Non-tagged magnetic resonance longitudinal and volumetric diastolic strain rate for the evaluation of left ventricular filling pressures

Cardiovascular Aspects of Radiolog

Persistent microvascular obstruction-like lesion after ventricular tachycardia ablation detected by novel dark-blood late gadolinium enhancement

Microvascular obstruction is a transient phenomenon of "no reflow" after myocardial infarction or radiofrequency ablation, diagnosed using late gadolinium enhancement cardiac MRI. We present a patient with a persistent microvascular obstruction-like lesion following radiofrequency ventricular tachycardia ablation post-myocardial infarction, which was best characterized by a novel dark-blood late gadolinium enhancement technique

Feasibility of Diastolic Function Assessment With Cardiac CT Feasibility Study in Comparison With Tissue Doppler Imaging

OBJECTIVES This study aimed to demonstrate the feasibility of multidetector row computed tomography (CT) for assessment of diastolic function in comparison with 2-dimensional (2D) echocardiography using tissue Doppler imaging (TDI). BACKGROUND Diastolic left ventricular (LV) function plays an important role in patients with cardiovascular disease. 2D echocardiography using TDI has been used most commonly to evaluate diastolic LV function. Although the role of cardiac CT imaging for evaluation of coronary atherosclerosis has been explored extensively, its feasibility to evaluate diastolic function has not been studied. METHODS Patients who had undergone 64-multidetector row CT and 2D echocardiography with TDI were enrolled. Diastolic function was evaluated using early (E) and late (A) transmitral peak velocity (cm/s) and peak mitral septal tissue velocity (Ea; cm/s). Peak transmitral velocity (cm/s) was calculated by dividing peak diastolic transmitral flow (ml/s) by the corresponding mitral valve area (cm(2)). Mitral septal tissue velocity was calculated from changes in LV length per cardiac phase. Subsequently, the estimation of LV filling pressures (E/Ea) was determined. RESULTS Seventy patients (46 men; mean age 55 +/- 11 years) who had undergone cardiac CT and 2D echocardiography with TDI were included. Good correlations were observed between cardiac CT and 2D echocardiography for assessment of E (r = 0.73; p < 0.01), E/A (r = 0.87; p < 0.01), Ea (r = 0.82; p < 0.01), and E/Ea (r = 0.81; p < 0.01). Moreover, a good diagnostic accuracy (79%) was found for detection of diastolic dysfunction using cardiac CT. Finally, the study showed a low intraobserver and interobserver variability for assessment of diastolic function on cardiac CT. CONCLUSIONS Cardiac CT imaging showed good correlations for transmitral velocity, mitral septal tissue velocity, and estimation of LV filling pressures when compared with 2D echocardiography. Additionally, cardiac CT and 2D echocardiography were comparable for assessment of diastolic dysfunction. Accordingly, cardiac CT may provide information on diastolic dysfunction. (J Am Coll Cardiol Img 2011;4:246-56) (C) 2011 by the American College of Cardiology FoundationCardiovascular Aspects of Radiolog