Hypertensive heart disease: MR tissue phase mapping reveals altered left ventricular rotation and regional myocardial long-axis velocities

• Published in: European radiology Vol. 23; no. 2; pp. 339 - 347
• Main Authors: Foell, D., Jung, B., Germann, E., Staehle, F., Bode, C., Markl, M.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.02.2013; Springer Nature B.V
• Subjects: Adult; Age; Aged; Blood pressure; Body mass index; Cardiac; Cardiovascular disease; Case-Control Studies; Correlation analysis; Diagnostic Radiology; Disease Progression; Ejection fraction; Female; Heart failure; Humans; Hypertension; Hypertension - complications; Hypertension - diagnosis; Hypertrophy, Left Ventricular - complications; Hypertrophy, Left Ventricular - diagnosis; Imaging; Imaging, Three-Dimensional; Internal Medicine; Interventional Radiology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Contraction - physiology; Neuroradiology; Pattern Recognition, Automated; Radiology; Reference Values; Risk Assessment; Rotation; Sensitivity and Specificity; Severity of Illness Index; Ultrasound; Velocity; United States > US; Germany; Chicago Illinois; Hypertension; Myocardium; Ventricular function; Diastole; MRI
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-012-2613-0

Objectives The aim of this study was the evaluation of left ventricular (LV) segmental 3D velocities in patients with hypertensive heart disease using magnetic resonance (MR) tissue phase mapping (TPM). Methods LV radial, long-axis and rotational myocardial velocities were assessed by TPM in patients with LV hypertrophy and preserved EF ( n  = 18, age = 53 ± 12 years) and volunteers ( n  = 20, age = 51 ± 4 years). Systolic and diastolic peak and time-to-peak velocities were mapped onto a 16-segment LV model. 3D myocardial motion was displayed on an extended visualisation model. Correlation coefficients were calculated to investigate differences in regional dynamics. Results Patients revealed diastolic dysfunction as expressed by decreased peak long-axis velocities in all (except apical) segments (basal, P  ≤ 0.01; two midventricular segments, P  = 0.02, P  = 0.03). During systole, hypertrophy was associated with heterogeneous behaviour for long-axis velocities including an increase in anteroseptal apical and midventricular regions ( P  = 0.001), a reduction in mid-inferior segments ( P  = 0.03) and enhanced septal velocities ( P  < 0.05). Segmental correlation analysis revealed altered dynamics of LV base rotation and increased dyssynchrony of lateral long-axis motion. Conclusions Patients with hypertensive heart disease demonstrated alterations in systolic long-axis motion, basal rotation and dyssynchrony. Longitudinal studies are needed to investigate the value of regional wall motion abnormalities regarding disease progression and outcome. Key Points • Magnetic resonance tissue phase mapping enables segmental evaluation of 3D myocardial velocities. • Patients with hypertensive heart disease demonstrated new alterations in systolic long-axis motion. • Correlation analysis revealed left ventricular long-axis dyssynchrony and an altered rotation. • MR may provide new, sensitive diagnostic markers concerning hypertensive heart disease.