Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case–control study

AbstractVentricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Most SLV patients had a normal systolic function but median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR (from 2D-CMR-FT) were not significantly different between DILV and TA patients. Although most SLV patients had a preserved EF derived by CMR, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.

Download Full-text

Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case-control study

10.21203/rs.3.rs-238338/v1 ◽

2021 ◽

Author(s):

Fabian Strodka ◽

Jana Logoteta ◽

Roman Schuwerk ◽

Mona Salehi Ravesh ◽

Dominik Daniel Gabbert ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Left Ventricle ◽

Feature Tracking ◽

Nyha Class ◽

Radial Strain ◽

Left Ventricular ◽

Lv Function ◽

Significant Difference ◽

Lv Volumes

Abstract Purpose Ventricular dysfunction is a well-known complication in single ventricle patients in Fontan circulation. As studies exclusively examining patients with a single left ventricle (SLV) are sparse, we assessed left ventricular (LV) function in SLV patients by using 2D-cardiovascular magnetic resonance (CMR) feature tracking (2D-CMR-FT) and 2D-speckle tracking echocardiography (2D-STE). Methods 54 SLV patients (11.4, 3.1–38.1 years) and 35 age-matched controls (12.3, 6.3–25.8 years) were included. LV global longitudinal, circumferential and radial strain (GLS, GCS, GRS) and strain rate (GLSR, GCSR, GRSR) were measured using 2D-CMR-FT. LV volumes, ejection fraction (LVEF) and mass were determined from short axis images. 2D-STE was applied in patients to measure peak systolic GLS and GLSR. In a subgroup analysis, we compared double inlet left ventricle (DILV) with tricuspid atresia (TA) patients. Results The population consisted of 19 DILV patients, 24 TA patients and 11 patients with diverse diagnoses. 52 patients were in NYHA class I and 2 patients were in class II. Median LVEF in patients was lower compared to controls (55.6% vs. 61.2%, p = 0.0001). 2D-CMR-FT demonstrated reduced GLS, GCS and GCSR values in patients compared to controls. LVEF correlated with GS values in patients (p < 0.05). There was no significant difference between GLS values from 2D-CMR-FT and 2D-STE in the patient group. LVEF, LV volumes, GS and GSR were not significantly different between DILV and TA patients. Conclusion Although most SLV patients had a preserved EF, our results suggest that, LV deformation and function may behave differently in SLV patients compared to healthy subjects.

Download Full-text

Strain parameters for predicting the prognosis of non‐ischemic dilated cardiomyopathy using cardiovascular magnetic resonance tissue feature tracking

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-021-00726-3 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Chengjie Gao ◽

Yajie Gao ◽

Jingyu Hang ◽

Meng Wei ◽

Jingbo Li ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Dilated Cardiomyopathy ◽

Feature Tracking ◽

Systolic Function ◽

Radial Strain ◽

Left Ventricular ◽

Multivariate Logistic Regression Model ◽

Non Ischemic Dilated Cardiomyopathy

Abstract Background A considerable number of non-ischemic dilated cardiomyopathy (NDCM) patients had been found to have normalized left ventricular (LV) size and systolic function with tailored medical treatments. Accordingly, we aimed to evaluate if strain parameters assessed by cardiovascular magnetic resonance (CMR) feature tracking (FT) analysis could predict the NDCM recovery. Methods 79 newly diagnosed NDCM patients who underwent baseline and follow-up CMR scans were enrolled. Recovery was defined as a current normalized LV size and systolic function evaluated by CMR. Results Among 79 patients, 21 (27%) were confirmed recovered at a median follow-up of 36 months. Recovered patients presented with faster heart rates (HR) and larger body surface area (BSA) at baseline (P < 0.05). Compared to unrecovered patients, recovered pateints had a higher LV apical radial strain divided by basal radial strain (RSapi/bas) and a lower standard deviation of time to peak radial strain in 16 segments of the LV (SD16-TTPRS). According to a multivariate logistic regression model, RSapi/bas (P = 0.035) and SD16-TTPRS (P = 0.012) resulted as significant predictors for differentiation of recovered from unrecovered patients. The sensitivity and specificity of RSapi/bas and SD16-TTPRS for predicting recovered conditions were 76%, 67%, and 91%, 59%, with the area under the curve of 0.75 and 0.76, respectively. Further, Kaplan Meier survival analysis showed that patients with RSapi/bas ≥ 0.95% and SD16-FTPRS ≤ 111 ms had the highest recovery rate (65%, P = 0.027). Conclusions RSapi/bas and CMR SD16-TTPRS may be used as non-invasive parameters for predicting LV recovery in NDCM. This finding may be beneficial for subsequent treatments and prognosis of NDCM patients. Registration number: ChiCTR-POC-17012586.

Download Full-text

Insight form cardiovascular magnetic resonance on cardiac sarcoidosis: a single centre experience

European Heart Journal ◽

10.1093/ehjci/ehaa946.0217 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Alderighi ◽

A Baritussio ◽

O Ozden Tok ◽

M Perazzolo Marra ◽

S Iliceto ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

T1 Mapping ◽

Cardiac Involvement ◽

Cardiac Sarcoidosis ◽

T2 Mapping ◽

Left Ventricular ◽

Lv Function ◽

Post Contrast ◽

Lv Volumes

Abstract Background Clinically manifest cardiac sarcoidosis (CS) has a prevalence of 5%, but is more frequent in autoptic series (25%). Diagnosis is multiparametric and relies on clinical criteria and imaging findings, although a certain diagnosis, especially in the case of isolated CS (ICS), can only be based on endomyocardial biopsy. Cardiovascular magnetic resonance (CMR) has a comprehensive role in the assessment of CS: left ventricular (LV) dysfunction and extent of late gadolinium enhancement (LGE)are important predictors of prognosis, T2 mapping provides information on disease activity and global longitudinal strain (GLS) analysis can uncover subclinical LV impairment. Purpose To assess the prevalence of CS by CMR in patients with biopsy-proven extracardiacsarcoidosis (ECS); to describe the imaging characteristics of patients with ECS and those with high clinical suspicionof ICS; to investigate the contribution of more recent techniques to the diagnosis of CS alongside traditional LGE assessment. Methods We retrospectively enrolled 84 patients (66% males, mean age 59±13 years) referred to our centreforsuspected CS (biopsy-proven ECS, n=61; clinical presentation suggestive of CS,, n=23). CMR was performed on a 1.5T scanner, with a protocol comprehensive of biventricular functional assessment and post-contrast images; T2-STIR images (n=30), native myocardial T1 mapping (n=24) and T2 mapping (n=19) were also performed in selected patients. Tissue tracking analysis was perfomed in all patients using a dedicated software. Results Based on CMR findings, 35 patients (42%) with ECS did not show cardiac involvement (SS), 26 (31%) showed both cardiac and systemic involvement (CS-SS) and 23 (27%) had evidence of ICS (ICS). 43% of patients had history of arrhythmias, but life-threatening tachyarrhythmiaswere more frequent in patients with CS (p=0.02).Patients with CS had significantly lower LVEF (p<0,01), larger LV volumes (p<0,01) and greater LV mass (p<0,01). GLS values were impaired in all the groups but significantly more in patients with CS (p<0,01). With regards to LGE distribution, ICS patients showed a higher number of segments involved (p=0,011) as compared to CS patients. T2-STIRimages were positive in 3 out of 30 patients; T2 mapping detected myocardial oedema in 1 patient with negative T2- STIR and was positive in 7 who did not undergo traditional oedema evaluation. T1 mapping mainly confirmed the results provided by LGE, but was altered in 1 patient who could not receive gadolinium. Conclusions CMR findings consistent with CS were found in 49 patients referred for suspected CS. Patients with cardiac involvement, particularly if isolated, had significantly lower LVEF, greater LV volumes and more impaired GLS. Patients with SS, despite a normal LV function, showed mildly impaired GLS, subtending subclinical cardiac involvement. Funding Acknowledgement Type of funding source: None

Download Full-text

Prognostic Value of Left Ventricular Function and Mechanics in Pulmonary Hypertension: A Pilot Cardiovascular Magnetic Resonance Feature Tracking Study

Medicina ◽

10.3390/medicina55030073 ◽

2019 ◽

Vol 55 (3) ◽

pp. 73 ◽

Cited By ~ 5

Author(s):

Lina Padervinskienė ◽

Aušra Krivickienė ◽

Deimantė Hoppenot ◽

Skaidrius Miliauskas ◽

Algidas Basevičius ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Cardiovascular Magnetic Resonance ◽

Feature Tracking ◽

Prognostic Value ◽

Longitudinal Strain ◽

Systolic Function ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Lv Function ◽

Lv Systolic Function

Background and objective: Cardiovascular magnetic resonance (CMR) - based feature tracking (FT) can detect left ventricular (LV) strain abnormalities in pulmonary hypertension (PH) patients, but little is known about the prognostic value of LV function and mechanics in PH patients. The aim of this study was to evaluate LV systolic function by conventional CMR and LV global strains by CMR-based FT analysis in precapillary PH patients, thereby defining the prognostic value of LV function and mechanics. Methods: We prospectively enrolled 43 patients with precapillary PH (mean pulmonary artery pressure (mPAP) 55.91 ± 15.87 mmHg, pulmonary arterial wedge pressure (PAWP) ≤15 mmHg) referred to CMR for PH evaluation. Using FT software, the LV global longitudinal strain (GLS) and global circumferential strain (GCS), also right ventricular (RV) GLS were analyzed. Results: Patients were classified into two groups according to survival (survival/non-survival). LV GLS was significantly reduced in the non-survival group (−12.4% [−19.0–(−7.8)] vs. −18.4% [−22.5–(−15.5)], p = 0.009). By ROC curve analysis, LV GLS > −14.2% (CI: 3.229 to 37.301, p < 0.001) was found to be robust predictor of mortality in PH patients. Univariable analysis using the Cox model showed that severely reduced LV GLS > −14.2%, with good sensitivity (77.8%) and high specificity (93.5%) indicated an increase of the risk of death by 11-fold. LV GLS significantly correlated in PH patients with RV ESVI (r = 0.322, p = 0.035), RV EF (r = 0.444, p < 0.003). Conclusions: LV systolic function and LV global longitudinal strain measurements using CMR-FT correlates with RV dysfunction and is associated with poor clinical outcomes in precapillary PH patients.

Download Full-text

Evaluation of left ventricular systolic function and mechanics

The ESC Textbook of Cardiovascular Imaging ◽

10.1093/med/9780198703341.003.0023 ◽

2015 ◽

pp. 315-322

Author(s):

Rainer Hoffmann ◽

Paolo Colonna

Keyword(s):

Cardiac Magnetic Resonance ◽

Quantitative Analysis ◽

Magnetic Resonance ◽

Systolic Function ◽

Left Ventricular ◽

Tissue Imaging ◽

Lv Function ◽

2D Echocardiography ◽

Other Information ◽

Lv Volumes

Analysis of left ventricular (LV) systolic function is the most frequent indication to perform echocardiography and an integral part of cardiac magnetic resonance (CMR) or radionuclide studies. Visual estimation of LV function may be supplemented by quantitative analysis of 2D images to obtain parameters of global or regional function. Administration of contrast agents to improve identification of myocardium–blood interface has been demonstrated to improve the reproducibility of 2D-echocardiography-based analysis of LV function and should be applied in cases of insufficient endocardial border definition (more than two LV segments not adequately visualized). 2D-echocardiography-based analysis of LV volumes results in underestimation of end-systolic and end-diastolic LV volumes compared to CMR. 3D-echocardiography results in significantly less volume underestimation and higher accuracy in the analysis of ejection fraction. Analysis of regional wall motion is mainly based on subjective visual assessment, which is limited by significant inter-observer variability. Doppler tissue imaging and speckle tracking echocardiography have become validated methods for quantitative analysis of regional LV function. Similarly, tagging, strain-encoded cardiac magnetic resonance (SENC) and feature tracking are modalities to quantify regional LV function based on CMR. Echocardiography should be used as a primary technique to assess systolic LV function as it is the cheapest, widely available and can be applied without the use of ionizing radiation or nephrotoxic contrast material. CMR has become the clinical gold standard for quantification of LV function and may be applied if other information achievable best by CMR is required. Similarly, nuclear techniques should be applied to assess LV function only if simultaneous assessment of myocardial perfusion is requested.

Download Full-text

Systolic function evaluated with cardiovascular magnetic resonance imaging in HIV-infected patients

South African Journal of Radiology ◽

10.4102/sajr.v20i2.1044 ◽

2016 ◽

Vol 20 (2) ◽

Author(s):

Leonie Scholtz ◽

André Du Plessis ◽

Savvas Andronikou ◽

Anelia Swart ◽

Anton Stoltz ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Systolic Function ◽

Left Ventricular ◽

Sub Saharan Africa ◽

Uninfected Control ◽

Whole Body ◽

Functional Impairments ◽

Significant Difference ◽

Asymptomatic Hiv

Background: Of all areas worldwide, sub-Saharan Africa is worst affected by the HIV and/or AIDS epidemic. Cardiovascular manifestations are very common and are a powerful contributor to mortality, but often go undetected. Cardiovascular magnetic resonance (CMR) is the most reliable method of assessing cardiac function and morphology and, with this in mind, we initiated a cross-sectional study comparing CMR-determined morphological and functional parameters in asymptomatic HIV-infected patients who were not yet on treatment and early in the disease, with HIV-uninfected control patients.Objectives: To ascertain whether there were any morphological abnormalities or systolic functional impairments on CMR in untreated asymptomatic HIV-infected patients, compared with HIV-uninfected control individuals.Methods: The CMR studies were performed using a 1.5-T whole-body clinical magnetic resonance 16-channel scanner (Achieva, Philips Medical Systems, Best, The Netherlands), using a cardiac five-element phased-array receiver coil (SENSE coil). Functional assessment was performed on 36 HIV-infected patients and the findings compared with 35 HIV-uninfected control patients who were matched for age and sex.Results: There was no significant difference in systolic function between the HIV-uninfected and the HIV-infected patients. The left ventricular end diastolic mass (LVEDM) was slightly higher in the HIV-infected group, but this was statistically insignificant.Conclusion: No significant differences were found regarding the CMR systolic functional analysis and morphological parameters between the HIV-infected and the healthy volunteers.

Download Full-text

Myocardial Characterization in Patients with Nonischemic Dilated Cardiomyopathy Combined with Ventricular Arrhythmias: Insights from Cardiovascular Magnetic Resonance Feature Tracking

10.21203/rs.3.rs-444134/v1 ◽

2021 ◽

Author(s):

Hai-Yan Ma ◽

Xi-Hui Zhao ◽

Jian Tao ◽

Pan Liu ◽

Rong-Pin Wang

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Strain Rate ◽

Dilated Cardiomyopathy ◽

Ventricular Arrhythmias ◽

Feature Tracking ◽

Radial Strain ◽

Left Ventricular ◽

Global Deformation ◽

Global Peak

Abstract This study investigated the feasibility of using cardiovascular magnetic resonance feature tracking (CMR-FT) for analysis of left ventricular (LV) strain and strain rate in patients with non-ischemic dilated cardiomyopathy (NIDCM) combined with ventricular arrhythmias (VAs). And evaluated the correlation between the LV global strain and left ventricular ejection (LVEF). We performed a retrospective study in a cohort of 34 consecutive patients with NIDCM combined with VAs who underwent CMR examination in our hospital between January 2016 and December 2019. Global and segmental peak values of LV longitudinal, circumferential, radial strain, and systolic strain rate were analyzed. Pearson analysis was calculated to assess the correlation of LV global deformation and LVEF as well as the correlation of between LV global deformation. Compared with the healthy controls, the global peak radial strain (GPRS), global peak circumferential strain (GPCS), and global peak longitudinal strain (GPLS) were significantly reduced in patients with NIDCM combined with VAs (P < 0.001, respectively). Additionally, Pearson analysis showed GPCS negatively correlated with LVEF (r=-0.946, P < 0.001), GPLS negatively correlated with LVEF (r=-0.860, P < 0.001), and GPRS positively correlated with LVEF (r = 0.920, P < 0.001). CMR-FT is a feasible and promising technique for assessing LV myocardial deformation of patients with NIDCM combined with VAs. And, GPCS was better negatively correlated with LVEF and higher reproducibility of intra-class correlation coefficient (ICC), which can help to guide clinical treatment and have great implication on clinical decision.

Download Full-text

P5282Comparison of cardiovascular magnetic resonance ejection fraction and left ventricular volumes by long axis feature tracking strain analysis versus standard short axis stack contour tracing

European Heart Journal ◽

10.1093/eurheartj/ehz746.0253 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

M Vasquez ◽

V Puntmann ◽

E Nagel

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Ejection Fraction ◽

Feature Tracking ◽

Left Ventricular ◽

Systematic Bias ◽

Short Axis ◽

Reference Standard ◽

Post Processing ◽

Lv Volumes

Abstract Introduction Cardiovascular magnetic resonance (CMR) feature tracking (FT) is based on the recognition of endocardial features obtained during standard CMR cine imaging to be tracked and followed throughout the cardiac cycle. Global longitudinal strain (GLS) has been proposed as a superior measure for diagnosis and prognosis than ejection fraction (EF). However, EF remains an important primary parameter to describe cardiac function. A rapid determination of GLS based on three long axis views (LAX) allows for a simultaneous calculation of EF without additional imaging or post-processing promising a significant reduction of scan and post-processing time. Purpose The purpose of this work is to compare the LV volumes and EF obtained during assessment of GLS based on CMR feature tracking with standard analysis of a short axis (SAX) stack used as the reference standard. Methods 75 consecutive patients underwent a routine clinical scan obtaining a full SAX stack as well as 3 standard LAX views using either 3-Tesla or 1,5-Tesla clinical scanners. We determined LV volumes and EF based on the reference standard as well as feature tracking analysis with additional GLS. A p value <0.01 was considered statistically significant. Results Mean EF was 45.9% using standard SAX (range, 13%-72%) and 51.1% using triplanar feature tracking (r=0.950; p<0.0001, figure 1A). Bland-Altman analysis showed a systematic bias of 5,27%; without proportional bias (figure 1B). End-diastolic volumes (r=0,975; p<0.0001) and end-systolic volumes (r=0.985; p<0.0001) demonstrated similar results. Mean GLS was −17.3% (range: −30,7% to −3,3%) and was significantly correlated with standard EF (r=−0,884; p<0.0001). Classification of EF into categories: reduced, mid-range or preserved (<40%, 40–49%, ≥50%) remain unchanged in 79% of patients when using EF by feature tracking analysis. Twelve of 16 reclassifications occurred in the mid-range category. Figure 1 Conclusion There is a good correlation between EF obtained by rapid post-processing of GLS with EF based on a full SAX stack resulting in an identical categorization in 79% of patients. Reduction of EF within the mid-range might be best assesses by the standard SAX stack.

Download Full-text

The Improvement of Torsion Assessed by Cardiovascular Magnetic Resonance Feature Tracking after Coronary Artery Bypass Grafting: A Sensitive Index of Cardiac Function

The Heart Surgery Forum ◽

10.1532/hsf.1655 ◽

2017 ◽

Vol 20 (1) ◽

pp. 026 ◽

Cited By ~ 2

Author(s):

Nan Cheng ◽

Liuquan Cheng ◽

Rong Wang ◽

Lin Zhang ◽

Changqing Gao

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Ejection Fraction ◽

Cardiac Function ◽

Feature Tracking ◽

Artery Bypass ◽

Left Ventricular ◽

Rapid Acquisition ◽

Left Ventricular Torsion ◽

Ventricular Torsion

Objective: The aim of this study was to quantify left ventricular torsion by newly applied cardiovascular magnetic resonance feature tracking (CMR-FT), and to evaluate the clinical value of the ventricular torsion as a sensitive indicator of cardiac function by comparison of preoperative and postoperative torsion.Methods: A total of 54 volunteers and 36 patients with previous myocardial infarction (MI) and LV ejection fraction (EF) between 30%-50% were screened preoperatively or postoperatively by MRI. The patients’ short axis views of the whole heart were acquired, and all patients had a scar area >75% in at least one of the anterior or inferior segments. Their apical and basal rotation values were analyzed by feature tracking, and the correlation analysis was performed for the improvement of LV torsion and ejection fraction after CABG. The intra- and inter-observer reliabilities of torsion measured by CMR-FT were assessed.Results: In normal hearts, the apex rotated counterclockwise in the systolic period with the peak rotation as 10.2 ± 4.8°, and the base rotated clockwise as the peak value was 7.0 ± 3.3°. There was a timing hiatus between the apex and base untwisting, during which period the heart recoils and its suction sets the stage for the following rapid filling period. The postoperative torsion and rotation significantly improved compared with preoperative ones. However, the traditional indicator of cardiac function, ejection fraction, didn’t show significant improvement.Conclusion: Left ventricular torsion derived from CMR-FT, which does not require specialized CMR sequences, was sensitive to patients with low ejection fraction whose cardiac function significantly improved after CABG. The rapid acquisition of this measurement has potential for the assessment of cardiac function in clinical practice.

Download Full-text