1.2 ASSESSMENT OF DIASTOLIC FUNCTION IN PAEDIATRIC PATIENTS BY MEANS OF WAVE INTENSITY ANALYSIS DERIVED FROM CARDIOVASCULAR MAGNETIC RESONANCE IMAGING

DOI

10.1016/j.artres.2013.10.003How to use a DOI?

Abstract

Evaluating diastolic function in children remains a topic of clinical discussion and a gold standard measurement technique is still lacking. Wave intensity analysis can provide insight into ventricular filling mechanisms and ventriculo-vascular coupling, and it can be derived directly from cardiovascular magnetic resonance (CMR) imaging data, specifically from routine phase-contrast flow acquisitions, by defining wave intensity in terms of simultaneous changes of velocity and fractional changes of area. This method was applied to a group of 53 cases (12 healthy controls, 12 congenital aortic stenosis, 11 hypertrophic cardiomyopathy, 8 restrictive cardiomyopathy, 10 dilated cardiomyopathy). All patients also had full CMR and echocardiographic examinations. A new wave intensity parameter FCW/FEW was defined (=ratio of peak forward compression wave in early systole, typically associated with ventricular dP/dt, and peak forward expansion wave at end systole, associated with diastolic time constant τ) and compared with accepted indicators of diastolic dysfunction, i.e. left atrium area from CMR, E/A ratio, E/E’ ratio and E-wave deceleration time (DT) from echo. Differences between cohorts were firstly appreciated in terms of ejection fraction and aortic distensibility. Receiver operating characteristic (ROC) curves then revealed that FCW/FEW, LA area and E/E’ ratio were overall good, statistically significant discriminators between controls and patients with presumed compromised diastolic function, while E/A and DT failed to differentiate (Fig. 1, Table 1). This study proposes CMR-derived wave intensity analysis as an additional medium to non-invasively investigate diastolic function in children, contributing to a point of on-going clinical debate.

Parameter	AUC	p Value
FCW/FEW	0.881	<0.001*
LA area	0.846	0.001*
E/A	0.412	0.398
E/E’	0.884	<0.001*
Dec time	0.380	0.247

Table 1

(AUC = area under the curve)

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TY  - JOUR
AU  - G. Biglino
AU  - H. Ntsinjana
AU  - R. Chung
AU  - S. Schievano
AU  - P. Ciliberti
AU  - K.H. Parker
AU  - A.M. Taylor
PY  - 2013
DA  - 2013/11/11
TI  - 1.2 ASSESSMENT OF DIASTOLIC FUNCTION IN PAEDIATRIC PATIENTS BY MEANS OF WAVE INTENSITY ANALYSIS DERIVED FROM CARDIOVASCULAR MAGNETIC RESONANCE IMAGING
JO  - Artery Research
SP  - 161
EP  - 162
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.003
DO  - 10.1016/j.artres.2013.10.003
ID  - Biglino2013
ER  -