Artery Research

Volume 7, Issue 3-4, September 2013, Pages 161 - 162

1.2 ASSESSMENT OF DIASTOLIC FUNCTION IN PAEDIATRIC PATIENTS BY MEANS OF WAVE INTENSITY ANALYSIS DERIVED FROM CARDIOVASCULAR MAGNETIC RESONANCE IMAGING

Authors
G. Biglino1, 2, H. Ntsinjana1, 2, R. Chung2, S. Schievano1, 2, P. Ciliberti2, K.H. Parker3, A.M. Taylor1, 2
1Institute of Cardiovascular Science, University College London, London, United Kingdom
2Great Ormond Street Hospital for Children, London, United Kingdom
3Imperial College, London, United Kingdom
Available Online 11 November 2013.
DOI
10.1016/j.artres.2013.10.003How to use a DOI?
Abstract

Evaluating diastolic function in children remains a topic of clinical discussion and a gold standard measurement technique is still lacking. Wave intensity analysis can provide insight into ventricular filling mechanisms and ventriculo-vascular coupling, and it can be derived directly from cardiovascular magnetic resonance (CMR) imaging data, specifically from routine phase-contrast flow acquisitions, by defining wave intensity in terms of simultaneous changes of velocity and fractional changes of area. This method was applied to a group of 53 cases (12 healthy controls, 12 congenital aortic stenosis, 11 hypertrophic cardiomyopathy, 8 restrictive cardiomyopathy, 10 dilated cardiomyopathy). All patients also had full CMR and echocardiographic examinations. A new wave intensity parameter FCW/FEW was defined (=ratio of peak forward compression wave in early systole, typically associated with ventricular dP/dt, and peak forward expansion wave at end systole, associated with diastolic time constant τ) and compared with accepted indicators of diastolic dysfunction, i.e. left atrium area from CMR, E/A ratio, E/E’ ratio and E-wave deceleration time (DT) from echo. Differences between cohorts were firstly appreciated in terms of ejection fraction and aortic distensibility. Receiver operating characteristic (ROC) curves then revealed that FCW/FEW, LA area and E/E’ ratio were overall good, statistically significant discriminators between controls and patients with presumed compromised diastolic function, while E/A and DT failed to differentiate (Fig. 1, Table 1). This study proposes CMR-derived wave intensity analysis as an additional medium to non-invasively investigate diastolic function in children, contributing to a point of on-going clinical debate.

Parameter AUC p Value
FCW/FEW 0.881 <0.001*
LA area 0.846 0.001*
E/A 0.412 0.398
E/E 0.884 <0.001*
Dec time 0.380 0.247
Table 1

(AUC = area under the curve)

Open Access
This is an open access article distributed under the CC BY-NC license.

Journal
Artery Research
Volume-Issue
7 - 3-4
Pages
161 - 162
Publication Date
2013/11/11
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2013.10.003How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - G. Biglino
AU  - H. Ntsinjana
AU  - R. Chung
AU  - S. Schievano
AU  - P. Ciliberti
AU  - K.H. Parker
AU  - A.M. Taylor
PY  - 2013
DA  - 2013/11/11
TI  - 1.2 ASSESSMENT OF DIASTOLIC FUNCTION IN PAEDIATRIC PATIENTS BY MEANS OF WAVE INTENSITY ANALYSIS DERIVED FROM CARDIOVASCULAR MAGNETIC RESONANCE IMAGING
JO  - Artery Research
SP  - 161
EP  - 162
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.003
DO  - 10.1016/j.artres.2013.10.003
ID  - Biglino2013
ER  -