Diagnostic value of 31P magnetic resonance spectroscopy (MRS) and velocity encoded MRI (VEC-MRI) in suspected diastolic dysfunction with normal myocardial mass. – Comparison to echocardiographic criteria

Purpose: To evaluate the diagnostic role of VEC-MRI combined with 31P-MRS in hypertensive patients compared to echocardiographic and tissue Doppler results.

Material and Methods: 30 patients (19 men and 11 women, mean age 59±11 years) were prospectively studied by echocardiography and velocity encoded MRI (VEC-MRI) in order to calculate E/A ratio and deceleration time of the early diastolic filling curve (DT(E)). Results of both modalities were correlated. Patients in whom VEC-MRI was not able to distinguish normal diastolic function from pseudonormalization decisively additionally underwent 31P-MRS. Statistical analysis was performed by using mean±SD for description of the data, Spearman correlation, Bland-Altman- and Lin-correlation and 2-tailed student-t test for independent samples.

Results: No differences were found in weight, age, LVEF, endsystolic volume, enddiastolic volume, myocardial mass, cardiac output and BNP levels between patients and control group. Significant correlation existed between echocardiographic and VEC-MRI results of diastolic function. Bland-Altman correlation was r=0.53, p=0.03; Lin-concordance was: r=0.41, p=0.03, 95%-CI for r: [0.03; 0.52]. Myocardial PCr/ATP-ratio assessed by 31P-MRS was significantly decreased in pseudonormalization compared to normal diastolic function according to echocardiographic results (1.20±0.19 versus 1.64±0.2; p=0.005).

Conclusions: VEC-MRI correlates well with echocardiographic findings in patients with diastolic dysfunction. In combination with 31P-MRS it could be a non invasive means for detecting early states of heart failure in hypertensive patients.

velocity encoded MRI - 31P-MR-Spectroscopy - diastolic dysfunction