#3421 MRI PREDICTORS OF DIASTOLIC DYSFUNCTION OF THE LEFT VENTRICLE

Abstract

Abstract Background and Aims Non-invasive assessment of diastolic dysfunction remains challenging, this study aims to identify the most informative cardiac magnetic resonance imaging (CMR) parameters for assessing left ventricular diastolic dysfunction (LVDD). Objective To study MRI parameters as predictors of left ventricular diastolic dysfunction (LVDD) in patients with suspected heart failure. Method The study included 39 patients with CHF, 25 were men (61%), and the average age of patients was 48.12 ± 16.79 years. The study was based on a retrospective examination of patients who underwent MRI in the period from April 2021 to August 2022. All patients underwent a comprehensive clinical and instrumental examination taking into account such factors as age, gender, nationality, smoking, diabetes mellitus (DM), arterial hypertension (AH), lipid profile, body mass index (BMI). A total of 39 patients, 28 of them with suspected myocarditis, 7 patients with fibrosis in heart failure, 4 patients with congenital heart disease identified during the study. The CMR measurements of the patients' heart chambers were obtained from an independent manual examination using an image archiving and transmission system. CMR measurements were performed as follows. The patients were examined with a 1.5 Tesla MRI machine and eight-channel cardiac coils were used to acquire the image. The position and orientation of the heart in the chest were determined after serial reference images of the chest were taken. Using stationary free precession sequences, a two-chamber image of the left ventricle was obtained with a breath hold of 10 – 15 seconds at the end of exhalation (image parameters: repetition time 3.6 ms; echo time 1.6 ms; 350 mm; slice thickness 6 mm; gap 2 mm; angle of rotation 45°, 14 projections per segment, matrix 224 160). Four-chamber short axes and three-chamber sequences were then obtained. The right ventricular end-diastolic size (EDD) diameter was measured between the right ventricular endocardium and the interventricular septum, parallel to the tricuspid valve and 1 cm distal to the valve on four-chamber sinusoids with free precession (SSFP). Results As a result the left atrial enlargement is the most prognostic factor for diastolic dysfunction (DD) among the assessed complex MRI parameters. TBI and tissue tracking reflect internal aberration, revealing abnormal deformity patterns in the basolateral segments compared to patients with normal diastolic function. Based on the quantitative assessment of the size of the LA, it is possible to determine the threshold value for the detection of DD. In addition, it was found that the quantitative assessment of LV diastolic deformity is predictive for identifying patients with DD. Increased LA dimensions have a diagnostic accuracy according to our data for detecting diastolic dysfunction (DD). Conclusion Tissue tracking and TRM reveal impaired diastolic deformity of the basal-lateral wall in DD+ as a direct sign of DD.