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Quantification of left ventricular internal flow from cardiac magnetic resonance images in patients with dyssynchronous heart failure

✍ Scribed by Brandon K. Fornwalt; Patrick C. Gonzales; Jana G. Delfino; Robert Eisner; Angel R. León; John N. Oshinski


Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
948 KB
Volume
28
Category
Article
ISSN
1053-1807

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✦ Synopsis


Abstract

Purpose

To develop a method for quantifying left ventricular (LV) internal flow as a measure of dyssynchrony using standard cine cardiac magnetic resonance (CMR) images.

Materials and Methods

CMR images were obtained from 10 healthy controls and 10 patients with dyssynchronous heart failure (class III/IV, LV ejection fraction <35%, pattern seen in an electrocardiogram QRS duration > 150 msec). The LV volume was reconstructed and divided into 16 regions. Internal flow was defined as the sum of the regional volume changes minus the global volume change during each time step in the cardiac cycle. Internal flow fraction (IFF) was defined as the total internal flow as a percentage of stroke volume during systole (IFF~systole~), diastole (IFF~diastole~), or the whole cycle (IFF~whole~).

Results

IFF~whole~ was significantly increased in the patients (9.9 ± 5.0% vs. 1.5 ± 0.5% in the controls, P < 0.001). An IFF~whole~ threshold of 4% discriminated between patients and controls with 90% sensitivity and 100% specificity. IFF~diastole~ (2.3 ± 0.8%) was greater than IFF~systole~ (0.8 ± 0.5%) in the normal controls (P < 0.001) while the patients had similar IFF~diastole~ (7.8 ± 4.2%) and IFF~systole~ (12.0 ± 7.8%).

Conclusion

Left ventricular internal flow fraction can be quantified from standard CMR images. In this preliminary study, Left ventricular internal flow fraction discriminated patients with dyssynchronous heart failure from normal controls with 95% accuracy. J. Magn. Reson. Imaging 2008;28:375–381. © 2008 Wiley‐Liss, Inc.