scholarly journals P984 A head-to-head comparison between 2D and 3D segmental strain parameters in hypertrophic cardiomyopathy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Pagourelias ◽  
O Mirea ◽  
J Duchenne ◽  
S Unlu ◽  
J Van Cleemput ◽  
...  

Abstract Funding Acknowledgements Supported with a scholarship by the Greek State Scholarship Foundation (IKY). Background Previous studies have suggested that in normal and ischemic hearts three- (3D) and two-dimensional (2D) strain values present a moderate agreement which is prone to technical considerations. However, the level of agreement between 2D and 3D-strain imaging has never been adequately addressed in hypertrophic hearts, nor has it been validated against a "ground truth". Especially in hypertrophic cardiomyopathy (HCM), the magnitude and eccentricity of hypertrophy set additional challenges in standardization and measurement of regional 3D deformation parameters. Purpose Aims of this study were i) to investigate the consistency between 3D and 2D regional deformation parameters in HCM and ii) to test their accuracy in identifying regional fibrosis as this is defined by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). Methods We included 40 HCM patients (54.1 ± 14.3 years, 82.5% male, maximum wall thickness 19.3 ± 4.8mm) who have consecutively undergone 2D-,3D-speckle tracking echocardiography and CMR. Segmental circumferential (SCS) and longitudinal (SLS) strain have been calculated from 2D acquisitions and 3D full volume data, where additionally radial (SRS) and area (SAS) strain have been extracted using an 18 segment left ventricle model. Accordingly, segmental fibrosis was defined by LGE in corresponding CMR slices. Results Out of 720 segments evaluated, 134 (19.7%) were enhanced and 95(13.2%) thickened (thickness > 12 mm). Two dimensional LS and CS analysis was feasible in 719 (99.9%) and 678 (94.2%) segments respectively, while 686 segments (95.3%) were appropriate for 3D tracking. 3D_SLS values were -7.9 ± 6.8% less negative compared to 2D_SLS values [level of agreement (LOA)(-21.1-5.4%)], while the bias for SCS values was even higher -8.5 ± 8.6 [LOA(-25.4-8.4%)]. Absolute agreement between 2D and 3D deformation imaging modalities was poor to moderate [Intra-class Correlation Coefficient (ICC)= 0.46, 95%CI (0.15-0.68), p < 0.0005 for SLS and ICC = 0.19, 95%CI(0.07-0.38), p < 0.0005 for SCS] (Panel A). Following regression analysis, regional thickness was the only segmental factor to influence the correlation between 3D and 2D_SLS [R2 = 0.504, B = 0.33, 95%CI(0.22-0.44), p < 0.0005)], without, however, being a significant regressor for the other 2D vs 3D correlations. Among deformation indices, 2D_SLS showed the best area under the curve [(AUC)=0.78, 95%CI(0.75-0.81), p < 0.0005] to detect segmental fibrosis identified by CMR LGE, with 3D_SLS, 3D_SAS and 3D_SRS showing similar AUC (0.65) and 3D_SLS presenting the highest specificity [93.1%, 95%CI(90.6-95.1)] (Panel B). Conclusions In HCM, 2D and 3D deformation parameters are not interchangeable, showing modest agreement. Thickness and tracking algorithm calculating assumptions seem to induce this inconsistency. Among HCM patients, 2D_SLS remains the most accurate strain parameter to detect regional fibrosis. Abstract P984 Figure.

2020 ◽  
Vol 21 (11) ◽  
pp. 1262-1272 ◽  
Author(s):  
Efstathios D Pagourelias ◽  
Oana Mirea ◽  
Jürgen Duchenne ◽  
Serkan Unlu ◽  
Johan Van Cleemput ◽  
...  

Abstract Aims We aimed at directly comparing three-dimensional (3D) and two-dimensional (2D) deformation parameters in hypertrophic hearts and depict which may best reflect underlying fibrosis in hypertrophic cardiomyopathy (HCM), defined by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). Methods and results We included 40 HCM [54.1 ± 14.3 years, 82.5% male, maximum wall thickness (MWT) 19.3 ± 4.8 mm] and 15 hypertensive (HTN) patients showing myocardial hypertrophy (58.1 ± 15.6 years, 80% male, MWT 12.8 ± 1.4 mm) who have consecutively undergone 2D-, 3D-speckle tracking echocardiography and LGE CMR. Deformation parameters (2D and 3D) presented overall poor to moderate correlations, with 3D_longitudinal strain (LS) and 3D_circumferential strain (CS) values being constantly higher compared to 2D derivatives. By regression analysis, hypertrophy substrate (HCM vs. hypertension) and hypertrophy magnitude were the parameters to influence 2D–3D LS and CS strain correlations (R2 = 0.66, P < 0.001 and R2 = 0.5, P = 0.001 accordingly). Among segmental deformation indices, 2D_LS showed the best area under the curve [AUC = 0.78, 95% confidence intervals (CI) (0.75–0.81), P < 0.0005] to detect fibrosis, with 3D deformation parameters showing similar AUC (0.65) and 3D_LS presenting the highest specificity [93.1%, 95% CI (90.6–95.1)]. Conclusions In hypertrophic hearts, 2D and 3D deformation parameters are not interchangeable, showing modest correlations. Thickness, substrate, and tracking algorithm calculating assumptions seem to induce this variability. Nevertheless, among HCM patients 2D_peak segmental longitudinal strain remains the best strain parameter for tissue characterization and fibrosis detection.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Pagourelias ◽  
O Mirea ◽  
J Duchenne ◽  
S Unlu ◽  
J Van Cleemput ◽  
...  

Abstract Background Previous studies have directly compared 2-dimensional (2D) and 4-dimensional (4D) deformation imaging in normal and ischemic hearts suggesting a moderate agreement prone to technical considerations. However, the level of agreement between 2D and 4D-strain imaging has never been adequately addressed in hypertrophic hearts, nor has it been validated against a “ground truth”. Purpose We aimed at directly comparing 4D and 2D global and regional deformation parameters and depict which may best reflect underlying segmental fibrosis in hypertrophic cardiomyopathy (HCM), as defined by late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). Methods We included 40 HCM patients (54.1±14.3 years, 82.5% male, maximum wall thickness 19.3±4.8mm) who have consecutively undergone 2D-,4D-speckle tracking echocardiography and CMR. Global and segmental circumferential (CS) and longitudinal (LS) strain have been calculated from 2D acquisitions and 4D full volume data, where additionally radial (RS) and area (AS) strain have been extracted using an 18 segment left ventricle model. Accordingly, segmental fibrosis was defined by LGE in corresponding CMR slices. Results Deformation parameters (2D and 4D, global and regional) presented overall poor to moderate agreement (Figure A+B) with regional 4D_LS and 4D_CS values being constantly less negative compared to 2D derivatives (−7.29±6.94% and −8.53±8.8% accordingly). In regional analysis, 720 segments were evaluated of which 134 (19.7%) were enhanced and 95 of them thickened (68.8%) (thickness>12 mm), with segments presenting both characteristics showing the greatest impairment both in 2D and 4D strain values. Among segmental deformation indices, 2D_SLS showed the best area under the curve [(AUC)=0.78, 95% CI (0.75–0.81), p<0.0005] to detect segmental fibrosis, with 2D_SCS and all 4D deformation indices presenting significantly lower AUC (Figure C). Conclusions In HCM, 2D and 4D deformation parameters are not interchangeable, showing modest agreement. Thickness and tracking algorithm calculating assumptions seem to induce this variability. Nevertheless, among HCM patients 2D_SLS remains the best strain parameter for tissue characterization and fibrosis detection. Acknowledgement/Funding Supported with a scholarship by the Greek State Scholarship Foundation (IKY).


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kiyoshi Masuyama ◽  
Tomoaki Higo ◽  
Jong-Kook Lee ◽  
Ryohei Matsuura ◽  
Ian Jones ◽  
...  

AbstractIn contrast to hypertrophic cardiomyopathy, there has been reported no specific pattern of cardiomyocyte array in dilated cardiomyopathy (DCM), partially because lack of alignment assessment in a three-dimensional (3D) manner. Here we have established a novel method to evaluate cardiomyocyte alignment in 3D using intravital heart imaging and demonstrated homogeneous alignment in DCM mice. Whilst cardiomyocytes of control mice changed their alignment by every layer in 3D and position twistedly even in a single layer, termed myocyte twist, cardiomyocytes of DCM mice aligned homogeneously both in two-dimensional (2D) and in 3D and lost myocyte twist. Manipulation of cultured cardiomyocyte toward homogeneously aligned increased their contractility, suggesting that homogeneous alignment in DCM mice is due to a sort of alignment remodelling as a way to compensate cardiac dysfunction. Our findings provide the first intravital evidence of cardiomyocyte alignment and will bring new insights into understanding the mechanism of heart failure.


2021 ◽  
Vol 7 (3) ◽  
pp. 209-219
Author(s):  
Iris J Holzleitner ◽  
Alex L Jones ◽  
Kieran J O’Shea ◽  
Rachel Cassar ◽  
Vanessa Fasolt ◽  
...  

Abstract Objectives A large literature exists investigating the extent to which physical characteristics (e.g., strength, weight, and height) can be accurately assessed from face images. While most of these studies have employed two-dimensional (2D) face images as stimuli, some recent studies have used three-dimensional (3D) face images because they may contain cues not visible in 2D face images. As equipment required for 3D face images is considerably more expensive than that required for 2D face images, we here investigated how perceptual ratings of physical characteristics from 2D and 3D face images compare. Methods We tested whether 3D face images capture cues of strength, weight, and height better than 2D face images do by directly comparing the accuracy of strength, weight, and height ratings of 182 2D and 3D face images taken simultaneously. Strength, height and weight were rated by 66, 59 and 52 raters respectively, who viewed both 2D and 3D images. Results In line with previous studies, we found that weight and height can be judged somewhat accurately from faces; contrary to previous research, we found that people were relatively inaccurate at assessing strength. We found no evidence that physical characteristics could be judged more accurately from 3D than 2D images. Conclusion Our results suggest physical characteristics are perceived with similar accuracy from 2D and 3D face images. They also suggest that the substantial costs associated with collecting 3D face scans may not be justified for research on the accuracy of facial judgments of physical characteristics.


2021 ◽  
pp. 021849232110304
Author(s):  
Mehrnoush Toufan ◽  
Zahra Jabbary ◽  
Naser Khezerlou aghdam

Background To quantify valvular morphological assessment, some two-dimensional (2D) and three-dimensional (3D) scoring systems have been developed to target the patients for balloon mitral valvuloplasty; however, each scoring system has some potential limitations. To achieve the best scoring system with the most features and the least restrictions, it is necessary to check the degree of overlap of these systems. Also the factors related to the accuracy of these systems should be studied. We aimed to determine the correlation between the 2D Wilkins and real-time transesophageal three-dimensional (RT3D-TEE) scoring systems. Methods This cross-sectional study was performed on 156 patients with moderate to severe mitral stenosis who were candidates for percutaneous balloon valvuloplasty. To morphologic assessment of mitral valve, patients were examined by 2D-transthoracic echocardiography and RT3D-TEE techniques on the same day. Results A strong association was found between total Wilkins and total RT3D-TEE scores (r = 0.809, p < 0.001). The mean mitral valve area assessed by the 2D and 3D was 1.07 ± 0.25 and 1.03 ± 0.26, respectively, indicating a mean difference of 0.037 cm2 (p = 0.001). We found a strong correlation between the values of mitral valve area assessed by 2D and 3D techniques (r = 0.846, p < 0.001). Conclusion There is a high correlation between the two scoring systems in terms of evaluating dominant morphological features. Partially, mitral valve area overestimation in the 2D-transthoracic echocardiography and its inability to assess commissural involvement as well as its dependence on patient age were exceptions in this study.


2017 ◽  
Vol 19 (12) ◽  
pp. 1283-1289 ◽  
Author(s):  
Ryohei Suzuki ◽  
Yohei Mochizuki ◽  
Hiroki Yoshimatsu ◽  
Takahiro Teshima ◽  
Hirotaka Matsumoto ◽  
...  

Objectives Hypertrophic cardiomyopathy, a primary disorder of the myocardium, is the most common cardiac disease in cats. However, determination of myocardial deformation with two-dimensional speckle-tracking echocardiography in cats with various stages of hypertrophic cardiomyopathy has not yet been reported. This study was designed to measure quantitatively multidirectional myocardial deformations of cats with hypertrophic cardiomyopathy. Methods Thirty-two client-owned cats with hypertrophic cardiomyopathy and 14 healthy cats serving as controls were enrolled and underwent assessment of myocardial deformation (peak systolic strain and strain rate) in the longitudinal, radial and circumferential directions. Results Longitudinal and radial deformations were reduced in cats with hypertrophic cardiomyopathy, despite normal systolic function determined by conventional echocardiography. Cats with severely symptomatic hypertrophic cardiomyopathy also had lower peak systolic circumferential strain, in addition to longitudinal and radial strain. Conclusions and relevance Longitudinal and radial deformation may be helpful in the diagnosis of hypertrophic cardiomyopathy. Additionally, the lower circumferential deformation in cats with severe hypertrophic cardiomyopathy may contribute to clinical findings of decompensation, and seems to be related to severe cardiac clinical signs. Indices of multidirectional myocardial deformations by two-dimensional speckle-tracking echocardiography may be useful markers and help to distinguish between cats with hypertrophic cardiomyopathy and healthy cats. Additionally, they may provide more detailed assessment of contractile function in cats with hypertrophic cardiomyopathy.


2013 ◽  
Vol 62 (18) ◽  
pp. C155
Author(s):  
Atilla Koyuncu ◽  
Gokhan Kahveci ◽  
Alev Kilicgedik ◽  
Cuneyt Toprak ◽  
Ruken Bengi Bakal ◽  
...  

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