Myocardial deformation is a sensitive marker of sub-clinical myocardial dysfunction that carries independent prognostic significance across a broad range of cardiovascular diseases. It is now possible to perform 3D feature tracking of SSFP cines on cardiac magnetic resonance imaging (FT-CMR). This study provides reference ranges for 3D FT-CMR and assesses its reproducibility compared to 2D FT-CMR. One hundred healthy individuals with 10 men and women in each of 5 age deciles from 20 to 70 years, underwent 2D and 3D FT-CMR of left ventricular myocardial strain and strain rate using SSFP cines. Good health was defined by the absence of hypertension, diabetes, obesity, dyslipidaemia, or any cardiovascular, renal, hepatic, haematological and systemic inflammatory disease. Normal values for myocardial strain assessed by 3D FT-CMR were consistently lower compared with 2D FT-CMR measures [global circumferential strain (GCS) 3D − 17.6 ± 2.6% vs. 2D − 20.9 ± 3.7%, P < 0.005]. Validity of 3D FT-CMR was confirmed against other markers of systolic function. The 3D algorithm improved reproducibility compared to 2D, with GCS having the best inter-observer agreement [intra-class correlation (ICC) 0.88], followed by global radial strain (GRS; ICC 0.79) and global longitudinal strain (GLS, ICC 0.74). On linear regression analyses, increasing age was weakly associated with increased GCS (R2 = 0.15, R = 0.38), peak systolic strain rate, peak late diastolic strain rate, and lower peak early systolic strain rate. 3D FT-CMR offers superior reproducibility compared to 2D FT-CMR, with circumferential strain and strain rates offering excellent intra- and inter-observer variability. Normal range values for myocardial strain measurements using 3D FT-CMR are provided.Electronic supplementary materialThe online version of this article (10.1007/s10554-017-1277-x) contains supplementary material, which is available to authorized users.

BackgroundReproducible and repeatable assessment of right heart function is vital for monitoring congenital and acquired heart disease. There is increasing evidence for the additional value of myocardial deformation (strain and strain rate) in determining prognosis. This study aims to determine the reproducibility of deformation analyses in the right heart using cardiovascular magnetic resonance feature tracking (FT-CMR); and to establish normal ranges within an adult population.MethodsA cohort of 100 healthy subjects containing 10 males and 10 females from each decade of life between the ages of 20 and 70 without known congenital or acquired cardiovascular disease, hypertension, diabetes, dyslipidaemia or renal, hepatic, haematologic and systemic inflammatory disorders underwent FT-CMR assessment of right ventricular (RV) and right atrial (RA) myocardial strain and strain rate.ResultsRV longitudinal strain (Ell) was − 21.9 ± 3.24% (FW + S Ell) and − 24.2 ± 3.59% (FW-Ell). Peak systolic strain rate (S′) was − 1.45 ± 0.39 s− 1 (FW + S) and − 1.54 ± 0.41 s− 1 (FW). Early diastolic strain rate (E′) was 1.04 ± 0.26 s− 1 (FW + S) and 1.04 ± 0.33 s− 1 (FW). Late diastolic strain rate (A′) was 0.94 ± 0.33 s− 1 (FW + S) and 1.08 ± 0.33 s− 1 (FW). RA peak strain was − 21.1 ± 3.76%. The intra- and inter-observer ICC for RV Ell (FW + S) was 0.92 and 0.80 respectively, while for RA peak strain was 0.92 and 0.89 respectively.ConclusionsNormal values of RV & RA deformation for healthy individuals using FT-CMR are provided with good RV Ell and RA peak strain reproducibility. Strain rate suffered from sub-optimal reproducibility and may not be satisfactory for clinical use.

Background: Cardiac magnetic resonance (CMR) imaging has several advantages over other imaging modalities in adult patients with congenital heart disease. Limitations remain however, in the assessment of myocardial function based on volumetric methods. There is increasing evidence in a range of diseases that myocardial strain is a more sensitive measure of regional and global ventricular contractile function. Main body: Feature tracking (FT), is a CMR-based method that measures strain without the need for additional sequence acquisition which can be analyzed rapidly, opening the possibility of use in adult congenital heart disease (ACHD). The aim of this review is to outline the technique of FT-CMR, its advantages and disadvantages compared to other techniques, review the values obtained, and to outline the preliminary data in support of its use in ACHD. In short, FT is a semi-automated post-processing technique that can be performed on routinely acquired images and thereby does not prolong scan time, is reproducible and not overly time-consuming. Although FT-CMR promises much, inevitably there remain limitations. While FT has excellent spatial resolution, temporal resolution is sub-optimal relative to speckle tracking echocardiography. Conclusion: FT-CMR is an emerging technique of measuring the myocardial strain that is comparable to speckle tracking echocardiography and the gold standard myocardial tagging CMR. FT-CMR derived strain parameters have potential diagnostic, risk stratification and prognostic value in the growing ACHD population.