Bosmans, Johan M

Lamb, Hildo J

Paelinck, Bernard P

Van Herck, Paul L

Vrints, Christiaan J

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PubMed

Vrints Christiaan J

Bosmans Johan M

Van Herck Paul L

Paelinck Bernard P

Lamb Hildo J

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Journal of Cardiovascular Magnetic Resonance

Non-invasive estimation of increased LV filling pressures in LV hypertrophy with normal systolic function: Comparison between CMR and Doppler, validated by invasive PCWP measurements

Bernard P Paelinck

Paul L Van Herck

Johan M Bosmans

Christiaan J Vrints

Hildo J Lamb

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ORAL PRESENTATION Open AccessNon-invasive estimation of increased LV fillingpressures in LV hypertrophy with normal systolicfunction: Comparison between CMR and Doppler,validated by invasive PCWP measurementsBernard P Paelinck1*, Paul L Van Herck1, Johan M Bosmans1, Christiaan J Vrints1, Hildo J Lamb2From 2011 SCMR/Euro CMR Joint Scientific SessionsNice, France. 3-6 February 2011IntroductionTransmitral flow is unreliable for the estimation of leftventricular (LV) filling pressures in hypertrophy andnormal systolic function. Mitral early peak filling velo-city E divided by mitral annulus early peak velocity Ea(E/Ea) and global diastolic strain rate (SR) during peakfilling provide a relatively load independent measure-ment of global myocardial performance.PurposeWe aimed to compare Doppler and cardiovascular mag-netic resonance (CMR) assessed E/Ea and non-taggedCMR assessed global diastolic SR for the estimation of fill-ing pressure, in comparison with invasive measurement.MethodsSixteen patients with hypertensive heart disease (LV massindex: 111 ± 18 g/m2), absence of valvular regurgitationand with normal systolic function (LV ejection fraction:67 ± 7 %) referred for cardiac catheterization were studied.Measurement of mitral flow and mitral annulus velocitieswere performed by Doppler and phase-contrast CMR.CMR derived global longitudinal and global volumetric SRduring early peak filling was measured using long-axiscine CMR images. These data were validated by catheterbased mean pulmonary capillary wedge pressure (PCWP).ResultsMitral flow E/A had no significant correlation withmean PCWP. E/Ea (Doppler r= 0.74, p<0.01 and CMRr=0.56, p<0.05), longitudinal diastolic SR (r=0.65,p<0.01) and long-axis volumetric diastolic SR (r=0.51,p<0.05) related to invasively measured mean PCWP.Best prediction of elevated mean PCWP was per-formed by Doppler assessed E/Ea (sensitivity 75%, speci-ficity: 100%, area under the curve: 0.88, p<0,05). CMRassessed E/Ea, longitudinal volumetric diastolic SR andlong-axis volumetric diastolic SR had similar sensitivity(respectively 75%, 87.5 % and 75 %), specificity (respec-tively 75%, 62.5 % and 87.5 %) and area under the curve(respectively 0.80, 0.80 and 0.80, p<0.05) for the predic-tion of elevated mean PCWP.ConclusionsNon-invasive estimation of increased LV filling pres-sures in LV hypertrophy with normal systolic functioncan be performed with CMR and Doppler techniques.Doppler assessed E/Ea provided best prediction of ele-vated LV filling pressure.Author details1University Hospital Antwerp, Edegem, Belgium. 2Leiden University MedicalCenter, Leiden, Netherlands.Published: 2 February 2011doi:10.1186/1532-429X-13-S1-O34Cite this article as: Paelinck et al.: Non-invasive estimation of increasedLV filling pressures in LV hypertrophy with normal systolic function:Comparison between CMR and Doppler, validated by invasive PCWPmeasurements. Journal of Cardiovascular Magnetic Resonance 2011 13(Suppl 1):O34.1University Hospital Antwerp, Edegem, BelgiumFull list of author information is available at the end of the articlePaelinck et al. Journal of Cardiovascular Magnetic Resonance 2011, 13(Suppl 1):O34http://jcmr-online.com/content/13/S1/O34© 2011 Paelinck et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative CommonsAttribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly cited.

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Non-invasive estimation of increased LV filling pressures in LV hypertrophy with normal systolic function: Comparison between CMR and Doppler, validated by invasive PCWP measurements

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