Quantification of left atrial strain and strain rate using Cardiovascular Magnetic Resonance myocardial feature tracking: a feasibility study

Journal of Cardiovascular Magnetic Resonance

Research

Shelby Kutty¹  Frank Edelmann²  Gerd Hasenfuß²  Andreas Schuster³  Michael Steinmetz⁴  Adriana Villa⁵  Amedeo Chiribiri⁵  Nuno Bettencourt⁶  Johannes Tammo Kowallick⁷  Wieland Staab⁷  Jan Martin Sohns⁷  Joachim Lotz⁷  Christina Unterberg-Buchwald⁸ 

[1] Children’s Hospital and Medical Center Joint Division of Pediatric Cardiology, University of Nebraska/Creighton University, Omaha, Nebraska, USA;Department of Cardiology and Pneumology, Georg-August-University, Göttingen, Germany;DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany;Department of Cardiology and Pneumology, Georg-August-University, Göttingen, Germany;Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas’ Hospital, King’s College London, London, UK;DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany;Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August-University, Göttingen, Germany;DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany;Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas’ Hospital, King’s College London, London, UK;Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas’ Hospital, King’s College London, London, UK;Cardiology Department, Centro Hospitalar de Gaia/Espinho, Vila Nova de Gaia, Portugal;Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany;DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany;Institute for Diagnostic and Interventional Radiology, Georg-August-University, Göttingen, Germany;Department of Cardiology and Pneumology, Georg-August-University, Göttingen, Germany;DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany;

关键词: Cardiovascular magnetic resonance;    Feature tracking;    Diastolic dysfunction;    Hypertrophic cardiomyopathy;    Strain;    Strain rate;    Atrial physiology;   

DOI  :  10.1186/s12968-014-0060-6

 received in 2014-05-08, accepted in 2014-07-28,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundCardiovascular Magnetic Resonance myocardial feature tracking (CMR-FT) is a quantitative technique tracking tissue voxel motion on standard steady-state free precession (SSFP) cine images to assess ventricular myocardial deformation. The importance of left atrial (LA) deformation assessment is increasingly recognized and can be assessed with echocardiographic speckle tracking. However atrial deformation quantification has never previously been demonstrated with CMR. We sought to determine the feasibility and reproducibility of CMR-FT for quantitative derivation of LA strain and strain rate (SR) myocardial mechanics.Methods10 healthy volunteers, 10 patients with hypertrophic cardiomyopathy (HCM) and 10 patients with heart failure and preserved ejection fraction (HFpEF) were studied at 1.5 Tesla. LA longitudinal strain and SR parameters were derived from SSFP cine images using dedicated CMR-FT software (2D CPA MR, TomTec, Germany). LA performance was analyzed using 4- and 2-chamber views including LA reservoir function (total strain [εs], peak positive SR [SRs]), LA conduit function (passive strain [εe], peak early negative SR [SRe]) and LA booster pump function (active strain [εa], late peak negative SR [SRa]).ResultsIn all subjects LA strain and SR parameters could be derived from SSFP images. There was impaired LA reservoir function in HCM and HFpEF (εs [%]: HCM 22.1 ± 5.5, HFpEF 16.3 ± 5.8, Controls 29.1 ± 5.3, p < 0.01; SRs [s-1]: HCM 0.9 ± 0.2, HFpEF 0.8 ± 0.3, Controls 1.1 ± 0.2, p < 0.05) and impaired LA conduit function as compared to healthy controls (εe [%]: HCM 10.4 ± 3.9, HFpEF 11.9 ± 4.0, Controls 21.3 ± 5.1, p < 0.001; SRe [s-1]: HCM -0.5 ± 0.2, HFpEF -0.6 ± 0.1, Controls -1.0 ± 0.3, p < 0.01). LA booster pump function was increased in HCM while decreased in HFpEF (εa [%]: HCM 11.7 ± 4.0, HFpEF 4.5 ± 2.9, Controls 7.8 ± 2.5, p < 0.01; SRa [s-1]: HCM -1.2 ± 0.4, HFpEF -0.5 ± 0.2, Controls -0.9 ± 0.3, p < 0.01). Observer variability was excellent for all strain and SR parameters on an intra- and inter-observer level as determined by Bland-Altman, coefficient of variation and intraclass correlation coefficient analyses.ConclusionsCMR-FT based atrial performance analysis reliably quantifies LA longitudinal strain and SR from standard SSFP cine images and discriminates between patients with impaired left ventricular relaxation and healthy controls. CMR-FT derived atrial deformation quantification seems a promising novel approach for the study of atrial performance and physiology in health and disease states.

【 授权许可】

Unknown   
© Kowallick et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.