Assessing diastolic function using CMR as an alternative to echocardiography: age- and gender-related normal reference values

Clinical Research in Cardiology, vol. 114, pp. 1641–1657

Abstract

Abstract Background Impaired diastolic function is associated with a variety of diseases such as myocarditis or dilated cardiomyopathy. Currently, echocardiography is the standard method for assessing diastolic function. Recently, it has been postulated that cardiovascular magnetic resonance (CMR) is an at least equivalent or superior alternative to echocardiography. To assess CMR-based age- and gender-dependent diastolic functional normal reference values, pulmonary venous and transmitral blood-flow parameters were examined in heart-healthy test persons. Methods and results Flow-sensitive phase-contrast CMR imaging was performed in the right upper pulmonary vein (RUPV) and at the level of the mitral valve (MV) in 183 healthy subjects (age 10–70 years; 97 women, 86 men). The data was distributed as evenly as possible across all groups. Strong age-dependence was observed for PV S/D; r = 0.718, p < 0.001 (Pearson product–moment correlation) and for transmitral MV E/A; ρ = −0.736, p < 0.001 (Spearman’s Rho correlation). Moderate age-dependence was found for PV slope D-wave; r = 0.394, p < 0.001. Except for MV slope E-wave (male −292 cm/s 2 interquartile range (IQR) {−338; −243} vs. female −319 ± 82 cm/s 2 ; p = 0.047), no gender-related differences were observed. In a subgroup ( N = 100), CMR data were compared with echocardiographic data. Strong correlation was found between CMR and echocardiography for PV S/D; r = 0.545, p < 0.001 and MV E/A; ρ = 0.692, p < 0.001. Conclusion Diastolic functional parameters change with age, while gender-differences are small. CMR and echocardiography showed similar PV S/D and MV E/A ratios, making CMR a promising alternative for assessing diastolic function. Graphical abstract

Authors 7

1. Lilly Charlotte Cirener

   Ruhr University Bochum · Heart and Diabetes Center North Rhine-Westphalia

   Affiliation as printed

   Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany

2. Hermann Körperich corresponding

   Ruhr University Bochum · Heart and Diabetes Center North Rhine-Westphalia

   Affiliation as printed

   Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany. hkoerperich@hdz-nrw.de

3. A. Racolta Aachen Clinic for Pediatric Cardiology Center for Congenital Heart Defects

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Clinic for Pediatric Cardiology, Center for Congenital Heart Defects, University Hospital RWTH Aachen, Aachen, Germany

4. Misagh Piran

   Ruhr University Bochum · Heart and Diabetes Center North Rhine-Westphalia

   Affiliation as printed

   Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany

5. Wolfgang Burchert

   Ruhr University Bochum · Heart and Diabetes Center North Rhine-Westphalia

   Affiliation as printed

   Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany

6. Oliver M. Weber

   Philips (Germany)

   Affiliation as printed

   Philips Clinical Science, Hamburg, Germany

7. Jan Eckstein

   Ruhr University Bochum · Heart and Diabetes Center North Rhine-Westphalia

   Affiliation as printed

   Institute for Radiology, Nuclear Medicine and Molecular Imaging, Heart and Diabetes Center North Rhine Westphalia, Ruhr-University of Bochum, Georgstr. 11, 32545, Bad Oeynhausen, Germany