FEATURE TRACKING MULTI-DETECTOR ROW COMPUTED TOMOGRAPHY-DERIVED LEFT VENTRICULAR GLOBAL LONGITUDINAL STRAIN IN A LARGE COHORT OF TAVR PATIENTS AND ASSOCIATION WITH ALL-CAUSE MORTALITY

ABSTRACT Background Patients with end-stage kidney disease (ESKD) are at increased risk premature death, with cardiovascular disease being the predominant mode of death. We hypothesized that left ventricular global longitudinal strain (LV-GLS) measured by feature tracking cardiovascular magnetic resonance imaging (CMR) would be associated with all-cause mortality in patients with ESKD. Methods A pooled analysis of CMR studies in patients with ESKD acquired within a single centre between 2002 and 2016 was carried out. CMR parameters including left ventricular ejection fraction (LVEF), LV mass index (LVMI), left atrial emptying fraction (LAEF) and LV-GLS were measured. We tested independent associations of CMR parameters with survival using a multivariable Cox model. Results Among 215 patients (mean age: 54 years, 62% male), mortality was 53% over 5.0 years median follow-up. The median LVEF was 64.7% (IQR 58.5, 70.0) and median LV-GLS was -15.3% (-17.24, -13.6). While 90% of patients had preserved LVEF (>50%), 58% of this group had abnormal LVGLS (>-16%). On multivariable Cox regression, age (HR: 1.04, 95%CI: 1.02-1.05), future-renal transplant (HR 0.29 95%CI: 0.17-0.47), LAEF (HR: 0.98, 95%CI: 0.96-1.00) and LV-GLS (HR: 1.08, 95%CI: 1.01-1.16) were independently associated with mortality. Conclusions In this cohort of patients with ESKD, LV-GLS on feature tracking CMR and LAEF were associated with all-cause mortality, independent of baseline clinical variables and future renal transplantation. This effect was present even when >90% of the cohort had normal left ventricular ejection fraction (LVEF). Using LV-GLS, instead of LVEF, to diagnose cardiac dysfunction in patients with ESKD could result in a major advance in our understanding of cardiovascular disease in ESKD.

Download Full-text

Association of Feature-Tracking Cardiac Magnetic Resonance Imaging Left Ventricular Global Longitudinal Strain With All-Cause Mortality in Patients With Reduced Left Ventricular Ejection Fraction

Circulation ◽

10.1161/circulationaha.117.027740 ◽

2017 ◽

Vol 135 (23) ◽

pp. 2313-2315 ◽

Cited By ~ 23

Author(s):

Simone Romano ◽

Robert M. Judd ◽

Raymond J. Kim ◽

Han W. Kim ◽

Igor Klem ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Cardiac Magnetic Resonance ◽

Feature Tracking ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Resonance Imaging ◽

Ventricular Ejection Fraction ◽

All Cause Mortality

Download Full-text

Impact of baseline feature tracking multi-detector row computed tomography-derived left ventricular global longitudinal strain on left ventricular functional recovery in TAVI patients

European Heart Journal ◽

10.1093/ehjci/ehaa946.0162 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Gegenava ◽

P Bijl ◽

M Vollema ◽

F Kley ◽

A Weger ◽

...

Keyword(s):

Computed Tomography ◽

Functional Recovery ◽

Feature Tracking ◽

Longitudinal Strain ◽

Systolic Function ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Lv Systolic Function

Abstract Background Advances in left ventricular (LV) analysis with dynamic multi-detector row computed tomography (MDCT) permit measurement of LV global longitudinal strain (GLS) and have shown their impact on risk stratification of patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). Purpose To evaluate the influence of baseline feature tracking (FT) MDCT- derived LV GLS on LV functional recovery in severe AS patients undergoing TAVI. Methods A total of 194 patients with severe AS (50% male, 80±7 years) with dynamic MDCT data allowing LV GLS measurement with a novel FT algorithm and having complete echocardiography evaluation at baseline, at 3–6 months and at 1 year follow-up were evaluated. FT MDCT-derived LV GLS was measured at baseline and the study population was divided according to a cut-off value of MDCT LV GLS −14% (≤−14% [more preserved LV systolic function] vs. >−14% [more impaired LV systolic function]). Results Transthoracic echocardiography (TTE)-derived Left ventricular ejection fraction (LVEF) increased over time in both groups: in patients with preserved and reduced MDCT LV GLS, and reached a higher value in patients with preserved MDCT LV GLS (52±7% at baseline, 55±7% at 3–6 months, 58±7% at 1 year follow-up vs. 43±10% at baseline, 49±10% at 3–6 months, 53±11% at 1 year follow-up; p=0.016) (Figure 1). TTE-derived LV GLS also showed greater improvement for patients with preserved MDCT LV GLS (−17±3% at baseline, −18±3% at 3–6 months, −20±3% at 1 year follow-up vs. −12±3% at baseline, −15±3% at 3–6 months, −16±3% at 1 year follow-up; p=0.027) (Figure 1). Conclusions In severe AS patients treated with TAVI, LV function improves significantly at 3–6 and at 12 months' follow-up and shows superior recovery in patients with more preserved baseline MDCT LV GLS, suggesting that MDCT-derived LV GLS has an important impact on LV functional recovery after TAVI. Funding Acknowledgement Type of funding source: None

Download Full-text

Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01916-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saikrishna Ananthapadmanabhan ◽

Giau Vo ◽

Tuan Nguyen ◽

Hany Dimitri ◽

James Otton

Keyword(s):

Feature Tracking ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Speckle Tracking Echocardiography ◽

Imaging Modality ◽

Global Longitudinal Strain ◽

Intraclass Correlation ◽

Strain Analysis ◽

Left Ventricular ◽

Multilayer Strain

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

Download Full-text

Feature-tracking cardiac magnetic resonance left ventricular global longitudinal strain improves 6 months after kidney transplantation associated with reverse remodeling, not myocardial tissue characteristics

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-021-02284-2 ◽

2021 ◽

Author(s):

Maurício Fregonesi Barbosa ◽

Mariana Moraes Contti ◽

Luis Gustavo Modelli de Andrade ◽

Alejandra del Carmen Villanueva Mauricio ◽

Sergio Marrone Ribeiro ◽

...

Keyword(s):

Kidney Transplantation ◽

Cardiac Magnetic Resonance ◽

Feature Tracking ◽

Longitudinal Strain ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Reverse Remodeling ◽

Myocardial Tissue ◽

Tissue Characteristics

AbstractTo determine whether left ventricular (LV) global longitudinal strain (GLS) measured by feature-tracking (FT) cardiac magnetic resonance (CMR) improves after kidney transplantation (KT) and to analyze associations between LV GLS, reverse remodeling and myocardial tissue characteristics. This is a prospective single-center cohort study of kidney transplant recipients who underwent two CMR examinations in a 3T scanner, including cines, tagging, T1 and T2 mapping. The baseline exam was done up to 10 days after transplantation and the follow-up after 6 months. Age and sex-matched healthy controls were also studied for comparison. A total of 44 patients [mean age 50 ± 11 years-old, 27 (61.4%) male] completed the two CMR exams. LV GLS improved from − 13.4% ± 3.0 at baseline to − 15.2% ± 2.7 at follow-up (p < 0.001), but remained impaired when compared with controls (− 17.7% ± 1.5, p = 0.007). We observed significant correlation between improvement in LV GLS with reductions of left ventricular mass index (r = 0.356, p = 0.018). Improvement in LV GLS paralleled improvements in LV stroke volume index (r = − 0.429, p = 0.004), ejection fraction (r = − 0.408, p = 0.006), global circumferential strain (r = 0.420, p = 0.004) and global radial strain (r = − 0.530, p = 0.002). There were no significant correlations between LV GLS, native T1 or T2 measurements (p > 0.05). In this study, we demonstrated that LV GLS measured by FT-CMR improves 6 months after KT in association with reverse remodeling, but not native T1 or T2 measurements.

Download Full-text

P1391 Global longitudinal strain in chronic asymptomatic aortic regurgitation: a meta-analysis

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.824 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

D De Campos ◽

R Teixeira ◽

A Botelho ◽

C Saleiro ◽

J Lopes ◽

...

Keyword(s):

Aortic Regurgitation ◽

Longitudinal Strain ◽

Meta Analysis ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Symptom Development ◽

Ventricular Ejection Fraction ◽

Asymptomatic Patients ◽

All Cause Mortality

Abstract BACKGROUND Previous studies have shown that left ventricle global longitudinal strain (GLS) assessed with 2D-speckle tracking echocardiography, is an independent predictor of outcome in asymptomatic moderate to severe chronic aortic regurgitation (AR) patients. OBJECTIVES To assess GLS impact on mortality and need for aortic valve replacement (AVR) or symptom development in chronic asymptomatic AR patients and preserved left ventricular ejection fraction (LVEF). METHODS A literature search was performed according with these key terms "aortic regurgitation" and "longitudinal strain." The primary endpoint was all-cause mortality. Secondary end-points were: a composite of all-cause mortality, need for AVR or symptom development; and only AVR plus symptom development. Data was pooled using random-effects meta-analysis models. Pooled Hazard Ratio (HR) was performed using its log transformation and inverse variances as weights were then calculated for each study . RESULTS Six studies were included, with a total of 1,571 asymptomatic patients with at least moderate AR and preserved LVEF. There were 996 events (death, AVR, symptom development) reported during follow-up. Pooled adjusted mortality HR tended to be higher for patients with worse GLS (1.14 [0.96–1.35], P = 0.13, I2 51%). GLS performed better in predicting AVR or symptom development (mean difference -0.72 [-1.29, -0.15], P = 0.01, I2 88%), with an estimated HR of 1.36 ([1.01–1.84], P = 0.04, I2 65%). CONCLUSIONS In asymptomatic chronic moderate to severe AR patients, impaired GLS was associated with adverse cardiac outcomes. Left ventricular GLS may offer incremental value on risk stratification as well as on decision-making. Abstract P1391 Figure 1

Download Full-text