Evaluate Left Ventricular Diastolic Function Of Hypertrophic Cardiomyopathy From Cine Magnetic Resonance Imaging

Purpose:Use of left ventricular automatic segmentation techniques on cardiac magnetic resonance imaging to get the left ventricular filling curve, and reveal the characteristics of hypertrophic cardiomyopathy (HCM) diastolic function changes by left ventricular filling curve analysis and processing.Methods:17cases of hypertrophic cardiomyopathy (HCM, Hypertrophy cardiomyopathy) and12healthy volunteers were received CMRI examination, and LV2-chamber long and short axis cine series were took, then LV filling curves were reconstructed on ADW4.3, Report Card4.0workstation, platform time, different diastolic volume recovery (DVR) time and their filling velocity corresponding and other parameters were calculate from LV filling curve off-line. Measurement datas were calculated by mean±standard deviation, measurement datas of independent samples of healthy volunteers and patients with HCM were analyzed by Student t test, the accuracy of DVR time and their filling rate among healthy volunteer group and HCM was analyzed by non-parametric test. Interobserver variability was was analyzed by Kappa test.Results:Healthy volunteers, the LV volume time curves can be divided into isovolumic relaxation, early diastolic, plateau, end-diastolic and systolic. Compared with the group of healthy volunteers, HCM group has increased left atrial size and left ventricular myocardial mass, but myocardial wall thickening rate reduced, the difference was statistically significant (P<0.01). Ventricular septal hypertrophic cardiomyopathy patients with left ventricular50%,70%capacity recovery time delay, the difference was statistically significant (P<0.05); and30%,50%of the capacity to restore the filling rate is reduced, the difference was statistically significant. In HCM patients, myocardial fibrosis can cause the late diastolic capacity recovery time delay, but no significant difference between the filling rate with no fibrosis. HCM patients group, no significant difference between the indicators associated with obstruction groups and not associated with obstruction group.Conclusion:Left ventricular filling curve analysis techniques can be used for detailed evaluation of left ventricular diastolic function. HCM diastolic dysfunction is predominantly occur in early and middle diastolic periods, but no obvious functional change during late diastolic and systolic periods. Myocardial fibrosis induced left ventricular early diastolic volume recovery time delay, and the left ventricular outflow tract obstruction less impact of changes in left ventricular diastolic function.There is only two cases in the statistics of17cases of patients with HCM by echocardiography diagnosis of diastolic dysfunction, suggesting that diastolic function evaluation of CMRI left ventricular filling curve maybe has a higher sensitivity compared with ultrasound.