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Left Ventricular Spherical Remodeling and Apical Myocardial Relaxation: Cardiovascular MR Imaging Measurement of Myocardial Segments¹

¹ From the Departments of Internal Medicine (Cardiology Section) (M.T., C.G.M., K.S.L., P.R., W.G.H.), Biomedical Engineering (E.B., C.A.H.), Radiology (K.M.L., W.G.H.), and Public Health Sciences (T.M.M.), Wake Forest University School of Medicine, Bowman Gray Campus, Medical Center Blvd, Winston-Salem, NC 27157-1045. Received May 3, 2006; revision requested June 26; revision received October 13; accepted November 3; final version accepted December 15. Supported in part by American Heart Association Grant-in-Aid 0250239N. M.T. supported by a grant from King Chulalongkorn Memorial Hospital, Bangkok, Thailand. Address correspondence to W.G.H. (e-mail: ghundley{at}wfubmc.edu).

Purpose: To prospectively evaluate left ventricular (LV) shape and regional relaxation to determine if rapid, early relaxation of the LV is lost with spherical remodeling of the LV.

Materials and Methods: This HIPAA-compliant study was approved by the institutional review board. All participants gave written informed consent. Cardiovascular magnetic resonance (MR) imaging and transthoracic echocardiography (TTE) were performed in 18 individuals. Each participant was classified into one of three groups according to LV shape and TTE-derived mitral filling parameters. Pairwise comparisons of cardiovascular MR imaging measurements of LV relaxation were made between healthy individuals and those with spherically shaped LVs.

Results: The LV regional relaxation rates were determined in a total of 108 basal, middle, and apical myocardial segments in 18 participants (13 women, five men; age range, 35–76 years). Participants with a spherically shaped LV (sphericity index, <1.5) and a mitral inflow velocity E wave/A wave ratio of less than 1.0 exhibited apical thinning velocities that were lower than those of healthy individuals (sphericity index, 1.5) (P < .01). The ratio of LV relaxation velocities in the apical versus middle LV segments correlated significantly with sphericity index (R² = 0.53; P = .0005).

Conclusion: LV apical relaxation velocities in participants with LV spherical remodeling (sphericity index, <1.5) were reduced compared with those of healthy individuals (sphericity index, 1.5).

© RSNA, 2007