Velocity-encoded cine MRI in the evaluation of left ventricular diastolic function: Measurement of mitral valve and pulmonary vein flow velocities and flow volume across the mitral valve

Abstract

Left ventricular diastolic function has been evaluated by means of analysis of the flow pattern through the mitral valve. Velocity-encoded cine magnetic resonance imaging (VEC-MR) is a new method for characterizing flow patterns in the heart. The feasibility of using VEC-MR to measure early diastolic (E) and atrial systolic (A) peak flow velocities and E/A ratios in the mitral inflow, as well as systolic (X), early diastolic (Y), and atrial systolic (Z) peak flow velocities and X/Y ratios in the pulmonary vein, was evaluated in 10 normal volunteers. The VEC-MR-derived velocities and indexes were compared with Doppler-derived results. Volumetric flow across the mitral valve was also used to measure stroke volume, cardiac output, and the left atrial contribution of left ventricular filling. VEC-MR yielded lower peak velocities than Doppler echocardiography. The velocities of the two measurements showed a significant linear correlation (Doppler E velocity = 1.30 × VEC-MR + 1.6 cm/sec, r = 0.68; Doppler A velocity = 1.83 × VEC-MR − 5.2 cm/sec, r = 0.83; and Doppler X velocity = 0.45 × VEC-MR + 0.09 cm/sec, r = 0.74). Consequently the E/A and X/Y ratios measured by these two methods showed statistically significant linear correlations with r values of 0.94 and 0.83. The volume of blood flow across the mitral valve measured by VEC-MR (5610 ± 620 ml/min) was not statistically different from the cardiac output measured from the ascending aorta by VEC-MR (5670 ± 590 ml/min) or by left ventricular cine magnetic resonance imaging (5440 ± 614 ml/min). The left atrial contribution to left ventricular filling was 25.9 ± 7.5%. Our results indicate that VEC-MR can be used not only for evaluation of left ventricular diastolic filling from the mitral valve and pulmonary vein flow velocities but also for quantitative measurement of the volume of blood flow across the mitral valve.