Myocardial dysfunction in patients with aortic stenosis and hypertensive heart disease assessed by MR tissue phase mapping

Purpose To identify abnormalities of myocardial velocities in patients with left ventricular pressure overload using magnetic resonance tissue phase mapping (TPM). Material and Methods Thirty‐three patients (nine with hypertensive heart disease [HYP], 24 with aortic stenosis [AS]) and 41 healthy controls were enrolled. To assess left ventricular motion, a basal, midventricular, and apical slice were acquired using three‐directional velocity‐encoded phase‐contrast MR with a 3T system. Target parameters were peak longitudinal (V z ) and radial (V r ) velocity in systole and diastole (Peak sys , Peak dias ). Analysis was done on each myocardial segment. In a subgroup ( n = 7 HYP, n = 12 AS, n = 24 controls), measurement was repeated during handgrip exercise. Results AS had significantly lower V z ‐Peak sys in the inferolateral and inferoseptal wall ( P = 0.003–0.029) and V r ‐Peak sys in the septum and anterior wall ( P = 0.001–0.013) than controls. V z ‐Peak dias and V r ‐Peak dias were lower in AS than in controls in almost all segments ( P < 0.001–0.028). HYP showed reduced V z ‐Peak dias compared to controls in all basal segments as well as in the lateral midventricular wall ( P < 0.001–0.045), and reduced V r ‐Peak dias compared to controls predominantly in the midventricular and apical segments ( P = 0.004–0.042). AS patients with focal fibrosis had significantly reduced myocardial velocities ( P = 0.001–0.047) in segments without late enhancement. During exercise, V z ‐Peak sys , V r ‐Peak sys , and V z ‐Peak dias remained unchanged in AS and HYP, but decreased in the lateral wall in controls ( P < 0.001–0.043). Conclusion Even with preserved left ventricle (LV) ejection fraction, peak longitudinal and radial velocities of the LV are reduced in AS and HYP, indicating early functional impairment. J. Magn. Reson. Imaging 2016;44:168–177.