Evaluation of diastolic function of hypertrophic cardiomyopathy using left ventricular volume-time curve / 中华放射学杂志

ABSTRACT

ObjectiveTo determine the feasibility of using left ventricular volume-time curve in the evaluation of left ventricular diastolic function,and to analyze characteristics of left ventricular volume-time curve changcs in hypertrophic cardiomyopathy (HCM).MethodsSeventeen cases of HCM and 12 healthy volunteers received cardiac MRI (CMRI) examination,and left ventricular (LV) 2-chamber long and short axis cine imaging were performed,LV volume-time curves were reconstructed and platform time,different diastolic volume recovery (DVR) time and their corresponding filling velocity were calculated from LV volume-time curve off-line.The DVR time and their corresponding filling velocity were analyzed by using multiple linear regression analysis. Results Compared with the group of healthy volunteers,ventricular septal HCM group had delayed left ventricular 50％,70％ DVR time[ (8.9 ± 1.3) versus (7.7 ± 0.8 ) phase,F=6.787,P=0.016;(11.3 ±1.6) versus(9.7±1.8) phase,F=4.927,P=0.036] and shortened plateau time [ ( 1.8 ± 1.7) versus ( 4.1 ± 1.4 ) phase,t =6.787,P ＜ 0.01 ].Ventricular septal HCM group had reduced 30％,50％ DVR filling rates [ (0.22 ± 0.11 ) versus (0.40 ± 0.15 ) ml/ms,F =12.916,P ＜ 0.01 ; (0.20 ± 0.09 ) versus (0.30 ± 0.10) ml/ms,F =7.121,P =0.014 ] compared with those in the group of healthy volunteers.But 70％,80％,90％ DVR filling rates showed no statistically significant different in the two groups.In HCM patients,myocardial fibrosis caused 50％,70％,80％ DVR time delay [ (9.6 ± 1.0) versus ( 7.9 ± 1.5 ) phase,F =5.000,P =0.045 ; ( 12.3 ± 1.4 ) versus ( 9.6 ± 1.8)phase,F=8.039,P=0.015;(13.1 ±1.4 ) versus(10.9±1.9)phase,F=5.060,P=0.044],but no significant difference of DVR filling rate was found between the two groups. Conclusions Left ventricular volume curve analysis techniques can be used for detailed evaluation of left ventricular diastolic function.The left ventricular diastolic dysfunction of hypertrophic cardiomyopathy occurs mainly in early diastolic period,and accompanied by the shortening of the plateau time. Myocardial fibrosis can aggravate early left ventricular diastolic dysfunction of hypertrophic cardiomyopathy.