4934Biventricular global and regional strain measured by cardiovascular magnetic resonance based tissue tracking

Abstract

Abstract Background CMR based tissue tracking (CMR-TT), considered as a novel modality, provides additional insight into left and right ventricular (LV/RV) mechanical function and deformation. The vendor-specific reference values of global and regional strains for volunteers without history of cardiovascular disease are necessary as an important step in clinical routine to help detect early abnormality. Purpose To determine the reference value of LV/RV multi-dimensional global and segmental strains and diagnostic specificity of global longitudinal peak strain (GLS). Biventricular global and segmental radial, circumferential and longitudinal systolic peak strains (GRS, GCS, GLS and SRS, SCS, SLS) of 150 healthy adults in three age subgroups (G20–40, G41–60 and G61–80) were derived by post-hoc imaging software in standard steady-state free precession cine images acquired at 1.5T. LV strains were calculated with three-dimensional (3D) CMR-TT in the modified AHA 16-segment model via a short-axis stack and long axis 2-, 3-, 4-chamber cine images, and RV strains were generated with 2D CMR-TT via 4-chamber cine images. Results The reference values of LV global peak strains resulted as 44.4±13.0% for GRS, −17.0±2.7% for GCS, and −15.4±2.3% for GLS, respectively. RV-GLS was measured as −24.9±5.1%. Global and segmental strains might differ between males and females. Females showed significant age-associated difference of LV global peak strains (P<0.05) as the opposite of males (Figure 1). Females also presented higher magnitude of LV global peak strains than males in the eldest group G61–80 (P<0.05). Unlike LV, no age-associated difference of RV-GLS was detected in both gender groups. However, females showed less negative RV-GLS than males in G20–40 and more negative RV-GLS than males older than 40 years old (P<0.05). The local discrepancy of biventricular SRS, SCS and SLS was observed. It seemed that LV mid-cavity played a more essential role on LV shortening (more negative SCS and SLS) than wall thickening (smaller SRS) compared with base and apex. RV basal and mid SLS, derived from segment 1–4, was more negative than apical SLS derived from segment 5–6. The specificity of LV- and RV-GLS cut-off value (mean value+1.96*standard deviation) generated from the vendor-, age- and gender-specific reference value in evaluating heart contractile function reached 97.3% and 94.7%, respectively. Conclusions Considering the vendor-, gender- and age-associated difference of biventricular global strains, specific reference values need to be established to facilitate the wide application of strain in clinical routine. Meanwhile, segmental strains are also fundamental for detecting local abnormality of myocardial deformation.