MR and compared with echocardiography as a gold standard.

Image acquisition time was less than 25 seconds in each sequence (routine, Valsalva, tissue). E and A velocities by VE-MR were somewhat lower than Echo, but well correlated (E, r=0.67, p<0.0001; A, r= 0.58, p<0.0001; E/A, r=0.58, p<0.0001). Based on routine VE-MR data, 30 patients were normal pattern, 21 were relaxation abnormality and 2 were restrictive physiology. Among the 30 patients showing normal pattern on routine VE-MR, conclusion of 21 patients was changed from normal pattern to pseudonormalization, who demonstrated reversal of E/A ratio on Valsalva VE-MR or reversed pattern of E’ and A’ on tissue velocity. Pattern of diastolic dysfunction by VE-MR was mismatched with Echo in 8 patients, however, 5 of whom were pseudonormalization pattern by VE-MR and relaxation abnormality by Echo.

In the evaluation of diastolic dysfunction, VE-MR during Valsalva and tissue velocity MR are useful methods to differentiate pseudonormalization from normal pattern.

Kim, Y, Choi, E, Seo, J, Choi, B, Kim, T, Choe, K, Nam, J, et al, , Assessment of Diastolic Dysfunction: Usefulness of Velocity Encoded MR during Valsalva Maneuver and Tissue Velocity MR.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4413410.html