Strain-Encoded Cardiac MRI as an Adjunct for Dobutamine Stress Testing

Korosoglou, Grigorios; Loßnitzer, Dirk; Schellberg, Dieter; Lewien, Antje; Wochele, Angela; Schaeufele, Tim; Neizel, Mirja; Steen, Henning; Giannitsis, Evangelos; Katus, Hugo A.; Osman, Nael F.

doi:10.1161/circimaging.108.790105

Cited by 56 publications

(42 citation statements)

References 30 publications

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“…Deformation imaging offers the opportunity to quantify both the magnitude and timing of regional systolic and diastolic deformation. Given its spatial resolution, magnetic resonance imaging-based strain has been particularly useful in detecting regional myocardial dysfunction related to ischemia 34 and in correlating regional function with regional fibrosis and metabolism. Regional myocardial function assessed by regional strain analysis correlates with regional scar burden in the post-myocardial infarction setting 35 and in the case of hypertrophic cardiomyopathy has also allowed assessment of the relative contribution of scar versus other myocardial derangements to regional functional impairment.…”

Section: Quantification Of Regional Functionmentioning

confidence: 99%

Myocardial Deformation Imaging

2012

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M yocardial deformation imaging is a novel echocardiographic method for assessment of global and regional myocardial function. As this technology has evolved, it has been applied to an increasing number of research questions, and the number of publications incorporating deformation imaging has grown in parallel.Although not yet sufficiently vetted for routine clinical use, these methods offer the long-term potential for more complete, accurate, and reproducible assessment of myocardial function. What Is Myocardial Deformation Imaging?Evaluation of contractile function with echocardiography has traditionally been limited to volume-based assessment of ejection fraction (EF) and assessment of regional wall motion or visual estimation of regional thickening. These methods have suffered from lack of reproducibility and standardization and are generally considered to be extremely sensitive to loading conditions. These limitations have led to an interest in techniques that provide more objective and reproducible measures of contractile function.During systole, the ventricular myocardium simultaneously shortens in the longitudinal and circumferential planes and thickens in the radial plane, with reciprocal changes in diastole ( Figure). Deformation imaging, in the broadest sense, allows for more direct assessment of myocardial muscle shortening and lengthening throughout the cardiac cycle by assessing regional myocardial strain and strain rate. Strain is defined as the change in length of a segment of myocardium relative to its resting length and is expressed as a percentage; strain rate is the rate of this deformation. Longitudinal and circumferential shortening results in negative strain values, whereas radial thickening results in a positive strain value. Previously, assessment of myocardial strain could be performed with the use of sonomicrometry crystals, which can only be performed experimentally 1 or with magnetic resonance imaging-based myocardial tagging, 2,3 which is limited by relatively low temporal resolution and the limited availability and expense of cardiac magnetic resonance imaging. Extension of these techniques to echocardiography has allowed for substantially greater utility in a broader range of patients.Myocardial deformation imaging with echocardiography can be performed with the use of either tissue Doppler-based or 2-dimensional speckle tracking-based methods. Doppler methods, developed initially, utilize the velocity gradient present along the length of the left ventricle (LV) to calculate strain rate, which is then integrated to derive strain. This technique suffers from limitations similar to those of traditional Doppler because it can only accurately assess deformation in the plane incident with the ultrasound beam and requires prospective acquisition of dedicated images at high frame rate. B-mode speckle tracking, sometimes referred to as feature tracking, utilizes the movement of the coherent ultrasound backscatter speckle pattern within B-mode echocardiographic images to assess myocardial...

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Section: Quantification Of Regional Functionmentioning

confidence: 99%

Myocardial Deformation Imaging

2012

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“…In addition, it was recently shown that in myocardial ischemia or hypertrophy, long-axis myocardial function is impaired early in the course of the disease [15,[25][26][27]. The higher sensitivity of longitudinal strain in detecting subtle changes in myocardial dysfunction, which are not detected by the assessment of radial wall motion, was recently confirmed also by cardiac MRI [28][29][30].…”

Section: Discussionmentioning

confidence: 97%

Rapid assessment of longitudinal systolic left ventricular function using speckle tracking of the mitral annulus

et al. 2011

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“…43 Low cardiac event rates are associated with normal stress CMR, and increasing risk is seen with increasing extent of ischemia. 44,45 Stress CMR can be combined with tagging to quantify myocardial strain, which improves diagnostic accuracy, 46 reduces observer variability, 47 and can be combined with perfusion imaging. 48 …”

Section: Ischemic Heart Disease Myocardial Ischemiamentioning

confidence: 99%