Myocardial dysfunction in patients with aortic stenosis and hypertensive heart disease assessed by MR tissue phase mapping.

von Knobelsdorff-Brenkenhoff, Florian; Hennig, Pierre; Menza, Marius; Dieringer, Matthias A; Foell, Daniela; Jung, Bernd; Schulz-Menger, Jeanette (2016). Myocardial dysfunction in patients with aortic stenosis and hypertensive heart disease assessed by MR tissue phase mapping. Journal of magnetic resonance imaging, 44(1), pp. 168-177. Wiley 10.1002/jmri.25125

[img] Text
Knobelsdorff-Brenkenhoff_et_al-2016-Journal_of_Magnetic_Resonance_Imaging.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (590kB) | Request a copy

PURPOSE To identify abnormalities of myocardial velocities in patients with left ventricular pressure overload using magnetic resonance tissue phase mapping (TPM). MATERIAL AND METHODS Thirty-three patients (nine with hypertensive heart disease [HYP], 24 with aortic stenosis [AS]) and 41 healthy controls were enrolled. To assess left ventricular motion, a basal, midventricular, and apical slice were acquired using three-directional velocity-encoded phase-contrast MR with a 3T system. Target parameters were peak longitudinal (Vz ) and radial (Vr ) velocity in systole and diastole (Peaksys , Peakdias ). Analysis was done on each myocardial segment. In a subgroup (n = 7 HYP, n = 12 AS, n = 24 controls), measurement was repeated during handgrip exercise. RESULTS AS had significantly lower Vz -Peaksys in the inferolateral and inferoseptal wall (P = 0.003-0.029) and Vr -Peaksys in the septum and anterior wall (P = 0.001-0.013) than controls. Vz -Peakdias and Vr -Peakdias were lower in AS than in controls in almost all segments (P < 0.001-0.028). HYP showed reduced Vz -Peakdias compared to controls in all basal segments as well as in the lateral midventricular wall (P < 0.001-0.045), and reduced Vr -Peakdias compared to controls predominantly in the midventricular and apical segments (P = 0.004-0.042). AS patients with focal fibrosis had significantly reduced myocardial velocities (P = 0.001-0.047) in segments without late enhancement. During exercise, Vz -Peaksys , Vr -Peaksys , and Vz -Peakdias remained unchanged in AS and HYP, but decreased in the lateral wall in controls (P < 0.001-0.043). CONCLUSION Even with preserved left ventricle (LV) ejection fraction, peak longitudinal and radial velocities of the LV are reduced in AS and HYP, indicating early functional impairment. J. Magn. Reson. Imaging 2016;44:168-177.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Jung, Bernd

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1053-1807

Publisher:

Wiley

Language:

English

Submitter:

Karin Hofmann

Date Deposited:

19 Apr 2017 16:19

Last Modified:

19 Apr 2017 16:19

Publisher DOI:

10.1002/jmri.25125

PubMed ID:

26687082

Uncontrolled Keywords:

aortic stenosis; exercise; hypertension; magnetic resonance; myocardial deformation

BORIS DOI:

10.7892/boris.94115

URI:

https://boris.unibe.ch/id/eprint/94115

Actions (login required)

Edit item Edit item
Provide Feedback