Left-Ventricular Reference Myocardial Strain Assessed by Cardiovascular Magnetic Resonance Feature Tracking and fSENC—Impact of Temporal Resolution and Cardiac Muscle Mass

Abstract

Aims: Cardiac strain parameters are increasingly measured to overcome shortcomings of ejection fraction. For broad clinical use, this study provides reference values for the two strain assessment methods feature tracking (FT) and fast strain-encoded (fSENC) cardiovascular magnetic resonance (CMR) imaging, including the child/adolescent group and systematically evaluates the influence of temporal resolution and muscle mass on strain.Methods and Results: Global longitudinal (GLS), circumferential (GCS), and radial (GRS) strain values in 181 participants (54% women, 11–70 years) without cardiac illness were assessed with FT (CVI42® software). GLS and GCS were also analyzed using fSENC (MyoStrain® software) in a subgroup of 84 participants (60% women). Fourteen patients suffering hypertrophic cardiomyopathy (HCM) were examined with both techniques. CMR examinations were done on a 3.0T MR-system.FT-GLS, FT-GCS, and FT-GRS were −16.9 ± 1.8%, −19.2 ± 2.1% and 34.2 ± 6.1%. fSENC-GLS was higher at −20.3 ± 1.8% (p < 0.001). fSENC-GCS was comparable at−19.7 ± 1.8% (p = 0.06). All values were lower in men (p < 0.001). Cardiac muscle mass correlated (p < 0.001) with FT-GLS (r = 0.433), FT-GCS (r = 0.483) as well as FT-GRS (r = −0.464) and acts as partial mediator for sex differences. FT-GCS, FT-GRS and fSENC-GLS correlated weakly with age. FT strain values were significantly lower at lower cine temporal resolutions, represented by heart rates (r = −0.301, −0.379, 0.385) and 28 or 45 cardiac phases per cardiac cycle (0.3–1.9% differences). All values were lower in HCM patients than in matched controls (p < 0.01). Cut-off values were −15.0% (FT-GLS), −19.3% (FT-GCS), 32.7% (FT-GRS), −17.2% (fSENC-GLS), and −17.7% (fSENC-GCS).Conclusion: The analysis of reference values highlights the influence of gender, temporal resolution, cardiac muscle mass and age on myocardial strain values.

The Combination of Feature Tracking and Late Gadolinium Enhancement for Identification Between Hypertrophic Cardiomyopathy and Hypertensive Heart Disease

“…We also provided evidence that the variation and distribution of circumferential strain were similar to those of the radial orientation. The alteration in circumferential direction in this study was consistent with previous investigation ( 21 ). This may indicate that motion abilities in radial and circumferential directions of the two diseases were different during the cardiac cycle.…”

Multi-parametric analyses to investigate dependencies of normal left atrial strain by cardiovascular magnetic resonance feature tracking

“…As shown in Supplement S1 , Table I , left atrial reservoir strain and left atrial conduit strain increase with higher heart rate in the total cohort by bivariate linear regression analysis. This is in line with a recent MRI study by Weise Valdés et al in which an increase in global longitudinal, circumferential and radial strain with increasing heart rate was also observed, but in the left ventricle of healthy subjects 15 . Consistent with our observations, they found significantly elevated left ventricular strain in women in contrast to men.…”

“…Consistent findings were demonstrated by Truong et al Although their study did not systematically filter participants by heart rate, this observation can be explained given the narrow range of their participants' mean heart rate of 63 ± 10 bpm 13 . As previously demonstrated 15 , cardiac strain could vary depending upon patient heart rate, important for diagnostic implications. An increased heart rate at rest is generally discussed as a risk factor for chronic heart failure 16 , which may explain strain deviation from a normal heart rate collective.…”

A head-to-head comparison of fast-SENC and feature tracking to LV long axis strain for assessment of myocardial deformation in chest pain patients

“…CMR strain imaging has gained more widespread attention in recent years and been shown to be highly reproducible [ 4 , 21 – 24 ]. Reference LV-strain values for FT and fSENC as well as LVLAS have been previously reported [ 16 , 25 ]. In direct comparison to echocardiographic speckle tracking CMR-derived strain has been shown to correlate significantly to echocardiographic data while being less user-dependent and less subject to suboptimal sonographic conditions [ 26 ].…”