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Quantification of left ventricular internal flow from cardiac magnetic resonance images in patients with dyssynchronous heart failure
Author(s) -
Fornwalt Brandon K.,
Gonzales Patrick C.,
Delfino Jana G.,
Eisner Robert,
León Angel R.,
Oshinski John N.
Publication year - 2008
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.21446
Subject(s) - cardiology , ejection fraction , cardiac cycle , systole , medicine , diastole , stroke volume , heart failure , magnetic resonance imaging , end systolic volume , blood flow , qrs complex , radiology , blood pressure
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.