Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy: a multisoftware feasibility and clinical implementation study

Bourfiss, Mimount; Vigneault, Davis M.; Ghasebeh, Mounes Aliyari; Murray, Brittney; James, Cynthia A.; Tichnell, Crystal; Hoesein, Firdaus A. Mohamed; Zimmerman, Stefan L.; Kamel, Ihab R.; Calkins, Hugh; Tandri, Harikrishna; Velthuis, Birgitta K.; Bluemke, David A.; Riele, Anneline S.J.M. te

doi:10.1186/s12968-017-0380-4

Cited by 62 publications

(49 citation statements)

References 42 publications

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“…Hence, we chose to assess the myocardial function with CMR FT, where the image quality is maintained throughout the cardiac cycle. Recently, strain results with CMR FT were shown to have inter-software variability in both feasibility and absolute strain values [29]. However, the non-rigid elastic registration-based FT used in this work has been shown to be reproducible and not be influenced by the level of training [30].…”

Section: Discussionmentioning

confidence: 83%

Severe pulmonary regurgitation in adolescents with tetralogy of Fallot leads to increased longitudinal strain

Ylitalo

Lehmonen

Lauerma

et al. 2019

Magn Reson Mater Phy

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Objectives Postoperative patients with tetralogy of Fallot (TOF) are often compromised by chronic pulmonary regurgitation and chronic right ventricular volume load. We sought to determine whether pulmonary regurgitation (PR) would affect right and left ventricle (RV and LV) strain. Materials and methods This cross-sectional analysis included 40 patients who had TOF with surgical repair, with an average follow-up period of 11.8 ± 3.0 years. Altogether, 44 healthy volunteers with similar age and gender distribution were recruited. A cardiovascular magnetic resonance imaging study with feature tracking analysis was performed on all patients and controls. Results RV peak longitudinal strain was increased in TOF patients with PR > 30 ml/m 2 when compared to those with PR < 30 ml/m 2 (− 22.5% ± 2.7% vs − 19.7% ± 3.5%, p = 0.018) and controls (p = 0.007). PR volume correlated with peak RV longitudinal strain (R = − 0.37, p = 0.030) and peak RV longitudinal strain rate (systolic: R = 0.37, p = 0.03; diastolic: R = 0.39, p = 0.021). The peak RV circumferential strain, from base to apex, increased more than in healthy controls (apexbase difference 7.6% ± 4.2% vs 3.3% ± 2.4%, p < 0.0001). Conclusions Pediatric patients with TOF and a severe pulmonary regurgitation show an enhanced longitudinal strain when compared to patients with milder regurgitation or to control subjects. In addition, mean RV circumferential strain of the patients is significantly enhanced compared to healthy individuals.

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Section: Discussionmentioning

confidence: 83%

Severe pulmonary regurgitation in adolescents with tetralogy of Fallot leads to increased longitudinal strain

Ylitalo

Lehmonen

Lauerma

et al. 2019

Magn Reson Mater Phy

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“…CMR feature tracking analysis was performed using the validated software Qstrain (v 7.6.14.0 Medis Medical Imaging Leiden, the Netherlands) [16][17][18]. Analysis was performed by manually tracing the endocardium and triggering the automatic computation.…”

Section: Cmr Feature Trackingmentioning

confidence: 99%

Serial cardiovascular magnetic resonance feature tracking indicates early worsening of cardiac function in Fontan patients

Ridderbos

Wolff

Eshuis

et al. 2020

International Journal of Cardiology

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Background: In Fontan patients, attrition of ventricular function is well recognized, but early detection of ventricular dysfunction is difficult. The aim of this study is to longitudinally assess ventricular strain in Fontan patients using a new method for cardiac magnetic resonance (CMR) feature tracking, and to investigate the relationship between ventricular strain and cardiac systolic function. Methods and results: In this prospective, standardized follow-up study in 51 Fontan patients, age ≥ 10 years, CMR and concomitant clinical assessment was done at the start of the study and after 2 years. CMR feature tracking was done combining the dominant and hypoplastic ventricles. Global longitudinal strain (GLS) (−17.3% versus −15.9%, P = 0.041) and global circumferential strain (GCS) (−17.7 versus −16.1, P = 0.047) decreased over 2 years' time. Ejection fraction (EF) (57%), cardiac index (CI) (2.7 l/min/m 2) and NYHA functional class (97% in class I/II) were preserved. The strain values of the combined dominant and hypoplastic ventricles were significantly worse compared to those of the dominant ventricle only (GLS −16.8 (−19.5 to −14.0) versus −18.8 (−21.3 to −15.3) respectively, P = 0.001, GCS −18.3 (−22.1 to −14.8) versus −22.5 (−26.3 to −19.4) respectively, P b 0.001). Conclusions: This study showed a decrease in cardiac strain over 2 years in Fontan patients without clinical signs of Fontan failure, where EF, CI and clinical status were still preserved. Cardiac strain might be a sensitive early indicator of systolic ventricular decline. Furthermore, combined strain of the hypoplastic and dominant ventricles seems a more accurate representation of cardiac strain in functionally univentricular hearts.

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“…RV deformation imaging using two-dimensional speckle tracking echocardiography, although currently available, is still challenging [ 23 ]. Based on recent data, global and regional right ventricular strain values of overt ARVC patients are decreased compared to healthy control subjects [ 5 – 8 ]. Moreover, multisoftware feasibility study of Bourfiss et al proved excellent intra- and inter-observer reproducibility for the right ventricular regional strain values established using Medis QStrain software [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Feature tracking technique allows us to estimate myocardial strain, a measure of deformation using balanced steady-state free precession (bSSFP) cine images. Recent literature data imply, that CMR based deformation imaging using feature tracking technology may have an important added value in the diagnostic workup of ARVC patients [ 5 – 8 ], although no data regarding athletes’ normal RV values are available. To the best of our knowledge, this is the first study to compare healthy athletes’ and ARVC patients’ strain parameters using feature tracking.…”

Section: Introductionmentioning

confidence: 99%

Cardiac magnetic resonance based deformation imaging: role of feature tracking in athletes with suspected arrhythmogenic right ventricular cardiomyopathy

Czimbalmos

Csécs

Dohy

et al. 2018

Int J Cardiovasc Imaging

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Both, arrhythmogenic right ventricular cardiomyopathy (ARVC) and regular training are associated with right ventricular (RV) remodelling. Cardiac magnetic resonance (CMR) is given an important role in the diagnosis of ARVC in current task force criteria (TFC), however, they contain no cut-off values for athletes. We aimed to confirm the added value of feature tracking and to provide new cut-off values to differentiate between ARVC and athlete’s heart. Healthy athletes with training of minimal 15 h/week (n = 34), patients with definite ARVC (n = 34) and highly trained athletes with ARVC (n = 8) were examined by CMR. Left and right ventricular volumes and masses were determined. Global right and left ventricular, and regional strain analysis for the RV free wall was performed using feature tracking on balanced steady-state free precession cine images. 94% of healthy athletes showed RV dilatation of the proposed TFC, 14.7% showed RV ejection fraction (RVEF) between 45–50%, none of them had RVEF < 45%. Although RVEF showed the highest accuracy in differentiating between athlete’s heart and ARVC, only 37.5% of athletes with ARVC showed RVEF < 45%. The only parameters falling in the pathological range (based on our established cut-off values: > − 25.6 and > − 1.4, respectively) in all athletes with ARVC were the strain and strain rate of the midventricular RV free wall. Establishing RVEF and RV strain analysis provides an important tool to distinguish ARVC from athlete’s heart. CMR based regional strain and strain rate values may help to identify ARVC even in highly trained athletes with preserved RVEF.

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Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy: a multisoftware feasibility and clinical implementation study

Cited by 62 publications

References 42 publications

Severe pulmonary regurgitation in adolescents with tetralogy of Fallot leads to increased longitudinal strain

Severe pulmonary regurgitation in adolescents with tetralogy of Fallot leads to increased longitudinal strain

Serial cardiovascular magnetic resonance feature tracking indicates early worsening of cardiac function in Fontan patients

Cardiac magnetic resonance based deformation imaging: role of feature tracking in athletes with suspected arrhythmogenic right ventricular cardiomyopathy

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