Abstract 2544: The Relationship Between Left Ventricular Mass Measured by Magnetic Resonance Imaging and Echo-Doppler Parameters of Diastolic Function in Hypertensive Patients with Echocardiographic Left Ventricular Hypertrophy: The ALIVE Study
Background: A significant relationship between left ventricular (LV) mass measured by M-mode or 2-D echocardiography and diastolic function reflected in the LV filling pattern and left atrial (LA) size has been reported in hypertensives. Cardiac MRI (CMR) is considered the most reproducible and reliable method for LV mass measurement. We hypothesized the presence of a quantitative relationship between CMR LV mass (CMR LVM) and echo-Doppler diastolic function variables.
Methods: In the ALIVE study, a clinical trial comparing the efficacy of 2 antihypertensive regimens for LV mass regression, 84 pts with echo LV hypertrophy (LVH) (mean age 66 ±12 years, 52% females, mean LVEF ± 59 ± 9% ) in sinus rhythm with no mitral annular calcification or valvular dysfunction had echo-Doppler exams including transmitral diastolic flow recordings and CMR LVM at study intake. Echo-Doppler variables (LVEF, LA area, peak velocity of E and A, E/A, Deceleration Time of E wave, IVRT, Echo LVM) were measured off line using a dedicated workstation (Digisonics, Inc). CMR LVM was determined from contiguous 8 mm LV short axis SSFP cine acquisitions. Of 84 pts, 21 had increased CMR LVM, and 53 pts had normal LV mass. Unpaired t-tests were used to compare the 2 groups and Pearson correlations and adjusted multiple logistic regression analyses including by body surface area (BSA) were done to determine the relationship between CMR LVM and echo-Doppler indices of diastolic function.
Results: There is a significant unadjusted correlation between CMR LVM/BSA and LA area /BSA (r = .27, p .02) and LA area/height (r = .32, p = .008). Adjusted logistic regression analysis showed a significant correlation only between CMR LVM and LA area (r2 = .37, P <.0001). None of the indices derived from transmitral flow were related to CMR LVM or Echo LVM.
Conclusions: 1. In adjusted models, no significant relationship was found between LV mass measured by CMR or by echo and transmitral flow derived Doppler variables assessing diastolic function. 2. In the same models, there is a quantitative relationship between CMR LV mass and LA area which increases by 0.1 cm2 for every 1 gram increase in LV mass. 3. In this hypertensive population, higher LV mass is reflected only by larger LA size and not in alteration of transmitral flow.