Abstract

BackgroundAssessment of left (LV) ventricular function is one of the most important tasks of cardiovascular magnetic resonance (CMR). Impairment of LV deformation is a strong predictor of cardiovascular outcome in various cardiac diseases like ischemic heart disease or cardiomyopathies. The aim of the study was to provide reference values for myocardial deformation derived from the CMR feature tracking imaging (FTI) algorithm in a reference population of healthy volunteers.MethodsFTI was applied to standard short axis and 2-, 3- and 4-chamber views of vector-ECG gated CMR cine SSFP sequences of 150 strictly selected healthy volunteers (75 male/female) of three age tertiles (mean age 45.8yrs). Global peak and mean radial, circumferential and longitudinal endo- and myocardial systolic strain values as well as early diastolic strain rates were measured using FTI within a standard protocol on a 1.5T whole body MR scanner.ResultsGlobal peak systolic values were 36.3 ± 8.7% for radial, −27.2 ± 4.0% for endocardial circumferential, −21.3 ± 3.3% for myocardial circumferential, −23.4 ± 3.4% for endocardial longitudinal and −21.6 ± 3.2% for myocardial longitudinal strain. Global peak values were -2.1 ± 0.5s−1 for radial, 2.1 ± 0.6s−1 for circumferential endocardial, 1.7 ± 0.5s−1 for circumferential myocardial, 1.8 (1.5-2.2)s−1 for longitudinal endocardial, 1.6 (1.4-2.0)s−1 for longitudinal myocardial early diastolic strain rates. Men showed a higher radial strain than women whereas the circumferential and longitudinal strains were lower resulting in less negative values. Circumferential and longitudinal strain rates were significantly higher in female subjects. Radial strain increased significantly with age whereas the diastolic function measured by the radial, circumferential and longitudinal strain rates showed a decrease.The coefficients of variation determined in ten further subjects, who underwent two CMR examinations within 12 days, were −4.8% for circumferential and −4.5% for longitudinal endocardial mean strains.ConclusionsMyocardial deformation analysis using FTI is a novel technique and robust when applied to standard cine CMR images providing the possibility of a reliable, objective quantification of global LV deformation. Since strain values and strain rates differed partly between genders as well as between age groups, the application of specific reference values as provided by this study is recommendable.

Highlights

  • Assessment of left (LV) ventricular function is one of the most important tasks of cardiovascular magnetic resonance (CMR)

  • Feasibility of radial, circumferential and longitudinal strain measurements A total of 2400 segments from 150 patients were evaluated for radial, circumferential and longitudinal strain using feature tracking imaging (FTI)

  • Strain and strain rate parameters evaluated on a global basis Global peak systolic values were 36.3 ± 8.7% for radial, −27.2 ± 4.0% for circumferential endocardial, −21.3 ± 3.3% for circumferential myocardial, −23.4 ± 3.4% for longitudinal endocardial and −21.6 ± 3.2% for longitudinal myocardial strain

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Summary

Introduction

Assessment of left (LV) ventricular function is one of the most important tasks of cardiovascular magnetic resonance (CMR). The feature tracking algorithm is a two-dimensional deformation analysis of the myocardium that was originally designed for post-processing echocardiographic imaging studies, which has been adapted and applied to standard CMR SSFP images without the need for additional, time-consuming CMR scans or sequences like myocardial tagging, strainencoding (SENC) or displacement-encoding (DENSE) CMR [7,8,9]. This novel approach may have potential advantages over existing methods, mainly its broad availability and applicability as well as its vendor independency. The aim of this study was to establish reference values of myocardial deformation analysis using FTI, including global peak and mean radial, circumferential and longitudinal systolic strains as well as early diastolic strain rates and to investigate possible age- and genderrelated differences

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