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PubMed · 42349572

Cine-derived mitral annular relaxation velocity for detection of preclinical left ventricular diastolic dysfunction.

Niall McVeigh·David Ryan·Fiona Ryan·Joseph McCambridge·Maria Ferre·Sebastian Flynn·David J Murphy·Mark Ledwidge·Ken McDonald·Jonathan D Dodd
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Abstract

OBJECTIVES: Imaging diastolic dysfunction in pre-clinical heart failure (HF) is challenging. We evaluated a novel cardiac MRI (CMR) biomarker, CMR e-prime (CMR-MARV), in patients at risk of HF. METHODS: In this substudy of the PARABLE trial (NCT04687111), 236 patients (71.6&#xa0;&#xb1;&#xa0;7.7&#xa0;years, 61.6% male) fulfilling trial-defined ALVDD citeria underwent CMR with measurement of mitral annular relaxation velocity (CMR-MARV) at four mitral annular anchor points. Diastolic strain rates from FT were also assessed. Twenty-five age- and sex-matched controls were included (73.8&#xa0;&#xb1;&#xa0;3.1&#xa0;years, 52% male). Group differences were tested with t-tests, diagnostic accuracy with ROC analysis, and predictors of diastolic dysfunction with adjusted logistic regression. RESULTS: Compared with controls, patients had significantly higher indexed maximal left atrial volume (LAVimax), LV end-diastolic and end-systolic volumes, and LV mass (all p&#xa0;<&#xa0;0.001). Of FT variables, only peak diastolic longitudinal velocity differed between groups (p&#xa0;<&#xa0;0.001). In multivariate models, CMR-MARV correlated with radial, circumferential, and longitudinal diastolic strain rates, radial and longitudinal diastolic velocities (all p&#xa0;<&#xa0;0.001), echocardiographic e' (r&#xa0;=&#xa0;0.20, p&#xa0;=&#xa0;0.007), LV mass (r&#xa0;=&#xa0;-0.18, p&#xa0;=&#xa0;0.008), LAVimax (r&#xa0;=&#xa0;-0.18, p&#xa0;=&#xa0;0.008), and NT-proBNP (r&#xa0;=&#xa0;-0.30, p&#xa0;<&#xa0;0.0001). LAVimax and CMR-MARV were strongly independently associated with ALVDD (AUC 0.89 and 0.76, respectively; p&#xa0;<&#xa0;0.0001). A combined model (LAVimax + CMR-MARV) achieved excellent discrimination (AUC 0.91, 95% CI 0.86-0.97, p&#xa0;<&#xa0;0.0001). Independent predictors included LAVimax, CMR-MARV, and peak diastolic longitudinal velocity (all p&#xa0;<&#xa0;0.001). CONCLUSION: CMR-MARV provides a simple cine-derived measure of longitudinal relaxation that correlates with established structural and biochemical markers of diastolic burden. Within an at-risk population, it offers incremental functional information beyond conventional parameters and may support multiparametric CMR phenotyping of preclinical diastolic dysfunction.

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AgedFemaleHumansMaleBiomarkersDiastoleHeart FailureHeart VentriclesMagnetic Resonance Imaging, CineMitral ValveROC CurveVentricular Dysfunction, LeftCardiac magnetic resonanceDiastolic dysfunctionHFpEFLeft atrial volume indexMitral annular motionPreclinical heart failureJournal ArticleRandomized Controlled Trial

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Niall McVeigh, David Ryan, Fiona Ryan, Joseph McCambridge, Maria Ferre, Sebastian Flynn, David J Murphy, Mark Ledwidge, Ken McDonald, Jonathan D Dodd. 2026-06-25. Cine-derived mitral annular relaxation velocity for detection of preclinical left ventricular diastolic dysfunction.. https://doi.org/10.1016/j.mri.2026.110733

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Journal Article; Randomized Controlled Trial resourceAged subjectBiomarkers subjectFemale subjectHeart Failure subjectHumans subjectJournal Article subjectMale subjectRandomized controlled trials study

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