Faculty Collaboration Database

The relationship between aortic stiffness and E/A filling ratio and myocardial strain in the context of left ventricular diastolic dysfunction in heart failure with normal ejection fraction: insights from magnetic resonance imaging. Magn Reson Imaging 2011 Nov;29(9):1222-34

Date

09/13/2011

Pubmed ID

21907518

DOI

10.1016/j.mri.2011.08.003

Scopus ID

2-s2.0-80054786405 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

The purpose of this study is to investigate the relationship between aortic stiffness and diastolic dysfunction in heart failure with normal ejection fraction (HFNEF) and compare the results to normal subjects using magnetic resonance imaging (MRI). Sixteen human subjects (eight HFNEF and eight volunteers) were scanned on a 3.0-T MRI system. Aortic stiffness was assessed using pulse wave velocity (PWV). Left ventricle (LV) diastolic function was assessed by the early/atrial (E/A) filling ratio and different myocardial strain components. The results showed that, in HFNEF, a major part of LV filling occurred later during the atrial filling phase. The E/A ratio was less than 1 in HFNEF and greater than 1 in volunteers. Left ventricular myocardial dynamic strain range (difference between end-diastolic and end-systolic strains) was reduced in HFNEF, with less relaxation (strain rate) during the diastolic phase. Aortic PWV was higher in HFNEF than in volunteers due to less vessel compliance. The E/A ratio and myocardial strain measurements showed inverse correlations with aortic stiffness in HFNEF. The resulting inter- and intraobserver variabilities showed no bias between repeated cardiovascular measurements. In conclusion, a comprehensive MRI exam was developed for assessing patients with HFNEF. Heart failure with normal EF is associated with impaired LV diastolic function and significant ventricular and aortic stiffening. The degree of aortic stiffness involvement suggests reduced aortic compliance as a major factor in HFNEF.

Author List

Ibrahim el-SH, Miller AB, White RD

MESH terms used to index this publication - Major topics in bold

Aged
Aorta
Case-Control Studies
Female
Heart
Heart Failure
Humans
Image Processing, Computer-Assisted
Magnetic Resonance Imaging
Male
Middle Aged
Models, Statistical
Myocardium
Observer Variation
Time Factors
Ventricular Dysfunction, Left