Osama Gomaa MD, Presenter: Nothing to Disclose

Charif Abdelrahman Sidani MD, Abstract Co-Author: Nothing to Disclose

Shabbir Hashimbhai Ezuddin MD, Abstract Co-Author: Nothing to Disclose

Eckart Fleck MD, Abstract Co-Author: Nothing to Disclose

Eike Nagel, Abstract Co-Author: Nothing to Disclose

Non-invasive assessment of diastolic changes in left ventricular hypertrophic disorders wether idiopathic or secondary is limited in the routine clinical practice on the assessment of 2 points of the cardiac cycle the end diastolic and end systolic volumes with the estimation only of the ejection fraction (EF).  We hypothesised that the use of 3D MRI VTCs on the other hand offers continuous quanitative information of cardiac performance throughout  the whole cardiac cycle for the assessment of diastolic function. 

10 control (9male, 31±7years), 15 idiopathic hypertrophic cardiomyopathy (12male, 41±16years) and 9 secondary hypertrophic cardiomyopathy (6male, 58±13years) were examined in 3 short axis slices (apical, mid cavity and basal) and 2 long axis slices (4 and 2chambers) each with 25 phases with retrospective gating to cover the whole cardiac cycle. All examinations were performed with a Philips ACS NT 1.5 T scanner using dedicated cardiac coil. Endo contour were automatically  traced with exclusion of papillary muscle whenever found.  VTCs  were generated from the short axis and the area in long axes. Different volumetric and stage changes in the diastolic phase were recorded where time changes expressed in the term of percentage of the diastolic phase time. Tri-plane cardiac model was used to create complete 3D cardiac model from the short and long axes. All results were expressed in term of mean ± standard deviation and P value <0.05 was considered statistically significant.

Using the fixed 2 point method in evaluating the LVF function there was only statistical significance in the EF in the 1ry LVH. In the 3D VTC volumetric data there were statistically significant increase in the late atrial filling and reduction in early ventricular filling and early ventricular /late atrial filling ratio .In the VTC time data there were significant prolongation of time to peak filling and atrial filling time and there were significant shortening in the diastasis period and the early ventricular/atrial filling time ration as shown in the table.

3D MRI VTCs provides more detailed quantitative volumetric and time data on the diastolic performance beyond ejection fraction offered by 2 point static method in left ventricular hypertrophy disorder.

Complete quantification of cardiac cycle changes using MRI  3D VTCs  is better reliable method  than evaluation of ejection fraction alone. 

Gomaa, O, Sidani, C, Ezuddin, S, Fleck, E, Nagel, E, 3D Quantification of Diastolic Function in Left Ventricular Hypertrophy Patients Using MRI Automatic Tracking Ventricular and Atrial Volume Time Curves (VTCs): A Better Tool than Two Fixed Points Measurements in the Evaluation of the Cardiac Cycle.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11000856.html