Abstract
Myocardial strain is a well validated parameter for estimating left ventricular (LV) performance. The aim of our study was to evaluate the inter-study as well as intra- and interobserver reproducibility of fast-SENC derived myocardial strain. Eighteen subjects (11 healthy individuals and 7 patients with heart failure) underwent a cardiac MRI examination including fast-SENC acquisition for evaluating left ventricular global longitudinal (GLS) and circumferential strain (GCS) as well as left ventricular ejection fraction (LVEF). The examination was repeated after 63 [range 49‒87] days and analyzed by two experienced observers. Ten datasets were repeatedly assessed after 1 month by the same observer to test intraobserver variability. The reproducibility was measured using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. Patients with heart failure demonstrated reduced GLS and GCS compared to healthy controls (−15.7 ± 3.7 vs. −20.1 ± 1.4; p = 0.002 for GLS and −15.3 ± 3.7 vs. −21.4 ± 1.1; p = 0.001 for GCS). The test-retest analysis showed excellent ICC for LVEF (0.92), GLS (0.94) and GCS (0.95). GLS exhibited excellent ICC (0.99) in both intra- and interobserver variability analysis with very narrow limits of agreement (−0.6 to 0.5 for intraobserver and −1.3 to 0.96 for interobserver agreement). Similarly, GCS showed excellent ICC (0.99) in both variability analyses with narrow limits of agreement (−1.1 to 1.2 for intraobserver and −1.7 to 1.3 for interobserver agreement), whereas LVEF showed larger limits of agreement (−14.4 to 10.1). The analysis of fast-SENC derived myocardial strain using cardiac MRI provides a highly reproducible method for assessing LV functional performance.
Highlights
Myocardial strain is a well validated parameter for estimating left ventricular (LV) performance
Phase velocity mapping (PVM), another method employed in the early days of Cardiac magnetic resonance (CMR) for extracting myocardial deformation parameters, uses the same principles that apply for extracting flow velocities
Displacement encoded with simulated echoes (DENSE) is a more recent method developed for measuring myocardial mechanics[13]
Summary
Myocardial strain is a well validated parameter for estimating left ventricular (LV) performance. Eighteen subjects (11 healthy individuals and 7 patients with heart failure) underwent a cardiac MRI examination including fast-SENC acquisition for evaluating left ventricular global longitudinal (GLS) and circumferential strain (GCS) as well as left ventricular ejection fraction (LVEF). The analysis of fast-SENC derived myocardial strain using cardiac MRI provides a highly reproducible method for assessing LV functional performance. The method was shown to have a good reproducibility, with low coefficient of variations for interobserver and intraobserver analysis[10] It proved useful in identifying viable myocardium and evaluating diastolic function, the method is still hampered by low spatial resolution, long acquisition times and even longer post-processing times[11]. The aim of our study was to evaluate the reproducibility at interstudy, interobserver and intraobserver levels for measuring longitudinal and circumferential strain using fast-SENC technique in a population of healthy volunteers and patients with heart failure (HF)
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