Comparing cardiovascular magnetic resonance strain software packages by their abilities to discriminate outcomes in patients with heart failure with preserved ejection fraction

Ying Zhang,David Mui,Yuchi Han,Julio A Chirinos,Payman Zamani,Victor A Ferrari,Yucheng Chen

doi:10.1186/s12968-021-00747-y

Abstract

BackgroundCardiovascular magnetic resonance (CMR) myocardial strain analysis using feature tracking (FT) is an increasingly popular method to assess cardiac function. However, different software packages produce different strain values from the same images and there is little guidance regarding which software package would be the best to use. We explored a framework under which different software packages could be compared and used based on their abilities to differentiate disease from health and differentiate disease severity based on outcome.MethodTo illustrate this concept, we compared 4-chamber left ventricular (LV) peak longitudinal strain (GLS) analyzed from retrospective electrocardiogram gated cine imaging performed on 1.5 T CMR scanners using three CMR post-processing software packages in their abilities to discriminate a group of 45 patients with heart failure with preserved ejection fraction (HFpEF) from 26 controls without cardiovascular disease and to discriminate disease severity based on outcomes. The three different post-processing software used were SuiteHeart, cvi42, and DRA-Trufistrain.ResultsAll three software packages were able to distinguish HFpEF patients from controls. 4-chamber peak GLS by SuiteHeart was shown to be a better discriminator of adverse outcomes in HFpEF patients than 4-chamber GLS derived from cvi42 or DRA-Trufistrain.ConclusionWe illustrated a framework to compare feature tracking GLS derived from different post-processing software packages. Publicly available imaging data sets with outcomes would be important to validate the growing number of CMR-FT software packages.

Highlights

Cardiovascular magnetic resonance (CMR) myocardial strain analysis using feature tracking (FT) is an increasingly popular method to assess cardiac function
All three software packages were able to distinguish heart failure with preserved ejection fraction (HFpEF) patients from controls. 4-chamber peak global longitudinal strain (GLS) by SuiteHeart was shown to be a better discriminator of adverse outcomes in HFpEF patients than 4-chamber GLS derived from cvi42 or Deformable registration algorithms (DRA)-Trufistrain
We propose that different CMR FT software packages be compared and used based on their abilities to differentiate disease from health and to discriminate disease severity based on patient outcome

Summary

Introduction

Cardiovascular magnetic resonance (CMR) myocardial strain analysis using feature tracking (FT) is an increasingly popular method to assess cardiac function. Cardiovascular magnetic resonance imaging (CMR) is recommended as the gold standard for the assessment of left ventricular (LV) systolic function [1]. Myocardial strain analysis using feature tracking (FT) has emerged to be a simple post-processing method to assess cardiac function in heart failure (HF) with preserved ejection. A reduced LV GLS has been shown to be an independent predictor for adverse cardiac outcomes in HFpEF patients [9]. The approach generally taken by investigators to overcome these issues has been to establish normative values within each laboratory with each software package and use that local standard for all the analysis performed locally. Which software package and strain analysis is able to better discriminate patients from non-cardiovascular disease controls and which software package can better discriminate patients with worse outcomes is not known

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