Regional myocardial strain by cardiac magnetic resonance feature tracking for detection of scar in ischemic heart disease.
Aged
Cicatrix
/ diagnostic imaging
Cohort Studies
Contrast Media
Female
Gadolinium DTPA
Heart
/ diagnostic imaging
Heart Ventricles
/ diagnostic imaging
Humans
Linear Models
Magnetic Resonance Imaging, Cine
Magnetic Resonance Spectroscopy
Male
Middle Aged
Myocardial Infarction
/ diagnostic imaging
Myocardial Ischemia
/ diagnostic imaging
Myocardium
/ pathology
ROC Curve
Retrospective Studies
Sensitivity and Specificity
Systole
Ventricular Function, Left
Late gadolinium enhancement
Left ventricular function
Myocardial deformation
Journal
Magnetic resonance imaging
ISSN: 1873-5894
Titre abrégé: Magn Reson Imaging
Pays: Netherlands
ID NLM: 8214883
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
01
10
2019
revised:
23
12
2019
accepted:
18
02
2020
pubmed:
23
2
2020
medline:
1
12
2020
entrez:
22
2
2020
Statut:
ppublish
Résumé
Although cardiac magnetic resonance (CMR) can accurately quantify global left ventricular strain using feature tracking (FT), it has been suggested that FT cannot reliably quantify regional strain. We aimed to determine whether abnormalities in regional strain measured using FT can be detected within areas of myocardial scar and to determine the extent to which the regional strain measurement is impacted by LV ejection fraction (EF). We retrospectively studied 96 patients (46 with LVEF ≤ 40%, 50 with LVEF > 40%) with coronary artery disease and a late gadolinium enhancement (LGE) pattern consistent with myocardial infarction, who underwent CMR imaging (1.5T). Regional peak systolic longitudinal and circumferential strains (RLS, RCS) were measured within LGE and non-LGE areas. Linear regression analysis was performed for strain in both areas against LVEF to determine whether the relationship between strain and LGE holds across the LV function spectrum. Receiver-operating curve (ROC) analysis was performed in 33 patients (derivation cohort) to optimize strain cutoff, which was tested in the remaining 63 patients (validation cohort) for its ability to differentiate LGE from non-LGE areas. Both RLS and RCS magnitudes were reduced in LGE areas: RLS = -10.4 ± 6.2% versus -21.0 ± 8.5% (p < 0.001); RCS = -10.4 ± 6.0% versus -18.9 ± 8.6%, respectively (p < 0.001), but there was considerable overlap between LGE and non-LGE areas. Linear regression revealed that it was partially driven by the natural dependence between strain and EF, suggesting that EF-corrected strain cutoff is needed to detect LGE. ROC analysis showed the ability of both RLS and RCS to differentiate LGE from non-LGE areas: area under curve 0.95 and 0.89, respectively. In the validation cohort, optimal cutoffs of RLS/EF = 0.36 and RCS/EF = 0.37 yielded sensitivity, specificity and accuracy 0.74-0.78. Abnormalities in RLS and RCS within areas of myocardial scar can be detected using CMR-FT; however, LVEF must be accounted for.
Sections du résumé
BACKGROUND
Although cardiac magnetic resonance (CMR) can accurately quantify global left ventricular strain using feature tracking (FT), it has been suggested that FT cannot reliably quantify regional strain. We aimed to determine whether abnormalities in regional strain measured using FT can be detected within areas of myocardial scar and to determine the extent to which the regional strain measurement is impacted by LV ejection fraction (EF).
METHODS
We retrospectively studied 96 patients (46 with LVEF ≤ 40%, 50 with LVEF > 40%) with coronary artery disease and a late gadolinium enhancement (LGE) pattern consistent with myocardial infarction, who underwent CMR imaging (1.5T). Regional peak systolic longitudinal and circumferential strains (RLS, RCS) were measured within LGE and non-LGE areas. Linear regression analysis was performed for strain in both areas against LVEF to determine whether the relationship between strain and LGE holds across the LV function spectrum. Receiver-operating curve (ROC) analysis was performed in 33 patients (derivation cohort) to optimize strain cutoff, which was tested in the remaining 63 patients (validation cohort) for its ability to differentiate LGE from non-LGE areas.
RESULTS
Both RLS and RCS magnitudes were reduced in LGE areas: RLS = -10.4 ± 6.2% versus -21.0 ± 8.5% (p < 0.001); RCS = -10.4 ± 6.0% versus -18.9 ± 8.6%, respectively (p < 0.001), but there was considerable overlap between LGE and non-LGE areas. Linear regression revealed that it was partially driven by the natural dependence between strain and EF, suggesting that EF-corrected strain cutoff is needed to detect LGE. ROC analysis showed the ability of both RLS and RCS to differentiate LGE from non-LGE areas: area under curve 0.95 and 0.89, respectively. In the validation cohort, optimal cutoffs of RLS/EF = 0.36 and RCS/EF = 0.37 yielded sensitivity, specificity and accuracy 0.74-0.78.
CONCLUSION
Abnormalities in RLS and RCS within areas of myocardial scar can be detected using CMR-FT; however, LVEF must be accounted for.
Identifiants
pubmed: 32084516
pii: S0730-725X(19)30591-0
doi: 10.1016/j.mri.2020.02.009
pii:
doi:
Substances chimiques
Contrast Media
0
Gadolinium DTPA
K2I13DR72L
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
190-196Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.