Myocardial strain in healthy adults across a broad age range as revealed by cardiac magnetic resonance imaging at 1.5 and 3.0T: Associations of myocardial strain with myocardial region, age, and sex.

Kenneth Mangion,John Mcclure,Guillaume Clerfond,Christie Mccomb,Samuli M Rauhalammi,Colin Berry,Rosemary Woodward,David S Corcoran,Vanessa Orchard,Aleksandra Radjenovic,David Carrick,Xiaodong Zhong

doi:10.1002/jmri.25280

Abstract

PurposeTo assess myocardial strain using cine displacement encoding with stimulated echoes (DENSE) using 1.5T and 3.0T MRI in healthy adults.Materials and MethodsHealthy adults without any history of cardiovascular disease underwent magnetic resonance imaging (MRI) at 1.5T and 3.0T within 2 days. The MRI protocol included balanced steady‐state free‐precession (b‐SSFP), 2D cine‐echo planar imaging (EPI)‐DENSE, and late gadolinium enhancement in subjects >45 years. Acquisitions were divided into six segments; global and segmental peak longitudinal and circumferential strain were derived and analyzed by field strength, age, and gender.ResultsIn all, 89 volunteers (mean age 44.8 ± 18.0 years, range: 18–87 years) underwent MRI at 1.5T, and 88 of these subjects underwent MRI at 3.0T (1.4 ± 1.4 days between the scans). Compared with 3.0T, the magnitudes of global circumferential (–19.5 ± 2.6% vs. –18.47 ± 2.6%; P = 0.001) and longitudinal (–12.47 ± 3.2% vs. –10.53 ± 3.1%; P = 0.004) strain were greater at 1.5T. At 1.5T, longitudinal strain was greater in females than in males: –10.17 ± 3.4% vs. –13.67 ± 2.4%; P = 0.001. Similar observations occurred for circumferential strain at 1.5T (–18.72 ± 2.2% vs. –20.10 ± 2.7%; P = 0.014) and at 3.0T (–17.92 ± 1.8% vs. –19.1 ± 3.1%; P = 0.047). At 1.5T, longitudinal and circumferential strain were not associated with age after accounting for sex (longitudinal strain P = 0.178, circumferential strain P = 0.733). At 3.0T, longitudinal and circumferential strain were associated with age (P < 0.05). Longitudinal strain values were greater in the apico‐septal, basal‐lateral, and mid‐lateral segments and circumferential strain in the inferior, infero‐lateral, and antero‐lateral LV segments.ConclusionMyocardial strain parameters as revealed by cine‐DENSE at different MRI field strengths were associated with myocardial region, age, and sex. J. Magn. Reson. Imaging 2016;44:1197–1205.

Highlights

Global longitudinal strain (GLS) has independent prognostic significance compared with LV ejection fraction (LVEF) in myocardial infarction survivors,[3,4] and in patients with cardiomyopathy.[5,6]
There are a number of ways of assessing myocardial strain with MR, including myocardial tagging,[8] strainencoding imaging (SENC),[9] phase contrast (PC) imaging,[10] and Displacement encoding with stimulated echoes (DENSE).[1]
Circumferential and longitudinal strain values revealed by 2D-DENSE had low interobserver variability, implying good reliability

Summary

Introduction

Displacement encoding with stimulated echoes (DENSE) is a magnetic resonance imaging (MRI) method that directly quantifies left ventricular (LV) mechanics within myocardial regions with high spatial and temporal resolution.[1] LV ejection fraction (LVEF) and wall motion score reflect displacement of LV borders, provide global measures of heart pump function, and are the standard imaging methods for describing LV function.[2] Global longitudinal strain (GLS) has independent prognostic significance compared with LVEF in myocardial infarction survivors,[3,4] and in patients with cardiomyopathy.[5,6] Echocardiography is the standard-of-care for imaging LVEF and GLS. The variation in strain values within a healthy population with age and field strength has still to be established. We hypothesized that magnitudes of strain are associated with age and sex, independent of field strength

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Conclusion