Strain analysis using feature tracking cardiac magnetic resonance (FT-CMR) in the assessment of myocardial viability in chronic ischemic patients

2020 ◽  
Author(s):  
Sara W. Tantawy ◽  
Shaimaa Abdelsattar Mohammad ◽  
Ahmed M. Osman ◽  
Wesam El Mozy ◽  
Ahmed S. Ibrahim
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Viability ◽  
Feature Tracking ◽  
Strain Analysis

scholarly journals Correlation between cardiac magnetic resonance feature tracking derived left ventricular strain and morphological characteristics of non-ischemic dilated cardiomyopathy at baseline and follow-up

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Pozo Osinalde ◽  
J Urmeneta Ulloa ◽  
J L Rodriguez Hernandez ◽  
L Perez De Isla ◽  
H Martinez Fernandez ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Feature Tracking ◽  
Systolic Function ◽  
Morphological Characteristics ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Morphological Parameters ◽  
Non Ischemic Dilated Cardiomyopathy

Abstract Background Left ventricular (LV) strain from echocardiography is a known useful predictor of LVEF recovery in non-ischemic dilated cardiomyopathy (NIDCM). More recently, feature tracking (FT) has allowed LV myocardial deformation analysis using conventional cardiac magnetic resonance (CMR) cine sequences. Purpose Our aim is to establish the correlation between LV strain values from CMR-FT at diagnosis and morphological parameters at baseline and during follow-up. Methods Consecutive patients with NIDCM who underwent CMR were retrospectively collected. All the studies were performed in a 1.5 Tesla magnet following a standard acquisition protocol of conventional SSFP cine sequences in long and short axis. Global longitudinal, circumferential and radial strain (GLS, GCS and GRS, respectively) were obtained with a dedicated FT software. Correlation with CMR morphological parameters at baseline were evaluated. Likewise, in the cases with follow-up echocardiogram association between FT LV strain and evolution of morphofunctional variables was explored. Results CMR-FT strain analysis was performed in 98 patients (age 68±13 years, 72% males) with NIDCM. They showed severe LV dilatation (LVEDVi= 133.6±33.4 mL/m2) and systolic dysfunction (LVEF= 29.5±9.6%) at baseline. Myocardial fibrosis was detected in 38.8% of the patients with late gadolium enhancement (LGE) sequence. All the basal CMR morphological characteristics were significantly correlated with FT strain analysis (Table), even more markedly for GCS. However, there was no association of baseline morphofunctional parameters with LGE. An echocardiogram was performed in 85.7% of the patients during the follow-up (2.4 [1.8–3.4] years), with an LVEF >50% in the 25.5% of the cases. These patients with preserved LVEF in the evolution showed better GCS (−9 vs −7.1%; p=0.019) at baseline, with no differences in the other FT LV strain parameters. Despite less fibrosis in LGE (16.1% vs 37.7%; p=0.037), none of the baseline morphofunctional CMR parameters (LVEF, LVEDVi...) were associated with systolic function restoration. In multivariate analysis, GCS was the only independent predictor (OR 1.16; p=0.045) of LVEF recovery among imaging variables. Conclusions All the FT derived LV strain values were correlated with the degree of basal morphofunctional involvement in NIDCM. Furthermore, GCS emerged as an independent imaging predictor of LV systolic function restoration in our series. FUNDunding Acknowledgement Type of funding sources: None. Table 1. Correlation between myocardial deformation values by feature tracking and morphofunctional variables in basal CMR.

P5253Does regional myocardial strain by cardiac magnetic resonance feature tracking reflect scar in ischemic heart disease?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Stathogiannis ◽  
V Mor-Avi ◽  
R Lang ◽  
A R Patel
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Feature Tracking ◽  
Circumferential Strain ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Lv Function ◽  
Regional Strain ◽  
The Relationship

Abstract Background Cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) is the gold standard for detection of myocardial scar. We hypothesized that CMR Feature Tracking (FT)-derived regional myocardial strain may reflect the presence of scar and could thus potentially be used instead of LGE imaging. Purpose The aim of this study was to determine the relationship between FT-derived regional myocardial strain and LGE in patients with coronary artery disease (CAD). Methods Seventy-five patients with CAD and typical ischemic LGE patterns on CMR (1.5T) were included (mean age 60±12 years, 70% males). Myocardial strain analysis and LGE identification were performed using dedicated commercial software. Scar was defined by presence of LGE in the same area of the myocardium in both short- and long-axis views. Peak systolic regional longitudinal and circumferential strain (RLS, RCS) values were calculated in the region of interest corresponding to the LGE area and also in a non-LGE myocardial region as a reference in each patient. These comparisons were repeated for a subgroup of 36 patients with left ventricular (LV) ejection fraction (EF) <40% to determine whether the relationship between strain and LGE holds in the presence of reduced LV function, when strain measurements may be altered as a reflection of reduced LVEF itself. Results Both global longitudinal and circumferential strain values were abnormal (−12.8±5.1% and −11.4±4.1%, respectively), reflecting LV dysfunction in this CAD cohort (EF = 40±16%). The magnitude of both RLS and RCS was significantly reduced in areas of LGE, compared to those without LGE: RLS −10.0±5.8% versus −20.4±7.5% (p<0.001); RCS −10.1±5.3±% versus −18.9±7.5%, respectively (p<0.001). Same pattern was noted in the reduced EF subgroup: RLS −8.0±4.7% versus −16.9±6.6% (p<0.001), RCS −7.7±4.3±% versus −16.0±7.9%, respectively (p<0.001). The figure depicts 2 representative cases in long and short axis views, LGE detection and concomitant regional strain analysis. LGE and regional strain analysis. Conclusion Reduced magnitude of regional longitudinal and circumferential strain by CMR-FT correlates with presence of LGE. Pending further validation, this finding may constitute the basis for detection of scar without contrast enhanced imaging, and would result in reduced cost, scan time and risk associated with gadolinium. Acknowledgement/Funding ARP: Research support (software) from Neosoft and Philips

scholarly journals Left atrial strain for predicting arrhythmia recurrence after atrial fibrillation ablation: cardiac magnetic resonance rapid strain vs. feature tracking strain

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L H G Hopman ◽  
M J Mulder ◽  
A Van Der Laan ◽  
P Bhagirath ◽  
A Demirkiran ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Left Atrial ◽  
Feature Tracking ◽  
Strain Analysis ◽  
Ablative Therapy ◽  
Atrial Strain ◽  
Long Axis Strain ◽  
Af Recurrence

Abstract Background Global left atrial (LA) strain is a predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). Recently, novel rapid LA strain assessment approaches have emerged: LA long axis strain and LA AV junction strain. Currently, it remains unknown whether these rapid strain approaches can predict AF recurrence after AF ablative therapy and hence may be a simple alternative for the cumbersome LA feature tracking strain analysis. Purpose The present study focusses on the predictive value of different atrial strain quantification methods in relation to AF recurrence after PVI. Rapid LA strain analysis is compared to LA feature tracking strain in AF patients. Methods A total of 58 AF patients (78% paroxysmal AF, 64% male, mean age 61±7 years) undergoing first radiofrequency PVI ablation were included. Prior to ablation, all patients underwent cardiac magnetic resonance imaging being in sinus rhythm. LA rapid strain (long axis strain and AV junction strain) and LA feature tracking strain were derived from 2-chamber and 4-chamber cine CMR images. All patients were routinely followed up for arrhythmia recurrence through 12-lead ECGs, mobile-based one-lead ECGs, and/or Holter monitoring. Results After one year follow-up, arrhythmia recurrence (after the 90-day blanking period) was observed in 21 patients (36%), occurring after a median of 159 (119–320) days. LA long axis strain, AV junction strain, and feature tracking strain were all significantly reduced in patients with AF recurrence compared to patients without AF recurrence (long axis strain: −19.96±11.03% vs. −28.18±9.93%, P=0.005; AV junction strain: −18.08±9.69% vs. −25.60±8.79%, P=0.004; feature tracking strain: −12.54±4.16% vs. −15.94±3.50%, P=0.002, respectively, figure A to C). ROC analysis identified LA feature tracking strain as having the highest area under the curve (AUC) for predicting AF recurrence after ablative therapy (AUC: 0.75 for LA feature tracking strain, 0.71 for LA long axis strain, 0.70 for AV junction strain, figure D). Both LA rapid strain methods had a significant correlation with LA feature tracking strain (LA long axis strain vs. LA feature tracking strain, r=0.76, P&lt;0.001 and LA AV junction strain vs. LA feature tracking strain, r=0.77, P&lt;0.001). Conclusion LA rapid strain and LA feature tracking strain both have clinically relevant predictive power for prediction of AF recurrence after index PVI in AF patients. Considering the ease of LA rapid strain analysis, this method may be a valuable parameter to assess in clinical practice. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

P5288Slice position vulnerability in the basal and apical parts for right ventricular circumferential strain measurement with feature tracking cardiac magnetic resonance

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Gleditsch ◽  
O Jervan ◽  
O Geier ◽  
A Tofteberg ◽  
W Ghanima ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Right Ventricular ◽  
Feature Tracking ◽  
Circumferential Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Cine Imaging ◽  
Short Axis ◽  
Percentage Points

Abstract Background Strain is a more sensitive and precise parameter than ejection fraction (EF) for detection and characterization of subclinical left ventricular (LV) dysfunction and remodeling. Similar relationship is expected for right ventricle (RV); however RV functional parameters are less validated. Feature tracking strain analysis based on standard cardiac magnetic resonance (CMR) cine imaging is available for both ventricles. We experience a large slice-to-slice variation for RV global circumferential strain (GCS), possibly making the parameter vulnerable to minute position changes. Purpose To evaluate slice-to-slice differences in RV GCS for identification of the least variation region in a patient group without regional RV disease, in order to achieve a robust method for measurement. Hypothesis The slice-to-slice difference in peak GCS is lower in the mid-ventricular part of the RV than in the basal and apical parts. Methods 50 patients 6–72 months after pulmonary embolism without other major cardiopulmonary disease were included; mean age 60 years (range: 18–75 years); 68% men. Standard 2D cine CMR was obtained in longitudinal planes and in 10–12 consecutive 10 mm short axis planes for complete coverage of the RV. RV free wall and the inner contour of the septum were manually segmented on every end-diastolic and end-systolic slice from the pulmonary valve to the apex for feature tracking strain analysis. Peak RV GCS for every short axis slice and GCS difference (absolute percentage points) between adjacent slices were calculated. RV EF and peak RV GLS from the 4-chamber image were measured for correlation to RV GCS. Wilcoxon signed rank test and Pearson correlation were performed. Confidence intervals of means are based on 1000 bootstrap samples. Results RV EF was 46.6% (95% CI: 44.3; 48.8), RV peak GLS was −17.6% (95% CI: −18.6; −16.6). RV mid-ventricular GCS was −10.9% (95% CI: −12.0; −9.9). RV peak GCS slice-to-slice difference was 6.8 absolute percentage points (95% CI: 6.0; 7.6) in the basal part, 2.7 (95% CI: 2.4; 3.0) in the mid-ventricular part and 4.6 (95% CI: 3.9; 5.3) apically. Difference was significantly lower in mid-ventricular (p<0.001) compared to both basal and apical. RV EF correlated to RV peak GLS (r: −0.397, p=0.004) and mid-ventricular peak GCS (r: −0.356, p=0.01) but not to basal or apical peak GCS. RV peak GLS correlated to basal and mid-ventricular peak GCS (r: 0.313, p=0.03 and r: 0.301, p=0.03 respectively) but not to apical peak GCS. Figure 1 shows slice-to-slice difference (expressed in absolute percentage points) in right ventricular peak GCS. Conclusion Slice-to-slice difference in RV peak GCS was significantly lower in the mid-ventricular region. Large differences in the basal and apical parts indicate that measurements largely depend on slice positioning.

scholarly journals Training- and sex related alterations of global feature-tracking strain values of highly trained athletes using cardiac magnetic resonance imaging

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L Szabo ◽  
V Juhasz ◽  
Z Dohy ◽  
C Czimbalmos ◽  
O Kiss ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Ejection Fraction ◽  
Feature Tracking ◽  
Female Athletes ◽  
Strain Analysis ◽  
Resonance Imaging ◽  
Male Athletes ◽  
Innovation And Technology

Abstract Introduction Cardiac magnetic resonance imaging (CMR) is a reference method for assessing the morphological and functional parameters of the heart, and more recently, strain analysis can detect mechanical features. Based on echocardiographic data, strain parameters may help to differentiate between physiological athlete adaptation and pathological hypertrophy, however, there are still little data available among elite athletes regarding strain values using CMR. Aims Our aim was to study the strain characteristics of the athlete's heart using CMR imaging. Methods Overall, 228 (149 male, 24±5 years) highly trained adult (18–35 years), Caucasian athletes (≥10h training hours/ week) who underwent CMR examination as part of their screening were included in our study. Cine movie images in long- and short axis views were performed. Standard CMR parameters including left- and right ventricular (LV and RV) volumes, ejection fraction and muscle masses were measured. Feature-tracking strain analyses were performed, global LV longitudinal, circumferential and radial strain and RV longitudinal strain were calculated. CMR parameters of athletes were compared with healthy sex- and age matched sedentary control groups (n=105, 55 men). Results Athletes competed in mixed (n=99), endurance (n=99) and power (n=30) sport disciplines, and performed sport activity in quite high training hours (average: 21±5 hours/week). Regarding standard CMR parameters we found pronounced sports adaptation in both male and female athletes compared to sex- and age matched controls including lower LV and RV ejection fraction (p&lt;0.05), elevated LV and RV volumes and masses (p&lt;0.001). Strain analysis also revealed differences between athletes and controls: LV- GLS, GCS, GRS were lower in athletes compared to controls, regardless of their sex (p&lt;0.05). RV-GLS was slightly lower in male athletes compared to male controls. Examining the effects of sport disciplines, we found the most marked sport adaptation in the case of endurance athletes. Training hours showed a positive correlation with LV-GLS and GCS values, and a negative correlation with GRS (p&lt;0.001). We found that male athletes had more pronounced cardiac adaptation compared to females (p&lt;0.001), and their LV-GLS and GRS values were lower (GLS: male athletes: −20±2% vs. female athletes: −22±2%; p&lt;0.001), while GCS and RV-GLS showed no difference between sexes. Conclusion Our results suggest that in addition to standard CMR parameters, global strain values also show a small but consistent change during sport adaptation. Moreover, our results support the use of sex specific strain normal values in highly trained athletes. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The study was financed by the Research Excellence Programme of the Ministry for Innovation and Technology in Hungary within the framework of the Bioimaging Thematic Programme of Semmelweis University. LS was supported by the ÚNKP-20-3-II-SE-61 New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund.

scholarly journals Prognostic significance of cardiac magnetic resonance-based markers in patients with hypertrophic cardiomyopathy

2021 ◽  
Author(s):  
Zsofia Dohy ◽  
Liliana Szabo ◽  
Attila Toth ◽  
Csilla Czimbalmos ◽  
Rebeka Horvath ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Hypertrophic Cardiomyopathy ◽  
Magnetic Resonance ◽  
Myocardial Fibrosis ◽  
Ventricular Arrhythmias ◽  
Prognostic Significance ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Icd Therapy ◽  
Lv Mass

AbstractThe prognosis of patients with hypertrophic cardiomyopathy (HCM) varies greatly. Cardiac magnetic resonance (CMR) is the gold standard method for assessing left ventricular (LV) mass and volumes. Myocardial fibrosis can be noninvasively detected using CMR. Moreover, feature-tracking (FT) strain analysis provides information about LV deformation. We aimed to investigate the prognostic significance of standard CMR parameters, myocardial fibrosis, and LV strain parameters in HCM patients. We investigated 187 HCM patients who underwent CMR with late gadolinium enhancement and were followed up. LV mass (LVM) was evaluated with the exclusion and inclusion of the trabeculae and papillary muscles (TPM). Global LV strain parameters and mechanical dispersion (MD) were calculated. Myocardial fibrosis was quantified. The combined endpoint of our study was all-cause mortality, heart transplantation, malignant ventricular arrhythmias and appropriate implantable cardioverter defibrillator (ICD) therapy. The arrhythmia endpoint was malignant ventricular arrhythmias and appropriate ICD therapy. The LVM index (LVMi) was an independent CMR predictor of the combined endpoint independent of the quantification method (p < 0.01). The univariate predictors of the combined endpoint were LVMi, global longitudinal (GLS) and radial strain and longitudinal MD (MDL). The univariate predictors of arrhythmia events included LVMi and myocardial fibrosis. More pronounced LV hypertrophy was associated with impaired GLS and increased MDL. More extensive myocardial fibrosis correlated with impaired GLS (p < 0.001). LVMi was an independent CMR predictor of major events, and myocardial fibrosis predicted arrhythmia events in HCM patients. FT strain analysis provided additional information for risk stratification in HCM patients.

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