Abstract
BackgroundThe objective assessment of global and regional cardiac function in children has shown to be clinically relevant but is challenging to conduct. Cardiovascular magnetic resonance (CMR) has emerged as a valuable diagnostic modality especially in patients with cardiomyopathy or congenital heart disease. However, data on the normal cardiac deformation in children assessed by CMR is lacking at present. Thus, the aim of this study was to provide reference values for cardiac strain and strain rate in children and adolescents derived from CMR feature tracking (FT) measurements.MethodsIn this binational study, eighty children and adolescents (age 0.4–18.0 years, 41 male, 39 female) free from cardiac diseases from two centers underwent CMR in 1.5 T whole-body scanners in supine position. Global peak radial, circumferential and longitudinal systolic strains as well as the corresponding early peak diastolic strain rates were assessed applying FT on short axis as well as 3- and 4-chamber views of standard cine steady-state free precession images.ResultsThe difference between genders yielded no significance for all assessed strains. Yet, all strains showed a significant parabolic relation to age and an even stronger one to body surface area (BSA). Therefore, BSA-specific reference values were determined using a polynomial regression model. The apical cardiac segments featured significant higher peak circumferential but lower peak radial systolic strains than the midventricular and basal segments (all p < 0.001).ConclusionsThe assessment of cardiac deformation by CMR-FT is feasible in children. This is the first CMR study providing specific reference values for FT-derived strain and strain rate in the pediatric age range.
Highlights
The objective assessment of global and regional cardiac function in children has shown to be clinically relevant but is challenging to conduct
Feature tracking (FT), which was originally developed for the cardiac deformation analysis of EC studies, has been applied to Cardiovascular magnetic resonance (CMR) steady-state free precession (SSFP) images
The body surface area (BSA) showed no significant difference between boys and girls (1.6 (1.1 to 1.7) m2 vs. 1.5 (1.2 to 1.6) m2, p > 0.6, Fig. 2c)
Summary
The objective assessment of global and regional cardiac function in children has shown to be clinically relevant but is challenging to conduct. The aim of this study was to provide reference values for cardiac strain and strain rate in children and adolescents derived from CMR feature tracking (FT) measurements. Cardiovascular magnetic resonance (CMR) has been established as an important non-invasive diagnostic modality for children and adults with CHD as it can provide anatomical and physiological information in a wide variety of ventricular geometry [3, 4]. Feature tracking (FT), which was originally developed for the cardiac deformation analysis of EC studies, has been applied to CMR steady-state free precession (SSFP) images. The accordance with MR tagging has shown to be good [9,10,11] and reference values for CMR-FT derived cardiac strains in adults have been published recently [12, 13]. The aim of this study was to determine reference values for the left ventricular (LV) deformation in children and adolescents applying FT on standard SSFP series
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