Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities

Abstract

The assessment of atrioventricular junction (AVJ) deformation plays an important role in evaluating left ventricular systolic and diastolic function in clinical practice. This study aims to demonstrate the effectiveness and consistency of cardiovascular magnetic resonance (CMR) for quantitative assessment of AVJ velocity compared with tissue Doppler echocardiography (TDE). A group of 145 human subjects comprising 21 healthy volunteers, 8 patients with heart failure, 17 patients with hypertrophic cardiomyopathy, 52 patients with myocardial infarction, and 47 patients with repaired Tetralogy of Fallot were prospectively enrolled and underwent TDE and CMR scan. Six AVJ points were tracked with three CMR views. The peak systolic velocity (Sm1), diastolic velocity during early diastolic filling (Em), and late diastolic velocity during atrial contraction (Am) were extracted and analyzed. All CMR-derived septal and lateral AVJ velocities correlated well with TDE measurements (Sm1: r = 0.736; Em: r = 0.835; Am: r = 0.701; Em/Am: r = 0.691; all p < 0.001) and demonstrated excellent reproducibility [intrastudy: r = 0.921-0.991, intraclass correlation coefficient (ICC): 0.918-0.991; interstudy: r = 0.900-0.970, ICC: 0.887-0.957; all p < 0.001]. The evaluation of three-dimensional AVJ motion incorporating measurements from all views better differentiated normal and diseased states [area under the curve (AUC) = 0.918] and provided further insights into mechanical dyssynchrony diagnosis in HF patients (AUC = 0.987). These findings suggest that the CMR-based method is feasible, accurate, and consistent in quantifying the AVJ deformation, and subsequently in diagnosing systolic and diastolic cardiac dysfunction.

Assessment of diastolic function and atrial remodeling by MRI - validation and correlation with echocardiography and filling pressure

“…For example, Leng et al. () obtained strong agreement when validating e′ by MRI to TTE, as did this study which used a freely available image analysis tool. Furthermore, interobserver and intraobserver variability in the proposed method for e′ quantification were in parity with reported repeatability in echocardiography (Frikha et al.…”

“…Furthermore, our central hypothesis, that LV filling pressure is correlated with LA fibrosis, was demonstrated using these MRI-based measures. Evaluation of e 0 by feature-tracking has been proposed and validated (Leng et al 2015;Seemann et al 2017). For example, Leng et al (2015) obtained strong agreement when validating e 0 by MRI to TTE, as did this study which used a freely available image analysis tool.…”

“…Evaluation of e′ by feature‐tracking has been proposed and validated (Leng et al. ; Seemann et al. ).…”

“…In cardiovascular magnetic resonance imaging (MRI), methods exist that can measure those diastolic parameters (Paelinck et al 2005;Bollache et al 2010;Duarte and Fernandez 2010;Leng et al 2015;Saba et al 2014;Seemann et al 2017). For example, quantification of LA volumes is established (Wylie et al 2008;Maceira et al 2010), but there is a lack of standardized methods for MRI assessment of diastolic parameters linked to valvular flow and motion (i.e., E, A, and especially e 0 ).…”

Normal Values of Myocardial Deformation Assessed by Cardiovascular Magnetic Resonance Feature Tracking in a Healthy Chinese Population: A Multicenter Study

“…Advantages of these techniques include excellent scan-rescan reproducibility, less dependence on operator technique, and more accurate and reproducible measures of the left and right ventricles. Consequently, CMR has become the standard reference modality for measurement of ventricular volume and function ( Bellenger et al, 2000 ), and arguably the optimal imaging modality for quantification of myocardial displacement ( Leng et al, 2015 , 2016 , 2018 ), strain and strain rate ( Rahman et al, 2017 ; Scatteia et al, 2017 ; Koh et al, 2018 ; Zhao et al, 2018 ).…”