Integrated assessment of diastolic and systolic ventricular function using diagnostic cardiac magnetic resonance catheterization: validation in XXXX and application in a clinical pilot study.

@entity1 @entity1707 @entity64 @entity452 @entity432 @entity2693
OBJECTIVES: This study sought to develop and validate a method for the integrated analysis of systolic and diastolic ventricular function. BACKGROUND: An integrated approach to assess ventricular pump function, myocontractility (end-systolic pressure-volume relationship [ESPVR]), and diastolic compliance (end-diastolic pressure-volume relation [EDPVR]) is of high clinical value. Cardiac magnetic resonance (CMR) is well established for measuring global pump function, and catheterization-combined CMR was previously shown to accurately measure ESPVR, but not yet the EDPVR. METHODS: In 8 @entity1707 , the CMR technique was compared with conductance catheter methods (gold standard) for measuring the EDPVR in the left and right ventricle. Measurements were performed at rest and during @entity452 administration. For CMR, the ESPVR was estimated with a single-beat approach by synchronizing invasive ventricular pressures with cine CMR-derived ventricular volumes. The EDPVR was determined during pre-load reduction from additional volume data that were obtained from real-time velocity-encoded CMR pulmonary/aortic blood flow measurements. Pre-load reduction was achieved by @entity432 . The @entity2693 coefficient beta was calculated by an exponential fit from the EDPVR. After validation in the animal experiments, the EDPVR was assessed in a pilot study of 3 @entity1 with a single ventricle using identical CMR and conductance catheter techniques. RESULTS: Bland-Altman tests showed good agreement between conductance catheter-derived and CMR-derived EDPVR. In both ventricles of the @entity1707 , @entity452 enhanced myocontractility (p < 0.01), increased @entity64 volume (p < 0.01), and improved diastolic function. The latter was evidenced by shorter early relaxation (p < 0.05), a downward shift of the EDPVR, and a decreased @entity2693 coefficient beta (p < 0.05). In contrast, in the @entity1 , early relaxation was inconspicuous but the EDPVR shifted left-upward and the @entity2693 constant remained unchanged. The observed changes in diastolic function were not significantly different when measured with conductance catheter and CMR. CONCLUSIONS: This novel CMR method provides differential information about diastolic function in conjunction with parameters of systolic contractility and global pump function.
