TCT-189 Effect of Low-Dose Intracoronary Alteplase on Global Circumferential Strain: Myocardial Strain Cardiovascular Magnetic Resonance Substudy of the T-TIME Trial

Abstract Background Several cardiovascular magnetic resonance (CMR) techniques can measure myocardial strain and torsion with high accuracy. The purpose of this study was to compare displacement encoding with stimulated echoes (DENSE), tagging and feature tracking (FT) for measuring circumferential and radial myocardial strain and myocardial torsion in order to assess myocardial function and infarct scar burden both at a global and at a segmental level. Method 116 patients with a high likelihood of coronary artery disease (European SCORE > 15%) underwent CMR examination including cine images, tagging, DENSE and late gadolinium enhancement (LGE) in the short axis direction. In total, 97 patients had signs of myocardial disease and 19 had no abnormalities in terms of left ventricular (LV) wall mass index, LV ejection fraction, wall motion, LGE or a history of myocardial infarction. Thirty-four patients had myocardial infarct scar with a transmural LGE extent (transmurality) that exceeded 50% of the wall thickness in at least one segment. Global circumferential strain (GCS) and global radial strain (GRS) was analyzed using FT of cine loops, deformation of tag lines or DENSE displacement. Results DENSE and tagging both showed high sensitivity (82% and 71%) at a specificity of 80% for the detection of segments with > 50% LGE transmurality, and receiver operating characteristics (ROC) analysis showed significantly higher area under the curve-values (AUC) for DENSE (0.87) than for tagging (0.83, p < 0.001) and FT (0.66, p = 0.003). GCS correlated with global LGE when determined with DENSE (r = 0.41), tagging (r = 0.37) and FT (r = 0.15). GRS had a low but significant negative correlation with LGE; DENSE r = − 0.10, FT r = − 0.07 and tagging r = − 0.16. Torsion from DENSE and tagging had a weak correlation (− 0.20 and − 0.22 respectively) with global LGE. Conclusion Circumferential strain from DENSE detected segments with > 50% scar with a higher AUC than strain determined from tagging and FT at a segmental level. GCS and torsion computed from DENSE and tagging showed similar correlation with global scar size, while when computed from FT, the correlation was lower.

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Low-Dose Dobutamine Cardiovascular Magnetic Resonance Segmental Strain Study of Early Phase of Intramyocardial Hemorrhage Rats

10.21203/rs.3.rs-506296/v1 ◽

2021 ◽

Author(s):

Rui Xia ◽

Bo He ◽

Tong Zhu ◽

Yu Zhang ◽

Yushu Chen ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Early Phase ◽

Low Dose ◽

T2 Mapping ◽

Myocardial Strain ◽

Cine Sequence ◽

Mapping Sequence ◽

Significant Difference ◽

Before And After

Abstract Background: This study investigates the segmental myocardial strain of the early phase of intramyocardial hemorrhage (IMH) caused by reperfused myocardial infarction (MI) in rats by low-dose dobutamine (LDD) cardiovascular magnetic resonance (CMR) feature-tracking. Methods: Nine sham rats and nine rats with 60-min myocardial ischemia followed by 48-h reperfusion were investigated using CMR, including T2*-mapping sequence and fast imaging with steady-state precession (FISP)–cine sequence. Another FISP–cine sequence was acquired after 2 min of dobutamine injection; the MI, IMH, and Non-MI (NMI) areas were identified. The values of peak radial strains (PRS) and peak circumferential strains (PCS) of the MI, IMH and NMI segments were acquired. The efficiency of PRS and PCS (EPRS and EPCS, respectively) were calculated on the basis of the time of every single heartbeat. Results: The PRS, PCS, EPRS, and EPCS of the sham group increased after LDD injection. However, the PRS, PCS, EPRS, and EPCS of the IMH segment did not increase. Moreover, the PRS and PCS of the MI and NMI segments did not increase, but the EPRS and EPCS of these segments increased. The PRS, PCS, EPRS, and EPCS of the IMH segment were lower than those of the MI and NMI segments before and after LDD injection, but without a significant difference between MI segment and NMI segment before and after LDD injection. Conclusions: LDD could help assess dysfunctions in segments with IMH, especially using the efficiency of strain. IMH was a crucial factor that decreased segmental movement and reserved function.

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Global Circumferential Strain by Cardiac Magnetic Resonance Tissue Tracking Associated With Ventricular Arrhythmias in Hypertrophic Cardiomyopathy Patients

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.670361 ◽

2021 ◽

Vol 8 ◽

Author(s):

Cailing Pu ◽

Jingle Fei ◽

Sangying Lv ◽

Yan Wu ◽

Chengbin He ◽

...

Keyword(s):

Cardiac Magnetic Resonance ◽

Hypertrophic Cardiomyopathy ◽

Magnetic Resonance ◽

Ventricular Arrhythmias ◽

Circumferential Strain ◽

Myocardial Strain ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Global Circumferential Strain ◽

Tissue Tracking

Background: Hypertrophic cardiomyopathy (HCM) is prone to myocardial heterogeneity and fibrosis, which are the substrates of ventricular arrhythmias (VAs). Cardiac magnetic resonance tissue tracking (CMR-TT) can quantitatively reflect global and regional left ventricular strain from different directions. It is uncertain whether the change of myocardial strain detected by CMR-TT is associated with VAs. The aim of the study is to explore the differential diagnostic value of VAs in HCM by CMR-TT.Materials and Methods: We retrospectively included 93 HCM patients (38 with VAs and 55 without VAs) and 30 healthy cases. Left ventricular function, myocardial strain parameters and percentage of late gadolinium enhancement (%LGE) were evaluated.Results: Global circumferential strain (GCS) and %LGE correlated moderately (r = 0.51, P < 0.001). HCM patients with VAs had lower left ventricular ejection fraction (LVEF), global radial strain (GRS), GCS, and global longitudinal strain (GLS), but increased %LGE compared with those without VAs (P < 0.01 for all). %LGE and GCS were indicators of VAs in HCM patients by multivariate logistic regression analysis. HCM patients with %LGE >5.35% (AUC 0.81, 95% CI 0.70–0.91, P < 0.001) or GCS >-14.73% (AUC 0.79, 95% CI 0.70–0.89, P < 0.001) on CMR more frequently had VAs. %LGE + GCS were able to better identify HCM patients with VAs (AUC 0.87, 95% CI 0.79–0.95, P < 0.001).Conclusion: GCS and %LGE were independent risk indicators of VAs in HCM. GCS is expected to be a good potential predictor in identifying HCM patients with VAs, which may provide important values to improve risk stratification in HCM in clinical practice.

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Comparison between conventional and compressed sensing cine cardiovascular magnetic resonance for feature tracking global circumferential strain assessment

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-021-00708-5 ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Tomoyuki Kido ◽

Kuniaki Hirai ◽

Ryo Ogawa ◽

Yuki Tanabe ◽

Masashi Nakamura ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Compressed Sensing ◽

Feature Tracking ◽

Circumferential Strain ◽

Strain Analysis ◽

Global Circumferential Strain ◽

Volume Assessment ◽

Lv Volume ◽

Cine Cmr

Abstract Background Feature tracking (FT) has become an established tool for cardiovascular magnetic resonance (CMR)-based strain analysis. Recently, the compressed sensing (CS) technique has been applied to cine CMR, which has drastically reduced its acquisition time. However, the effects of CS imaging on FT strain analysis need to be carefully studied. This study aimed to investigate the use of CS cine CMR for FT strain analysis compared to conventional cine CMR. Methods Sixty-five patients with different left ventricular (LV) pathologies underwent both retrospective conventional cine CMR and prospective CS cine CMR using a prototype sequence with the comparable temporal and spatial resolution at 3 T. Eight short-axis cine images covering the entire LV were obtained and used for LV volume assessment and FT strain analysis. Prospective CS cine CMR data over 1.5 heartbeats were acquired to capture the complete end-diastolic data between the first and second heartbeats. LV volume assessment and FT strain analysis were performed using a dedicated software (ci42; Circle Cardiovasacular Imaging, Calgary, Canada), and the global circumferential strain (GCS) and GCS rate were calculated from both cine CMR sequences. Results There were no significant differences in the GCS (− 17.1% [− 11.7, − 19.5] vs. − 16.1% [− 11.9, − 19.3; p = 0.508) and GCS rate (− 0.8 [− 0.6, − 1.0] vs. − 0.8 [− 0.7, − 1.0]; p = 0.587) obtained using conventional and CS cine CMR. The GCS obtained using both methods showed excellent agreement (y = 0.99x − 0.24; r = 0.95; p < 0.001). The Bland–Altman analysis revealed that the mean difference in the GCS between the conventional and CS cine CMR was 0.1% with limits of agreement between -2.8% and 3.0%. No significant differences were found in all LV volume assessment between both types of cine CMR. Conclusion CS cine CMR could be used for GCS assessment by CMR-FT as well as conventional cine CMR. This finding further enhances the clinical utility of high-speed CS cine CMR imaging.

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Low-dose dobutamine cardiovascular magnetic resonance segmental strain study of early phase of intramyocardial hemorrhage rats

BMC Medical Imaging ◽

10.1186/s12880-021-00709-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rui Xia ◽

Bo He ◽

Tong Zhu ◽

Yu Zhang ◽

Yushu Chen ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Early Phase ◽

Low Dose ◽

T2 Mapping ◽

Myocardial Strain ◽

Cine Sequence ◽

Mapping Sequence ◽

Significant Difference ◽

Before And After

Abstract Background This study investigates the segmental myocardial strain of the early phase of intramyocardial hemorrhage (IMH) caused by reperfused myocardial infarction (MI) in rats by low-dose dobutamine (LDD) cardiovascular magnetic resonance (CMR) feature-tracking. Methods Nine sham rats and nine rats with 60-min myocardial ischemia followed by 48-h reperfusion were investigated using CMR, including T2*-mapping sequence and fast imaging with steady-state precession (FISP)–cine sequence. Another FISP–cine sequence was acquired after 2 min of dobutamine injection; the MI, IMH, and Non-MI (NMI) areas were identified. The values of peak radial strains (PRS) and peak circumferential strains (PCS) of the MI, IMH and NMI segments were acquired. The efficiency of PRS and PCS (EPRS and EPCS, respectively) were calculated on the basis of the time of every single heartbeat. Results The PRS, PCS, EPRS, and EPCS of the sham group increased after LDD injection. However, the PRS, PCS, EPRS, and EPCS of the IMH segment did not increase. Moreover, the PRS and PCS of the MI and NMI segments did not increase, but the EPRS and EPCS of these segments increased. The PRS, PCS, EPRS, and EPCS of the IMH segment were lower than those of the MI and NMI segments before and after LDD injection, but without a significant difference between MI segment and NMI segment before and after LDD injection. Conclusions LDD could help assess dysfunctions in segments with IMH, especially using the efficiency of strain. IMH was a crucial factor that decreased segmental movement and reserved function.

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Correlation between left ventricular myocardial strain and left ventricular geometry in healthy adults: a cardiovascular magnetic resonance-feature tracking study

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-019-01644-3 ◽

2019 ◽

Vol 35 (11) ◽

pp. 2057-2065 ◽

Cited By ~ 1

Author(s):

Zhen Zhang ◽

Qiaozhi Ma ◽

Lizhen Cao ◽

Zhiwei Zhao ◽

Jun Zhao ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Feature Tracking ◽

Myocardial Strain ◽

Left Ventricular ◽

Healthy Adults ◽

Left Ventricular Geometry ◽

Ventricular Geometry

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Relationship between cardiovascular risk factors and myocardial strain values of both ventricles in asymptomatic Asian subjects: measurement using cardiovascular magnetic resonance tissue tracking

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-018-1414-1 ◽

2018 ◽

Vol 34 (12) ◽

pp. 1949-1957 ◽

Cited By ~ 4

Author(s):

Ji-won Hwang ◽

Min Jae Cha ◽

Sung Mok Kim ◽

Yiseul Kim ◽

Yeon Hyeon Choe

Keyword(s):

Risk Factors ◽

Cardiovascular Magnetic Resonance ◽

Cardiovascular Risk ◽

Magnetic Resonance ◽

Cardiovascular Risk Factors ◽

Myocardial Strain ◽

Tissue Tracking

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Association Between 2D- and 3D-Speckle-Tracking Longitudinal Strain and Cardiovascular Magnetic Resonance Evidence of Diffuse Myocardial Fibrosis in Heart Transplant Recipients

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.727745 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wei Sun ◽

Xuehua Shen ◽

Jing Wang ◽

Shuangshuang Zhu ◽

Yanting Zhang ◽

...

Keyword(s):

Cardiovascular Magnetic Resonance ◽

Magnetic Resonance ◽

Myocardial Fibrosis ◽

Heart Transplant ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Myocardial Strain ◽

Left Ventricular ◽

Healthy Controls ◽

2D And 3D

Objective: This study aimed to: (1) evaluate the association between myocardial fibrosis (MF) quantified by extracellular volume fraction (ECV) and myocardial strain measured by two-dimensional (2D)- and three-dimensional speckle-tracking echocardiography (3D-STE) and (2) further investigate which strain parameter measured by 2D- and 3D-STE is the more robust predictor of MF in heart transplant (HT) recipients.Methods: A total of 40 patients with HT and 20 healthy controls were prospectively enrolled. Left ventricular (LV)-global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured by 2D- and 3D-STE. LV diffuse MF was defined by cardiovascular magnetic resonance (CMR)-ECV.Results: The HT recipients had a significantly higher native T1 and ECV than healthy controls (1043.8 ± 34.0 vs. 999.7 ± 19.7 ms, p < 0.001; 26.6 ± 2.7 vs. 24.3 ± 1.8%, p = 0.02). The 3D- and 2D-STE-LVGLS and LVGCS were lower (p < 0.005) in the HT recipients than in healthy controls. ECV showed a moderate correlation with 2D-LVGLS (r = 0.53, p = 0.002) and 3D-LVGLS (r = 0.60, p < 0.001), but it was not correlated with 2D or 3D-LVGCS, or LVGRS. Furthermore, 3D-LVGLS and 2D-LVGLS had a similar correlation with CMR-ECV (r = 0.60 vs. 0.53, p = 0.670). A separate stepwise multivariate linear analysis showed that both the 2D-LVGLS (β = 0.39, p = 0.019) and 3D-LVGLS (β = 0.54, p < 0.001) were independently associated with CMR-ECV.Conclusion: CMR marker of diffuse MF was present in asymptomatic patients with HT and appeared to be associated with decreased myocardial strain by echocardiography. Both the 2D- and 3D-LVGLS were independently correlated with diffuse LVMF, which may provide an alternative non-invasive tool for monitoring the development of adverse fibrotic remodeling during the follow-up of HT recipients.

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