Abstract
Objectives
The aim of this study was the evaluation of left ventricular (LV) segmental 3D velocities in patients with hypertensive heart disease using magnetic resonance (MR) tissue phase mapping (TPM).
Methods
LV radial, long-axis and rotational myocardial velocities were assessed by TPM in patients with LV hypertrophy and preserved EF (n = 18, age = 53 ± 12 years) and volunteers (n = 20, age = 51 ± 4 years). Systolic and diastolic peak and time-to-peak velocities were mapped onto a 16-segment LV model. 3D myocardial motion was displayed on an extended visualisation model. Correlation coefficients were calculated to investigate differences in regional dynamics.
Results
Patients revealed diastolic dysfunction as expressed by decreased peak long-axis velocities in all (except apical) segments (basal, P ≤ 0.01; two midventricular segments, P = 0.02, P = 0.03). During systole, hypertrophy was associated with heterogeneous behaviour for long-axis velocities including an increase in anteroseptal apical and midventricular regions (P = 0.001), a reduction in mid-inferior segments (P = 0.03) and enhanced septal velocities (P < 0.05). Segmental correlation analysis revealed altered dynamics of LV base rotation and increased dyssynchrony of lateral long-axis motion.
Conclusions
Patients with hypertensive heart disease demonstrated alterations in systolic long-axis motion, basal rotation and dyssynchrony. Longitudinal studies are needed to investigate the value of regional wall motion abnormalities regarding disease progression and outcome.
Key Points
• Magnetic resonance tissue phase mapping enables segmental evaluation of 3D myocardial velocities.
• Patients with hypertensive heart disease demonstrated new alterations in systolic long-axis motion.
• Correlation analysis revealed left ventricular long-axis dyssynchrony and an altered rotation.
• MR may provide new, sensitive diagnostic markers concerning hypertensive heart disease.
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Abbreviations
- BNP:
-
Brain natriuretic peptide
- CC:
-
Correlation coefficient
- EF:
-
Ejection fraction
- LV:
-
Left ventricle left ventricular
- MRI:
-
Magnetic resonance imaging
- TPM:
-
Tissue phase mapping
- TTP:
-
Time to peak
- 3D:
-
3-Dimensional
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Acknowledgments
Michael Markl is supported by the NMH Excellence in Academic Medicine (EAM) Program ‘Advanced Cardiovascular MRI Research Center'. Daniela Föll is supported by the Deutsche Forschungsgemeinschaft (DFG; grant no. FO 507/2-1, FO 507/3-1)
Data from this cohort have been published previously [see references 14, 16, 17]. For this study a new retrospective analysis and visualisation of regional myocardial velocities as well as segmental correlation analysis were performed.
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Foell, D., Jung, B., Germann, E. et al. Hypertensive heart disease: MR tissue phase mapping reveals altered left ventricular rotation and regional myocardial long-axis velocities. Eur Radiol 23, 339–347 (2013). https://doi.org/10.1007/s00330-012-2613-0
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DOI: https://doi.org/10.1007/s00330-012-2613-0