Estimation of the left ventricular diastolic function with cardiac MDCT: correlation of the slope of the time-enhancement-curve with the mitral annulus diastolic velocity

Abstract

Patients with diastolic heart failure tend to have a poor outcome, similar to that for patients with systolic heart failure. The aim of this study was to explore the ability of MDCT to estimate the left ventricular diastolic function. Thirty patients with suspected coronary artery disease underwent MDCT and echocardiography. The early transmitral flow velocities (E) and the velocity of mitral annulus early diastolic motion (e') were measured in order to evaluate the diastolic function. The scanning delay of CT was determined using a test injection technique. The aortic enhancement was measured over the aortic-root lumen, and it was plotted over time to yield a time-enhancement-curve. A gamma variate function was then fit to the time-enhancement-curve and thereafter both the 'slope' of enhancement for each patient and the region of interest [ROI] were calculated. According to a univariate analysis, the slope of the time-enhancement-curve was found to correlate with the e' (r = 0.686, P = 0.000) and E/e' (r = -0.482, P = 0.007), however, no significant correlation was observed with the systolic parameters of the left ventricle. These results indicate that the slope of the time-enhancement-curve in the aorta significantly correlates with e', i.e. the diastolic parameters, which are independent of the systolic parameters. Based on these findings, we propose that the slope of the time-enhancement-curve may serve as a parameter for the left ventricular diastolic function on MDCT.