Abstract 17926: Non-Invasive Wave Intensity Analysis to Assess Ventricular Function in Children With Normal Ejection Fraction
Introduction: Evaluating systolic and diastolic dysfunction in children is challenging, with a gold standard method currently lacking. We propose a novel non-invasive potential biomarker, derived from cardiac magnetic resonance (CMR) imaging data, comparing its diagnostic performance against other echocardiographic and CMR parameters.
Methods: Patients with presumed diastolic dysfunction (n=18; 9 aortic stenosis, 5 hypertrophic cardiomyopathy, 4 restrictive cardiomyopathy) were compared with age-matched control subjects (n=18). All patients had no mitral regurgitation, aortic incompetence, significant residual aortic stenosis or reduced systolic ejection fraction (EF). E/A ratio, E/E’ ratio, deceleration time and isovolumic contraction time (IVCT) were assessed from echocardiography, and left atrial volume (LAVi), acceleration time (AT), ejection time (ET) and wave intensity analysis were calculated from CMR. Wave intensity was obtained from CMR phase-contrast flow data, defining a novel biomarker from the ratio of the peaks of the early systolic forward compression wave and the end-systolic forward expansion (FCW/FEW).
Results: Significant differences between patients and controls were seen in the E/E’ ratio (8.7±4.0 vs. 5.1±1.3, p=0.001), LAVi (80.7±22.5 vs. 51.0±10.9 mL/m2, p<0.001) and FCW/FEW ratio (3.7±2.7 vs. 12.7±7.9, p<0.001). In particular, patients exhibited a lower FCW (2.5±1.6 vs. 7.2±4.2 x10-5m/s, p<0.001) in the face of preserved EF (67±11% vs. 69±5%, p=0.392), as well as longer IVCT (49±7 vs. 34±7 ms, p<0.001) and ET/AT (0.35±0.04 vs. 0.27±0.04, p<0.001). According to ROC analysis, FCW/FEW was the best discriminator, with a value of area under the curve (AUC) of 0.923 (p<0.001) compared to LAVi (AUC=0.884,p<0.001) and E/E’ (AUC=0.881,p=0.001).
Conclusions: This study shows that the wave intensity derived novel biomarker can provide insight into ventricular function in children, on top of CMR and echocardiography, and it was able to identify ventricular dysfunction in a small group of patients with preserved EF.
Author Disclosures: G. Biglino: None. H.N. Ntsinjana: None. P. Ciliberti: None. V. Muthurangu: None. S. Schievano: None. R. Chung: None. J. Marek: None. K.H. Parker: None. A.M. Taylor: None.
- © 2014 by American Heart Association, Inc.