Journal article
Non-invasive intraventricular pressure differences estimated with cardiac MRI in subjects without heart failure and with heart failure with reduced and preserved ejection fraction
Open heart, Vol.6(2), p.e001088
10/01/2019
DOI: 10.1136/openhrt-2019-001088
PMCID: PMC6802988
PMID: 31673389
Abstract
Objective Non-invasive assessment of left ventricular (LV) diastolic and systolic function is important to better understand physiological abnormalities in heart failure (HF). The spatiotemporal pattern of LV blood flow velocities during systole and diastole can be used to estimate intraventricular pressure differences (IVPDs). We aimed to demonstrate the feasibility of an MRI-based method to calculate systolic and diastolic IVPDs in subjects without heart failure (No-HF), and with HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF).
Methods We studied 159 subjects without HF, 47 subjects with HFrEF and 32 subjects with HFpEF. Diastolic and systolic intraventricular flow was measured using two-dimensional in-plane phase-contrast MRI. The Euler equation was solved to compute IVPDs in diastole (mitral base to apex) and systole (apex to LV outflow tract).
Results Subjects with HFpEF demonstrated a higher magnitude of the early diastolic reversal of IVPDs (-1.30 mm Hg) compared with the No-HF group (-0.78 mm Hg) and the HFrEF group (-0.75 mm Hg; analysis of variance p=0.01). These differences persisted after adjustment for clinical variables, Doppler-echocardiographic parameters of diastolic filling and measures of LV structure (No-HF=-0.72; HFrEF=-0.87; HFpEF=-1.52 mm Hg; p=0.006). No significant differences in systolic IVPDs were found in adjusted models. IVPD parameters demonstrated only weak correlations with standard Doppler-echocardiographic parameters.
Conclusions Our findings suggest distinct patterns of systolic and diastolic IVPDs in HFpEF and HFrEF, implying differences in the nature of diastolic dysfunction between the HF subtypes.
Details
- Title: Subtitle
- Non-invasive intraventricular pressure differences estimated with cardiac MRI in subjects without heart failure and with heart failure with reduced and preserved ejection fraction
- Creators
- Francisco Londono-Hoyos - Hospital of the University of PennsylvaniaPatrick Segers - Ghent UniversityZeba Hashmath - Hospital of the University of PennsylvaniaGarrett Oldland - Philadelphia VA Medical CenterMaheshwara Reddy Koppula - Hospital of the University of PennsylvaniaKhuzaima Javaid - Philadelphia VA Medical CenterRachana Miller - Philadelphia VA Medical CenterRushikkumar Bhuva - Hospital of the University of PennsylvaniaIzzah Vasim - Philadelphia VA Medical CenterAli Tariq - Philadelphia VA Medical CenterWalter Witschey - Hospital of the University of PennsylvaniaScott Akers - Philadelphia VA Medical CenterJulio Alonso Chirinos - Hospital of the University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- Open heart, Vol.6(2), p.e001088
- DOI
- 10.1136/openhrt-2019-001088
- PMID
- 31673389
- PMCID
- PMC6802988
- NLM abbreviation
- Open Heart
- ISSN
- 2053-3624
- eISSN
- 2053-3624
- Publisher
- Bmj Publishing Group
- Number of pages
- 9
- Grant note
- R01HL137984 / National Heart Lung and Blood Institute; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Heart Lung & Blood Institute (NHLBI) VISN-4 research grant from the Department of Veterans Affairs R56HL-124073-01A1; R01 HL 121510-01A1; 5-R21-AG-043802-02 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 10/01/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985221144202771
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