Intraventricular 4D flow cardiovascular magnetic resonance for assessing patients with heart failure with preserved ejection fraction: a pilot study.

Autor: Kwan CT; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Ching OHS; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Yap PM; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Fung SY; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Tang HS; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Tse WWV; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Kwan CNF; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Chow YHP; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Yiu NC; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Lee YP; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Lau JWK; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Fong AHT; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Ren QW; Division of Cardiology, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong., Wu MZ; Division of Cardiology, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong., Wan EYF; Department of Family Medicine and Primary Care, The University of Hong Kong, Pok Fu Lam, Hong Kong., Lee KCK; Department of Medicine and Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals, Wan Chai, Hong Kong., Leung CY; Department of Medicine, Tseung Kwan O Hospital, Hong Hau, Hong Kong., Li A; Department of Medicine and Therapeutics, Chinese University of Hong Kong, New Territories, Hong Kong., Montero D; School of Public Health, Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong., Vardhanabhuti V; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong., Hai JSH; Division of Cardiology, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong., Siu CW; Division of Cardiology, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong., Tse HF; Division of Cardiology, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong., Zingan V; Circle Cardiovascular Imaging Inc, Calgary, Canada., Zhao X; Circle Cardiovascular Imaging Inc, Calgary, Canada., Wang H; GE HealthCare, Waukesha, WI, USA., Pennell DJ; Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.; National Heart and Lung Institute, Imperial College, London, UK., Mohiaddin R; Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.; National Heart and Lung Institute, Imperial College, London, UK., Senior R; Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.; National Heart and Lung Institute, Imperial College, London, UK., Yiu KH; Division of Cardiology, Department of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong., Ng MY; Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong. myng2@hku.hk.; Department of Medical Imaging, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China. myng2@hku.hk.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2023 Oct; Vol. 39 (10), pp. 2015-2027. Date of Electronic Publication: 2023 Jun 28.
DOI: 10.1007/s10554-023-02909-8
Abstrakt: Diagnosing heart failure with preserved ejection fraction (HFpEF) remains challenging. Intraventricular four-dimensional flow (4D flow) phase-contrast cardiovascular magnetic resonance (CMR) can assess different components of left ventricular (LV) flow including direct flow, delayed ejection, retained inflow and residual volume. This could be utilised to identify HFpEF. This study investigated if intraventricular 4D flow CMR could differentiate HFpEF patients from non-HFpEF and asymptomatic controls. Suspected HFpEF patients and asymptomatic controls were recruited prospectively. HFpEF patients were confirmed using European Society of Cardiology (ESC) 2021 expert recommendations. Non-HFpEF patients were diagnosed if suspected HFpEF patients did not fulfil ESC 2021 criteria. LV direct flow, delayed ejection, retained inflow and residual volume were obtained from 4D flow CMR images. Receiver operating characteristic (ROC) curves were plotted. 63 subjects (25 HFpEF patients, 22 non-HFpEF patients and 16 asymptomatic controls) were included in this study. 46% were male, mean age 69.8 ± 9.1 years. CMR 4D flow derived LV direct flow and residual volume could differentiate HFpEF vs combined group of non-HFpEF and asymptomatic controls (p < 0.001 for both) as well as HFpEF vs non-HFpEF patients (p = 0.021 and p = 0.005, respectively). Among the 4 parameters, direct flow had the largest area under curve (AUC) of 0.781 when comparing HFpEF vs combined group of non-HFpEF and asymptomatic controls, while residual volume had the largest AUC of 0.740 when comparing HFpEF and non-HFpEF patients. CMR 4D flow derived LV direct flow and residual volume show promise in differentiating HFpEF patients from non-HFpEF patients.
(© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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