Myocardial Strain Evaluation with Cardiovascular MRI: Physics,                     Principles, and Clinical Applications

Rajiah, Prabhakar; Kalisz, Kevin; Broncano, Jordi; Goerne, Harold; Collins, John T.; François, Christopher J.; Ibrahim, El-Sayed H.; Agarwal, Prachi P.

doi:10.1148/rg.210174

Cited by 47 publications

(19 citation statements)

References 71 publications

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“…Less affected by loading condition than volume, strain enables the quantification of the magnitude of myocardial deformation. As a sensitive tool, LA strain could be applied to evaluate the therapeutic effects [ 9 ], grade diastolic dysfunction [ 10 ], stratify the risk of atrial fibrillation (AF) [ 11 , 12 ], and predict adverse cardiac events in HCM, even in patients with normal LA size and LV filling pressure [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Reverse remodeling of left atrium assessed by cardiovascular magnetic resonance feature tracking in hypertrophic obstructive cardiomyopathy after septal myectomy

Yang

Chen

Zhao

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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Background Assessing the structure and function of left atrium (LA) is crucial in hypertrophic obstructive cardiomyopathy (HOCM) because LA remodeling correlates with atrial fibrillation. However, few studies have investigated the potential effect of myomectomy on LA phasic remodeling in HOCM after myectomy using cardiovascular magnetic resonance (CMR) feature tracking (FT). This study aims to evaluate the LA structural and functional remodeling with HOCM after myectomy by CMR-FT and to further investigate the determinants of LA reverse remodeling. Methods In this single-center study, we retrospectively studied 88 patients with HOCM who received CMR before and after myectomy between January 2011 and June 2021. Preoperative and postoperative LA parameters derived from CMR-FT were compared, including LA reservoir function (total ejection fraction [EF], total strain [εs], peak positive strain rate [SRs]), conduit function (passive EF, passive strain [εe], peak early negative strain rate [SRe]) and booster function (booster EF, active strain [εa], late peak negative strain rate [SRa]). Eighty-six healthy participants were collected for comparison. Univariate and multivariate linear regression identified variables associated with the rate of change of εa. Results Compared with preoperative parameters, LA reservoir function (total EF, εs, SRs), booster function (booster EF, εa, SRa), and SRe were significantly improved after myectomy (all P < 0.05), while no significant differences were observed in passive EF and εe. Postoperative patients with HOCM still had larger LA and worse LA function than healthy controls (all P < 0.05). After analyzing the rates of change in LA parameters, LA boost function, especially εa, showed the most dramatic improvement beyond the improvements in reservoir function, conduit function, and volume. In multivariable regression analysis, minimum LA volume index (adjusted β = − 0.39, P < 0.001) and Δleft ventricular outflow tract (LVOT) pressure gradient (adjusted β = − 0.29, P = 0.003) were significantly related to the rate of change of εa. Conclusions Patients with HOCM after septal myectomy showed LA reverse remodeling with a reduction in LA size and restoration in LA reservoir and booster function but unchanged LA conduit function. Among volumetric and functional changes, booster function had the greatest improvement postoperatively. Besides, preoperative LAVmin index and ΔLVOT might be potential factors associated with the degree of improvement in εa.

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Section: Introductionmentioning

confidence: 99%

Reverse remodeling of left atrium assessed by cardiovascular magnetic resonance feature tracking in hypertrophic obstructive cardiomyopathy after septal myectomy

Yang

Chen

Zhao

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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“…Cardiac magnetic resonance imaging (CMR) has emerged as the gold-standard method for evaluating RV function, as it allows full coverage of the complex RV geometry with superior image quality and provides low intra- and interobserver variability with good interstudy reproducibility [ 4 , 5 , 6 , 7 , 8 ]. In addition to allowing volumetric measurements of the RV ejection fraction (EF), CMR feature-tracking (FT) strain analysis is a promising new technique that can be used to quantify myocardial dysfunction [ 4 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Right Ventricular Strain by Magnetic Resonance Feature Tracking Is Largely Afterload-Dependent and Does Not Reflect Contractility: Validation by Combined Volumetry and Invasive Pressure Tracings

et al. 2022

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Cardiac magnetic resonance (CMR) is currently the gold standard for evaluating right ventricular (RV) function, which is critical in patients with pulmonary hypertension. CMR feature-tracking (FT) strain analysis has emerged as a technique to detect subtle changes. However, the dependence of RV strain on load is still a matter of debate. The aim of this study was to measure the afterload dependence of RV strain and to correlate it with surrogate markers of contractility in a cohort of patients with chronic thromboembolic pulmonary hypertension (CTEPH) under two different loading conditions before and after pulmonary endarterectomy (PEA). Between 2009 and 2022, 496 patients with 601 CMR examinations were retrospectively identified from our CTEPH cohort, and the results of 194 examinations with right heart catheterization within 24 h were available. The CMR FT strain (longitudinal (GLS) and circumferential (GCS)) was computed on steady-state free precession (SSFP) cine CMR sequences. The effective pulmonary arterial elastance (Ea) and RV chamber elastance (Ees) were approximated by dividing mean pulmonary arterial pressure by the indexed stroke volume or end-systolic volume, respectively. GLS and GCS correlated significantly with Ea and Ees/Ea in the overall cohort and individually before and after PEA. There was no general correlation with Ees; however, under high afterload, before PEA, Ees correlated significantly. The results show that RV GLS and GCS are highly afterload-dependent and reflect ventriculoarterial coupling. Ees was significantly correlated with strain only under high loading conditions, which probably reflects contractile adaptation to pulsatile load rather than contractility in general.

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“…3 To date, several MRI techniques have been available for evaluating myocardial strain, including tagging MRI, displacement encoding with stimulated echoes (DENSE), strainencoded MRI, and feature tracking (FT) analysis using cine MRI images. 1 As opposed to other MRI strain techniques, which require dedicated sequences, cine-based FT can provide quantitative assessment of myocardial strain in various settings [4][5][6] and can be performed retrospectively using routine cine MRI data. However, a time-consuming analytical process, such as transferring the data to a dedicated workstation and manually drawing the region of interest around the left ventricle in each image, may limit the use of FT strain analysis in routine clinical practice.…”

mentioning

confidence: 99%

“…Cardiac magnetic resonance imaging (MRI) plays an important role in the differential diagnosis, risk stratification, and evaluation of the treatment effects of cardiovascular diseases. Myocardial strain analysis has been developed as a contrast‐free quantitative method for the evaluation of myocardial deformation in different orientations, including longitudinal, circumferential, and radial strains 1 . Among these, left ventricular global longitudinal strain (GLS) is considered the most sensitive parameter to detect early disease because subendocardial fibers are longitudinally directed and sensitive to ischemia 2 .…”

mentioning

confidence: 99%

“…Impaired GCS is known to be an independent predictor of future cardiac events in patients with myocardial infarction, even after adjusting for left ventricular ejection fraction and the presence of late gadolinium enhancement 3 . To date, several MRI techniques have been available for evaluating myocardial strain, including tagging MRI, displacement encoding with stimulated echoes (DENSE), strain‐encoded MRI, and feature tracking (FT) analysis using cine MRI images 1 . As opposed to other MRI strain techniques, which require dedicated sequences, cine‐based FT can provide quantitative assessment of myocardial strain in various settings 4–6 and can be performed retrospectively using routine cine MRI data.…”

mentioning

confidence: 99%

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Editorial for “Comparison of DeepStrain and Feature Tracking for Cardiac MRI Strain Analysis”

Aikawa

Oyama‐Manabe

2022

Magnetic Resonance Imaging

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Myocardial Strain Evaluation with Cardiovascular MRI: Physics, Principles, and Clinical Applications

Cited by 47 publications

References 71 publications

Reverse remodeling of left atrium assessed by cardiovascular magnetic resonance feature tracking in hypertrophic obstructive cardiomyopathy after septal myectomy

Reverse remodeling of left atrium assessed by cardiovascular magnetic resonance feature tracking in hypertrophic obstructive cardiomyopathy after septal myectomy

Right Ventricular Strain by Magnetic Resonance Feature Tracking Is Largely Afterload-Dependent and Does Not Reflect Contractility: Validation by Combined Volumetry and Invasive Pressure Tracings

Editorial for “Comparison of DeepStrain and Feature Tracking for Cardiac MRI Strain Analysis”

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