Sharath Bhagavatula BS, Presenter: Nothing to Disclose

Sohae Chung PhD, Abstract Co-Author: Nothing to Disclose

Shahryar Saba MD, Abstract Co-Author: Nothing to Disclose

Robert Donnino MD, Abstract Co-Author: Nothing to Disclose

Monvadi B. Srichai MD, Abstract Co-Author: Nothing to Disclose

Leon Axel MD, PhD, Abstract Co-Author: Nothing to Disclose

We aim to assess cardiac diastolic function by three-dimensional volume tracking of the atrioventricular junction (AVJ) over the cardiac cycle with cine MRI.

Conventional cardiac cine MRI with electrocardiogram gating was performed on 18 normal volunteers (35.8 +/- 12.8 years old), using 3T MRI systems (Tim Trio, Siemens). We retrospectively evaluated 32 patients with known hypertrophic cardiomyopathy (HCM) (45.9 +/- 9.9 years old) and 10 heart failure patients with normal ejection fraction (HFNEF) (69.3 +/- 15.8 years old). All subjects chosen had normal ejection fraction. Images were obtained in 2-, 3-, and 4-chamber views with the following parameters: TR/TE=2.4/1.4ms, temporal resolution=37-63ms, flip angle=51°, in-plane resolution=1.4mm×1.4mm-1.8mmx1.8mm, slice thickness=6mm, receiver bandwidth=930Hz/pixel. The AVJ position was manually tracked over the cardiac cycle in each view. A 3D representation of the AVJ plane was created from the tracked AVJ positions in all three views, and the volume swept by the AVJ plane was calculated. Changes in AVJ sweep volumes (ΔV) were measured during three phases of diastole: early diastole, diastasis, and late diastole. Mean and standard deviation ΔV were calculated and paired t-tests were performed to compare the normal group and the patient groups.

The ΔV for the normal group were: (a) early diastole: 9.23 +/- 2.79 cm3; (b) diastasis: 0.669 +/- 0.432 cm3; (c) late diastole: 3.76 +/- 0.951 cm3. HCM ΔV and comparison with normal were: (a) early diastole: 6.79 +/- 2.65 cm3, p=.024; (b) diastasis: 1.43 +/- 1.06 cm3, p=0.018; (c) late diastole: 3.69 +/- 1.75 cm3, p=.702. HFNEF ΔV and comparison with normal were: (a) early diastole: 2.22 +/- 1.61 cm3, p=.00014; (b) diastasis: 2.46 +/- 2.22 cm3, p=0.042; (c) late diastole: 2.12 +/- 1.19 cm3, p=.0072. HCM and HFNEF ΔV comparison results were: (a) early diastole: p=.0153; (b) diastasis: p=0.4055; (c) late diastole: p=.0114.

Normal subjects, HCM patients, and HFNEF patients had different AVJ sweep volume profiles during diastole.

Atrioventricular junction (AVJ) volume tracking provides a new noninvasive way to assess cardiac diastolic behavior, with potential to differentiate various causes of diastolic dysfunction.

Bhagavatula, S, Chung, S, Saba, S, Donnino, R, Srichai, M, Axel, L, Assessing Cardiac Diastolic Function with Cine MRI: Three-Dimensional Volume Tracking of Atrioventricular Junction Motion.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12024667.html