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Clinical Articles
Feasibility study of cardiac magnetic resonance four-dimensional flow imaging in evaluating left ventricular diastolic function in patients with hypertrophic cardiomyopathy
LIU Yuhao  LI Wei  LIANG Wenying  OUYANG Lina  SUN Xiao  WANG Yifan  ZHU Li 

Cite this article as: Liu YH, Li W, Liang WY, et al. Feasibility study of cardiac magnetic resonance four-dimensional flow imaging in evaluating left ventricular diastolic function in patients with hypertrophic cardiomyopathy[J]. Chin J Magn Reson Imaging, 2022, 13(10): 127-131. DOI:10.12015/issn.1674-8034.2022.10.019.


[Abstract] Objective Cardiac magnetic resonance four-dimensional flow (CMR 4D Flow) was used to measure left ventricular blood flow in patients with hypertrophic cardiomyopathy (HCM) with impaired diastolic function relaxation and to explore the feasibility of using left ventricular hemodynamic characteristics to evaluate diastolic function.Materials and Methods A total of 45 HCM patients and 31 healthy controls were retrospectively collected. All subjects in both groups underwent a 3.0 T magnetic resonance steady-state free entry sequence and CMR 4D Flow sequence scan. The CVI42 post-processing software was used to measure the basic functional parameters of the left ventricle and the average blood flow velocity (cm/s) at the mitral valve level in the early (left ventricular aspiration) and late (left active atrial contraction) levels of the left ventricular inflow and outflow tract in the two groups. The independent samples t-test or Mann-Whitney U test were used to compare the clinical data and imaging parameters of the two groups; and Spearman correlation analysis was performed on the average blood flow velocity in early diastole, left ventricular myocardial mass, and peak diastolic thickness of the left ventricular wall.Results The left ventricular mass (LVmass) and the global peak wall thickness (GPWT) in the HCM group were significantly higher than those in the healthy control group [LVmass: (163.70±52.18) vs. (87.27±21.01), unit: g; GPWT: (19.64±3.85) vs. (9.99±2.00), unit: mm; HCM group vs. healthy control group, P<0.001]; for the average diastolic blood flow velocity at the level of the mitral valve, the average blood flow velocity in the early diastole of the HCM group was lower than that of the healthy control group [29.70 (17.90) vs. 50.50 (16.90), unit: cm/s; HCM group vs. healthy control group, P<0.001]; the mean blood flow velocity in late diastole between HCM patients and the control group was not statistically different; the E/A value of the HCM group was significantly lower than that of the healthy control group [(1.26±0.70) vs. (1.80±0.85), HCM group vs. healthy control group, P=0.003].Conclusions The use of CMR 4D Flow can visualize the blood flow in the left ventricle, accurately distinguish the intraventricular blood flow trajectory of the heart in the early and late diastole. In addition, the decrease of mean flow velocity in the early diastolic stage of mitral valve level (E peak) and E/A value is helpful for quantitative evaluation of left ventricular diastolic dysfunction in patients with hypertrophic cardiomyopathy, and provides a reference for patients to formulate individualized treatment plans.
[Keywords] hypertrophic cardiomyopathy;diastolic function;four-dimensional blood flow;left ventricle;cardiac magnetic resonance;magnetic resonance imaging

LIU Yuhao1, 2   LI Wei1   LIANG Wenying2   OUYANG Lina2   SUN Xiao3   WANG Yifan3   ZHU Li3*  

1 Department of Radiology, Baoji Central Hospital, Baoji 721000, China

2 Ningxia Medical University, Yinchuan 750000, China

3 Department of Radiology, General Hospital of Ningxia Medical University, Yichuan 750000, China

Zhu L, E-mail: zhuli72@163.com

Conflicts of interest   None.

Received  2022-05-24
Accepted  2022-10-09
DOI: 10.12015/issn.1674-8034.2022.10.019
Cite this article as: Liu YH, Li W, Liang WY, et al. Feasibility study of cardiac magnetic resonance four-dimensional flow imaging in evaluating left ventricular diastolic function in patients with hypertrophic cardiomyopathy[J]. Chin J Magn Reson Imaging, 2022, 13(10): 127-131.DOI:10.12015/issn.1674-8034.2022.10.019

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