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Background: The mechanism of left ventricular (LV) dilation with exercise or pharmacologic stress remains unknown. Mitral annular plane systolic excursion (MAPSE) is an established parameter of longitudinal LV fiber function. This study evaluated the role of longitudinal and circumferential fiber dysfunction in stress induced LV dilation(SILVD) using cardiac MRI(CMR).
Methods: This prospective study was comprised of 605 patients undergoing pharmacologic CMR stress imaging. A 4-chamber cine view was added to the imaging protocol to measure septal and lateral MAPSE, to assess longitudinal LV fiber function. A short axis cine at the papillary tips was used to assess LV midwall fractional shortening (MWFS). The study cohort consisted of patients with evidence of regadenoson SILVD, defined as an end-diastolic stress/end-diastolic rest diameter ratio > 1.08, a value previously established as the upper limit of normal, using CMR. Using a previously defined Normal patient cohort(n=63), the study cohort mean MAPSE and MWFS data were statistically compared, along with mean global LV ejection fraction data.
Results: 45 patients demonstrated SILVD. A significant reduction in both septal and lateral mean MAPSE values were found in patients with SILVD, shown in the table below. Patients with SILVD showed normal mean global LVEF and MWFS values.
Conclusions: Using CMR analysis of MAPSE, longitudinal LV fiber dysfunction at rest appears to be related to regadenoson induced LV dilation during stress testing.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Non Invasive Imaging: MR Structure and Valuvular Heart Disease
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1290-211
- 2017 American College of Cardiology Foundation