Strain‐encoded magnetic resonance: a method for the assessment of myocardial deformation

Abstract

This study aims to assess the usefulness of strain‐encoded magnetic resonance (SENC) for the quantification of myocardial deformation (‘strain’) in healthy volunteers and for the diagnostic workup of patients with different cardiovascular pathologies. SENC was initially described in the year 2001. Since then, the SENC sequence has undergone several technical developments, aiming at the detection of strain during single‐heartbeat acquisitions (fast‐SENC). Experimental and clinical studies that used SENC and fast‐SENC or compared SENC with conventional cine or tagged magnetic resonance in phantoms, animals, healthy volunteers, or patients were systematically searched for in PubMed. Using ‘strain‐encoded magnetic resonance and SENC’ as keywords, three phantom and three animal studies were identified, along with 27 further clinical studies, involving 185 healthy subjects and 904 patients. SENC (i) enabled reproducible assessment of myocardial deformation in vitro, in animals and in healthy volunteers, (ii) showed high reproducibility and substantially lower time spent compared with conventional tagging, (iii) exhibited incremental value to standard cine imaging for the detection of inducible ischaemia and for the risk stratification of patients with ischaemic heart disease, and (iv) enabled the diagnostic classification of patients with transplant vasculopathy, cardiomyopathies, pulmonary hypertension, and diabetic heart disease. SENC has the potential to detect a wide range of myocardial diseases early, accurately, and without the need of contrast agent injection, possibly enabling the initiation of specific cardiac therapies during earlier disease stages. Its one‐heartbeat acquisition mode during free breathing results in shorter cardiovascular magnetic resonance protocols, making its implementation in the clinical realm promising.

Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio‐Oncology Council of the European Society of Cardiology (ESC)

“…An advanced strain-encoded (SENC and fast-SENC) CMR tagging technology provides high accuracy and reproducibility during single heartbeat acquisitions without contrast and may be helpful in the future to detect early cardiotoxicity. 142 The PROACT study with mixed blinded and unblinded design will include breast cancer, lymphoma and sarcoma patients receiving AC chemotherapy, also aiming to initiate cardioprotection at the earliest possible moment (Figures 7 and 8). 143 Also, a decrease of native T1 times as early as 48 h after the first AC cycle has been shown to predict the development of CTRCD after completion of chemotherapy.…”

Comparison of feature tracking, fast‐SENC, and myocardial tagging for global and segmental left ventricular strain

“…Furthermore, a recent study by Lapinskas et al demonstrated feasibility of fast‐SENC to assess LV volumes and LVEF, making it a convenient option for functional assessment of the heart. Such short acquisition and post‐processing times make fast‐SENC technique very attractive in daily routine, especially in severely ill patients and children . It must be noted that due to technical limitations, radial strain cannot be assessed from SENC acquisitions .…”

“…It must be noted that due to technical limitations, radial strain cannot be assessed from SENC acquisitions . Additionally, it has a worse spatial resolution than TAG and FT . On the other end of the spectrum, FT is a post‐processing technique that does not require additional image acquisition.…”

The three‐dimensional speckle tracking echocardiography in distinguishing between ischaemic and non‐ischaemic aetiology of heart failure

“…Differentiating the ICM from the NICM is of paramount importance due to the different prognosis and treatment strategies. 4,6 Coronary angiography is a gold standard method to diagnose the CAD. Despite its routine use in the clinical practice, it is time requirements, radiation load, and periprocedural complications that make it a complex examination with strict indications.…”

“…5 Regarding prognosis and different therapeutic approaches, HF aetiology is usually specified with cardiac magnetic resonance (CMR), computed tomography, or invasive coronary angiography. [6][7][8] The 3D STE with its capability to analyse the myocardial mechanics is a cost-effective imaging modality. Its applicability and clinical relevance in the differentiation between ischaemic and non-ischaemic cardiomyopathy (NICM) lack sufficient data.…”