A head-to-head comparison of fast-SENC and feature tracking to LV long axis strain for assessment of myocardial deformation in chest pain patients.


Journal

BMC medical imaging
ISSN: 1471-2342
Titre abrégé: BMC Med Imaging
Pays: England
ID NLM: 100968553

Informations de publication

Date de publication:
05 09 2022
Historique:
received: 08 06 2022
accepted: 19 08 2022
entrez: 5 9 2022
pubmed: 6 9 2022
medline: 9 9 2022
Statut: epublish

Résumé

Myocardial strain imaging has gained importance in cardiac magnetic resonance (CMR) imaging in recent years as an even more sensitive marker of early left ventricular dysfunction than left-ventricular ejection fraction (LVEF). fSENC (fast strain encoded imaging) and FT (feature tracking) both allow for reproducible assessment of myocardial strain. However, left-ventricular long axis strain (LVLAS) might enable an equally sensitive measurement of myocardial deformation as global longitudinal or circumferential strain in a more rapid and simple fashion. In this study we compared the diagnostic performance of fSENC, FT and LVLAS for identification of cardiac pathology (ACS, cardiac-non-ACS) in patients presenting with chest pain (initial hscTnT 5-52 ng/l). Patients were prospectively recruited from the chest pain unit in Heidelberg. The CMR scan was performed within 1 h after patient presentation. Analysis of LVLAS was compared to the GLS and GCS as measured by fSENC and FT. In total 40 patients were recruited (ACS n = 6, cardiac-non-ACS n = 6, non-cardiac n = 28). LVLAS was comparable to fSENC for differentiation between healthy myocardium and myocardial dysfunction (GLS-fSENC AUC: 0.882; GCS-fSENC AUC: 0.899; LVLAS AUC: 0.771; GLS-FT AUC: 0.740; GCS-FT: 0.688), while FT-derived strain did not allow for differentiation between ACS and non-cardiac patients. There was significant variability between the three techniques. Intra- and inter-observer variability (OV) was excellent for fSENC and FT, while for LVLAS the agreement was lower and levels of variability higher (intra-OV: Pearson > 0.7, ICC > 0.8; inter-OV: Pearson > 0.65, ICC > 0.8; CoV > 25%). While reproducibility was excellent for both FT and fSENC, it was only fSENC and the LVLAS which allowed for significant identification of myocardial dysfunction, even before LVEF, and therefore might be used as rapid supporting parameters for assessment of left-ventricular function.

Sections du résumé

BACKGROUND
Myocardial strain imaging has gained importance in cardiac magnetic resonance (CMR) imaging in recent years as an even more sensitive marker of early left ventricular dysfunction than left-ventricular ejection fraction (LVEF). fSENC (fast strain encoded imaging) and FT (feature tracking) both allow for reproducible assessment of myocardial strain. However, left-ventricular long axis strain (LVLAS) might enable an equally sensitive measurement of myocardial deformation as global longitudinal or circumferential strain in a more rapid and simple fashion.
METHODS
In this study we compared the diagnostic performance of fSENC, FT and LVLAS for identification of cardiac pathology (ACS, cardiac-non-ACS) in patients presenting with chest pain (initial hscTnT 5-52 ng/l). Patients were prospectively recruited from the chest pain unit in Heidelberg. The CMR scan was performed within 1 h after patient presentation. Analysis of LVLAS was compared to the GLS and GCS as measured by fSENC and FT.
RESULTS
In total 40 patients were recruited (ACS n = 6, cardiac-non-ACS n = 6, non-cardiac n = 28). LVLAS was comparable to fSENC for differentiation between healthy myocardium and myocardial dysfunction (GLS-fSENC AUC: 0.882; GCS-fSENC AUC: 0.899; LVLAS AUC: 0.771; GLS-FT AUC: 0.740; GCS-FT: 0.688), while FT-derived strain did not allow for differentiation between ACS and non-cardiac patients. There was significant variability between the three techniques. Intra- and inter-observer variability (OV) was excellent for fSENC and FT, while for LVLAS the agreement was lower and levels of variability higher (intra-OV: Pearson > 0.7, ICC > 0.8; inter-OV: Pearson > 0.65, ICC > 0.8; CoV > 25%).
CONCLUSIONS
While reproducibility was excellent for both FT and fSENC, it was only fSENC and the LVLAS which allowed for significant identification of myocardial dysfunction, even before LVEF, and therefore might be used as rapid supporting parameters for assessment of left-ventricular function.

Identifiants

pubmed: 36064332
doi: 10.1186/s12880-022-00886-3
pii: 10.1186/s12880-022-00886-3
pmc: PMC9442977
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

159

Informations de copyright

© 2022. The Author(s).

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Auteurs

Deborah Siry (D)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany. deborah.siry@gmail.com.

Johannes Riffel (J)

Department of Cardiology and Angiology, Robert-Bosch-Hospital, Stuttgart, Germany.

Janek Salatzki (J)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany.

Florian André (F)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany.

Lukas Damian Weberling (LD)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany.
DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg, Heidelberg, Germany.

Marco Ochs (M)

Department of Cardiology, Angiology and Internal Intensive Care, Theresien-Hospital, Mannheim, Germany.

Noura A Atia (NA)

Diagnostic Radiology and Medical Imaging Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Elizabeth Hillier (E)

Departments of Medicine and Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada.

David Albert (D)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany.

Hugo A Katus (HA)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany.

Evangelos Giannitsis (E)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany.

Norbert Frey (N)

Department of Cardiology, Angiology and Pneumology, University Clinic of Heidelberg, Heidelberg, Germany.

Matthias G Friedrich (MG)

Departments of Medicine and Diagnostic Radiology, McGill University Health Centre, Montreal, QC, Canada.

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