Impact of Age and Diastolic Function on Novel, 4D flow CMR Biomarkers of Left Ventricular Blood Flow Kinetic Energy

Abstract

Two-dimensional (2D) methods of assessing mitral infow velocities are pre-load dependent, limiting their reliability for evaluating diastolic function. Left ventricular (LV) blood fow kinetic energy (KE) derived from four-dimensional fow cardiovascular magnetic resonance imaging (4D fow CMR) may ofer improvements. It remains unclear whether 4D LV blood fow KE parameters are associated with physiological factors, such as age when compared to 2D mitral infow velocities. Fifty-three healthy volunteers underwent standard CMR, plus 4D fow acquisition. LV blood fow KE parameters demonstrated good reproducibility with mean coefcient of variation of 6±2% and an accuracy of 99% with a precision of 97%. The LV blood fow KEiEDV E/A ratio demonstrated good association to the 2D mitral infow E/A ratio (r=0.77, P<0.01), with both decreasing progressively with advancing age (P<0.01). Furthermore, peak E-wave KEiEDV and A-wave KEiEDV displayed a stronger association to age than the corresponding 2D metrics, peak E-wave and A-wave velocity (r=−0.51 vs −0.17 and r=0.65 vs 0.46). Peak E-wave KEiEDV decreases whilst peak A-wave KEiEDV increases with advancing age. This study presents values for various LV blood fow KE parameters in health, as well as demonstrating that they show stronger and independent correlations to age than standard diastolic metrics.

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Item Type:	Article
Authors/Creators:	Crandon, S. Westenberg, J.J.M. Swoboda, P.P. Fent, G.J. Foley, J.R.J. Chew, P.G. Brown, L.A.E. Saunderson, C. Al-Mohammad, A. Greenwood, J.P. van der Geest, R.J. Dall'Armellina, E. Plein, S. Garg, P. https://orcid.org/0000-0002-5483-169X
Copyright, Publisher and Additional Information:	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Te images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2018
Dates:	Published: 26 September 2018 Accepted: 6 September 2018
Institution:	The University of Sheffield
Funding Information:	Funder Grant number ACADEMY OF MEDICAL SCIENCES SGL018\1100
Depositing User:	Symplectic Sheffield
Date Deposited:	11 Oct 2018 10:25
Last Modified:	11 Oct 2018 10:25
Published Version:	https://doi.org/10.1038/s41598-018-32707-5
Status:	Published
Publisher:	Nature Research
Refereed:	Yes
Identification Number:	10.1038/s41598-018-32707-5
Related URLs:	Author
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:136830

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Impact of Age and Diastolic Function on Novel, 4D flow CMR Biomarkers of Left Ventricular Blood Flow Kinetic Energy

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