Abstract

In this study, we used a single commercially available software solution to assess global longitudinal (GLS) and global circumferential strain (GCS) using cardiac computed tomography (CT) and cardiac magnetic resonance (CMR) feature tracking (FT). We compared agreement and reproducibility between these two methods and the reference standard, CMR tagging (TAG). Twenty-seven patients with severe aortic stenosis underwent CMR and cardiac CT examinations. FT analysis was performed using Medis suite version 3.0 (Leiden, The Netherlands) software. Segment (Medviso) software was used for GCS assessment from tagged images. There was a trend towards the underestimation of GLS by CT-FT when compared to CMR-FT (19.4 ± 5.04 vs. 22.40 ± 5.69, respectively; p = 0.065). GCS values between TAG, CT-FT, and CMR-FT were similar (p = 0.233). CMR-FT and CT-FT correlated closely for GLS (r = 0.686, p < 0.001) and GCS (r = 0.707, p < 0.001), while both of these methods correlated moderately with TAG for GCS (r = 0.479, p < 0.001 for CMR-FT vs. TAG; r = 0.548 for CT-FT vs. TAG). Intraobserver and interobserver agreement was excellent in all techniques. Our findings show that, in elderly patients with severe aortic stenosis (AS), the FT algorithm performs equally well in CMR and cardiac CT datasets for the assessment of GLS and GCS, both in terms of reproducibility and agreement with the gold standard, TAG.

Highlights

  • Multiple systemic and neuromuscular diseases can affect the cardiovascular system at some point in their course

  • left ventricular end-diastolic volume index (LVEDVi), left ventricular end-systolic volume index (LVESVi), left ventricular stroke volume index (LVSVi), left ventricular ejection fraction (LVEF), and Left ventricular mass index (LVMi) values were similar between cardiac magnetic resonance (CMR) and cardiac computed tomography (CT)

  • We found a strong correlation between computed tomography feature tracking (CT-feature tracking (FT)) and cardiac magnetic resonance feature tracking (CMR-FT), but CT-FT tended to underestimate both Global longitudinal strain (GLS) (22.40 ± 5.69 vs. 19.4 ± 5.04, p = 0.065) and global circumferential strain (GCS) (18.91 ± 5.97 vs. 18.13 ± 4.63, p = 0.233)

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Summary

Introduction

Multiple systemic and neuromuscular diseases can affect the cardiovascular system at some point in their course. Non-specific manifestations, such as a subtle decline in regional or global myocardial function, are common [2] It can often go unnoticed until the ejection fraction (EF) starts to decline or clinical symptoms of heart failure begin to develop. Recent studies have shown early reduction in myocardial strain in multiple systemic and neuromuscular disorders, such as amyloidosis [4], systemic sclerosis [5], rheumatoid arthritis [6], and Duchenne muscular dystrophy [7]. These data suggest that deformation imaging could become an important tool for the early identification of cardiac involvement in these patients

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