Quantification of myocardial deformation in children by cardiovascular magnetic resonance feature tracking: determination of reference values for left ventricular strain and strain rate

Abstract

BackgroundThe objective assessment of global and regional cardiac function in children has shown to be clinically relevant but is challenging to conduct. Cardiovascular magnetic resonance (CMR) has emerged as a valuable diagnostic modality especially in patients with cardiomyopathy or congenital heart disease. However, data on the normal cardiac deformation in children assessed by CMR is lacking at present. Thus, the aim of this study was to provide reference values for cardiac strain and strain rate in children and adolescents derived from CMR feature tracking (FT) measurements.MethodsIn this binational study, eighty children and adolescents (age 0.4–18.0 years, 41 male, 39 female) free from cardiac diseases from two centers underwent CMR in 1.5 T whole-body scanners in supine position. Global peak radial, circumferential and longitudinal systolic strains as well as the corresponding early peak diastolic strain rates were assessed applying FT on short axis as well as 3- and 4-chamber views of standard cine steady-state free precession images.ResultsThe difference between genders yielded no significance for all assessed strains. Yet, all strains showed a significant parabolic relation to age and an even stronger one to body surface area (BSA). Therefore, BSA-specific reference values were determined using a polynomial regression model. The apical cardiac segments featured significant higher peak circumferential but lower peak radial systolic strains than the midventricular and basal segments (all p < 0.001).ConclusionsThe assessment of cardiac deformation by CMR-FT is feasible in children. This is the first CMR study providing specific reference values for FT-derived strain and strain rate in the pediatric age range.Electronic supplementary materialThe online version of this article (doi:10.1186/s12968-016-0310-x) contains supplementary material, which is available to authorized users.

Quantitative comparison of two-dimensional and three-dimensional strain measurement using MRI feature tracking in repair Fontan patients and normal child volunteers

“…In our study, the 32 control group volunteers showed strain values within the reference range. In another study by André et al [23] that used parabolic regression equations, no sex-related differences were found in the assessed strain values in children and adolescents. Our study showed significant age differences between the patient group and control group.…”

Nomograms for Cardiovascular Magnetic Resonance Measurements in the Pediatric Age Group: To Define the Normal and the Expected Abnormal Values in Corrected/Palliated Congenital Heart Disease: A Systematic Review

“…Cardiovascular MRI is routinely used as the gold standard imaging technique for the assessment and follow‐up of specific groups of CHDs (eg, conotruncal abnormalities, right‐sided lesions, great vessels anomalies) . In such anomalies, to find measurements different from normal (eg, ascending aorta and pulmonary arteries in tetralogy of Fallot [TOF]) is almost the rule . In this setting it is important to understand not only how much a given measurement is distant from normal but also if this measure is or not similar to those of other children with the same defect.…”

“…1 In such anomalies, to find measurements different from normal (eg, ascending aorta and pulmonary arteries in tetralogy of Fallot [TOF]) is almost the rule. 1,[18][19][20][21][22][23] In this setting it is important to understand not only how much a given measurement is distant from normal but also if this measure is or not similar to those of other children with the same defect. Thus, a few recent studies [18][19][20][21][22][23] tried to derive expected abnormal cardiovascular MRI values in specific CHD with attention to repaired TOF, which is one of the most frequent indications for cardiovascular MRI examinations in the pediatric age and in young adults.…”

“…1,[18][19][20][21][22][23] In this setting it is important to understand not only how much a given measurement is distant from normal but also if this measure is or not similar to those of other children with the same defect. Thus, a few recent studies [18][19][20][21][22][23] tried to derive expected abnormal cardiovascular MRI values in specific CHD with attention to repaired TOF, which is one of the most frequent indications for cardiovascular MRI examinations in the pediatric age and in young adults. 1,[18][19][20] Shelby et al demonstrated how the variation in great arterial dimensions at any given BSA is much greater in TOF compared with normal healthy subjects and is significantly greater among men.…”

“…The population of patients living with congenital heart disease (CHD) has increased with a concomitant improvement in medical and surgical therapies. Cardiovascular magnetic resonance imaging (MRI) has become an integral part of the diagnostic work‐up in children and adults with congenital and acquired cardiac diseases . Cardiovascular MRI is a noninvasive, radiation‐free modality that is complementary to echocardiography .…”