Abstract 11066: Estimation of the Left Ventricular Diastolic Function with Cardiac MDCT: Correlation of the Slope of the Time-Enhancement-Curve with the Mitral Annulus Diastolic Velocity
Background: Since patients with cardiac diastolic heart failure have a poor outcome, precise and reliable evaluation of diastolic dysfunction is important. Multi-detector row computed tomography (MDCT) has proven an excellent modality for the noninvasive assessment of coronary artery disease and its potential utility for global LV function has been reported. This investigation was designed to explore the ability of MDCT to estimate left ventricular diastolic function in comparison with Doppler tissue imaging.
Methods: The protocol was approved by the Institutional Review Board, and all the patients gave their informed consent before participating in this study. Thirty patients with suspected coronary artery disease underwent MDCT and echocardiography. Patients with arrythmias, valvular heart disease, previous cardiac surgery and myocardial infarction were excluded for exact evaluation of echocardiographic parameters. The early transmitral flow velocities (E) and the velocity of mitral annulus early diastolic motion (e') were measured in order to evaluate the diastolic function. The scanning delay of CT was determined using a test injection technique. The aortic enhancement was measured over the aortic-root lumen, and it was plotted over time to yield a time-enhancement-curve. A gamma variate function was fit to the time-enhancement-curve. We searched for the point when CT value exceeded +20H.U. to +50H.U, and calculated the ‘slope' of enhancement in each patient and region of interest [ROI].
Results: According to a univariate analysis, the slope of the time-enhancement-curve was found to correlate with the e' (r=0.686, p=0.000) and E/e' (r=-0.482, P=0.007), however, no significant correlation was observed with the Left Ventricle systolic parameters (Stroke Volume, end-diastolic LV volume, end-systolic LV volume and Ejection fraction) in our study.
Conclusions: These results indicate that the slope of the time-enhancement-curve in the aorta significantly correlates with e', i.e. the diastolic parameters, which are independent of the systolic parameters. Based on these findings, we propose that the slope of the time-enhancement curve serves as a parameter for the left ventricular diastolic function on MDCT.
- © 2010 by American Heart Association, Inc.