Djeven Parameshvara Deva MBBCh, Presenter: Nothing to Disclose

Sebastian Ley MD, Abstract Co-Author: Nothing to Disclose

Laura Jimenez-Juan MD, Abstract Co-Author: Nothing to Disclose

Susan Helen James MD, Abstract Co-Author: Nothing to Disclose

Andrew Michael Dominic Crean MD, Abstract Co-Author: Nothing to Disclose

Elsie Nguyen MD, Abstract Co-Author: Nothing to Disclose

Rachel Wald MD, Abstract Co-Author: Nothing to Disclose

Harry Rakowski, Abstract Co-Author: Nothing to Disclose

Narinder S. Paul MD, Abstract Co-Author: Research support, Toshiba Corporation

Bernd J. Wintersperger MD, Abstract Co-Author: Speakers Bureau, Bayer AG Speakers Bureau, Siemens AG

To assess LV shortening using cine SSFP for differentiation between normal and abnormal long axis LV function.

40 HCM (23 asymmetric) patients underwent cardiac cine SSFP and late gadolinium enhancement (LGE) imaging at 1.5T (Magnetom Avanto). Cine SSFP images were acquired using a slice thickness of 6mm, in-plane resolution of 1.3-1.5x1.3-1.5mm2 and 40-45ms temporal resolution. Short axis stack LV volume analysis was performed using semi-automated post-processing (Syngo Argus) for end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF) and myocardial mass (MM). LV shortening (LVS) was manually assessed on 4-chamber acquisitions by measuring the distance between the midpoint of a line connecting the septal and lateral mitral valve annulus and the LV apex as well as between the septal and lateral mitral valve annulus and apex seperately at end-diastole (ED) and end-systole (ES). Results of LVS measurements were compared to those of 40 normal data sets (with matched BMI) and correlated with the presence of LGE in HCM patients.

While HCM patients showed a tendency to larger EDVi (88.0±18.7ml/m2 vs. 81.0±12.1ml/m2; P=0.053) there was no significant difference in ejection fraction (65.8±8.3% vs 65.6±5.1%; P=0.89). There is a significant negative correlation of the LV mass index and LVS (r=-0.61;P<0.001). HCM patients had significantly reduced LVS compared to normal subjects on absolute (10.8±4.2mm vs. 17.1±3.1mm; P<0.0001) and proportional (10.6±4.2% vs.17.4±3.1%;P<0.0001) values respectively. Patients with asymmetric septal HCM had better lateral wall LVS compared to patients with symmetric HCM (12.1±3.4% vs. 9.3±5.0%;P=0.049), but there was no difference in septal wall LVS (9.8±4.2% vs. 9.7±4.5%;P=0.93). LVS below 2SD of normal mean values (< 11.7%) had a sensitivity of 91% and a specificity of 11% for predicting presence of LGE in HCM patients. HCM patients with a LVS of < 9.3% (9.6mm) demonstrated LGE.

Impaired LV long axis function in HCM patients can be easily assessed on routine long axis cine SSFP techniques.

Routinely performed cardiac MR cine SSFP provides additional insights into LV long axis contractility In HCM and normal patients without need for dedicated MR imaging techniques.

Deva, D, Ley, S, Jimenez-Juan, L, James, S, Crean, A, Nguyen, E, Wald, R, Rakowski, H, Paul, N, Wintersperger, B, Left Ventricular Shortening Using Cine Steady-State Free Precession (SSFP) in Normal and Hypertrophic Cardiomyopathy Patients.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11009568.html