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Eckstein J, Körperich H, Weber OM, Burchert W, Pugachov V, Demydiuk O, Piran M. Assessment of CMR Feature-Tracking Age- and Sex-Dependent Right Ventricular Strain in a Healthy Caucasian Cohort. J Cardiovasc Transl Res 2024:10.1007/s12265-024-10557-z. [PMID: 39292408 DOI: 10.1007/s12265-024-10557-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 08/26/2024] [Indexed: 09/19/2024]
Abstract
Right ventricular (RV) strain offers crucial diagnostic insights in cardiovascular and pulmonary disorders. Nonetheless, the absence of established reference values impedes its clinical implementation. Utilizing CMR-feature tracking, age- and gender-dependent RV strains were systematically assessed in 175 heart-healthy Caucasians, 97 females, median 32.5 years. RV global longitudinal strain (GLS) was greater in females than males (median -26.8% (-28.3;-24.1) vs. -24.4 ± 3.0%; p < 0.001), whereby radial and circumferential strain remained comparable. Age subgroups exhibited increased RV-GLS for group B (30-50 years) (-26.0 ± 3.1% vs. -24.4 ± 3.2%; p = 0.011) and group C (> 50 years) (-26.7 ± 2.3% vs. -24.4 ± 3.2%; p < 0.001) compared to group A (< 30 years). High intra-class correlation coefficients (ICC) were exhibited by intrarater variability (ICC = 0.86-0.95) and moderate levels for interrater variability (ICC = 0.50-0.73). CMR-feature tracking provides a fair quantification method of age- and gender-specific normal RV strain values, demonstrating that higher RV-GLS is linked to female gender and advancing age within a healthy Caucasian cohort.
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Affiliation(s)
- Jan Eckstein
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum und Universität Bielefeld Medizinische Fakultät OWL, Bad Oeynhausen, Germany
| | - Hermann Körperich
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum und Universität Bielefeld Medizinische Fakultät OWL, Bad Oeynhausen, Germany.
| | | | - Wolfgang Burchert
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum und Universität Bielefeld Medizinische Fakultät OWL, Bad Oeynhausen, Germany
| | - Volodymyr Pugachov
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum und Universität Bielefeld Medizinische Fakultät OWL, Bad Oeynhausen, Germany
| | - Oleksandra Demydiuk
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum und Universität Bielefeld Medizinische Fakultät OWL, Bad Oeynhausen, Germany
| | - Misagh Piran
- Institut für Radiologie, Nuklearmedizin und Molekulare Bildgebung, Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum und Universität Bielefeld Medizinische Fakultät OWL, Bad Oeynhausen, Germany
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Villar-Calle P, Kochav JD, Vadaketh K, Chiu C, Tak K, Agoglia H, Liberman N, Nguyen KL, Vizcarra-Tellez A, Wu A, RoyChoudhury A, Khalique OK, Judd R, Kim RJ, Shah DJ, Heitner JF, Farzaneh-Far A, Shenoy C, Owyang CG, Mukherjee M, Horn E, Weinsaft JW, Kim J. Tissue-Based Predictors of Impaired Right Ventricular Strain in Coronary Artery Disease: A Multicenter Stress Perfusion Study. Circ Cardiovasc Imaging 2024; 17:e016852. [PMID: 39163376 PMCID: PMC11343094 DOI: 10.1161/circimaging.124.016852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/22/2024]
Abstract
BACKGROUND Right ventricular (RV) dysfunction is known to impact prognosis, but its determinants in coronary artery disease are poorly understood. Stress cardiac magnetic resonance (CMR) has been used to assess ischemia and infarction in relation to the left ventricle (LV); the impact of myocardial tissue properties on RV function is unknown. METHODS Vasodilator stress CMR was performed in patients with known coronary artery disease at 7 sites between May 2005 and October 2018. Myocardial infarction was identified on late gadolinium enhancement-CMR, and infarct transmurality was graded on a per-segment basis. Ischemia was assessed on stress CMR based on first-pass perfusion and localized by using segment partitions corresponding to cine and late gadolinium enhancement analyses. RV function was evaluated by CMR-feature tracking for primary analysis with a global longitudinal strain threshold of 20% used to define impaired RV strain (RVIS); secondary functional analysis via RV ejection fraction was also performed. RESULTS A total of 2604 patients were studied, among whom RVIS was present in 461 patients (18%). The presence and magnitude of RVIS were strongly associated with LV dysfunction, irrespective of whether measured by LV ejection fraction or wall motion score (P<0.001 for all). Regarding tissue substrate, regions of ischemic and dysfunctional myocardium (ie, hibernating myocardium) and infarct size were each independently associated with RVIS (both P<0.001). During follow-up (median, 4.62 [interquartile range, 2.15-7.67] years), 555 deaths (21%) occurred. Kaplan-Meier analysis for patients stratified by presence and magnitude of RV dysfunction by global longitudinal strain and RV ejection fraction each demonstrated strong prognostic utility for all-cause mortality (P<0.001). RVIS conferred increased mortality risk (hazard ratio, 1.35 [95% CI, 1.11-1.66]; P=0.003) even after controlling for LV function, infarction, and ischemia. CONCLUSIONS RVIS in patients with known coronary artery disease is associated with potentially reversible LV processes, including LV functional impairment due to ischemic and predominantly viable myocardium, which confers increased mortality risk independent of LV function and tissue substrate.
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Affiliation(s)
| | | | | | | | - Katherine Tak
- Weill Cornell Medicine (New York, New York)
- UMass Chan Medical School (Worcester, Massachusetts)
| | | | | | | | | | - Alan Wu
- Weill Cornell Medicine (New York, New York)
| | | | | | - Robert Judd
- Duke University Medical Center (Durham, North Carolina)
| | | | - Dipan J. Shah
- Houston Methodist De Bakey Heart & Vascular Center (Houston, Texas)
| | | | | | - Chetan Shenoy
- Division of Cardiology – University of Minnesota Medical Center (Minneapolis, Minnesota), Johns Hopkins University School of Medicine (Baltimore, MD)
| | | | - Monica Mukherjee
- Division of Cardiology – University of Minnesota Medical Center (Minneapolis, Minnesota), Johns Hopkins University School of Medicine (Baltimore, MD)
| | | | | | - Jiwon Kim
- Weill Cornell Medicine (New York, New York)
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Huang KY, Chung FP, Guo CY, Chiu JH, Kuo L, Lee YC, Weng CY, Chang YY, Lin YJ, Chen CK. Right ventricular scalloping index as cardiac magnetic resonance-derived marker for diagnosis of arrhythmogenic right ventricular cardiomyopathy. J Chin Med Assoc 2024; 87:531-537. [PMID: 38529961 DOI: 10.1097/jcma.0000000000001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The cardiac magnetic resonance (CMR) evaluation of right ventricular (RV) morphologic abnormalities in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is subjective. Here, we aimed to use a quantitative index, the right ventricular scalloping index (RVSI), to standardize the measurement of RV free wall scalloping and aid in the imaging diagnosis. METHODS We retrospectively included 15 patients with definite ARVC and 45 age- and sex-matched patients with idiopathic right ventricular outflow tract ventricular arrhythmia (RVOT-VA) as controls. The RVSI was measured from cine images on four-chamber view to evaluate its ability to distinguish between ARVC and RVOT-VA patients. Other cardiac functional parameters including strain analysis were also performed. RESULTS The RVSI was significantly higher in the ARVC than RVOT-VA group (1.56 ± 0.23 vs 1.30 ± 0.08, p < 0.001). The diagnostic performance of the RVSI was superior to the RV global longitudinal, circumferential, and radial strains, RV ejection fraction, and RV end-diastolic volume index. The RVSI demonstrated high intraobserver and interobserver reliability (intraclass correlation coefficient, 0.94 and 0.96, respectively). RVSI was a strong discriminator between ARVC and RVOT-VA patients (area under curve [AUC], 0.91; 95% CI, 0.82-0.99). A cutoff value of RVSI ≥1.49 provided an accuracy of 90.0%, specificity of 97.8%, sensitivity of 66.7%, positive predictive value (PPV) of 90.9%, and a negative predictive value (NPV) of 89.8%. In a multivariable analysis, a family history of ARVC or sudden cardiac death (odds ratio, 38.71; 95% CI, 1.48-1011.05; p = 0.028) and an RVSI ≥1.49 (odds ratio, 64.72; 95% CI, 4.58-914.63; p = 0.002) remained predictive of definite ARVC. CONCLUSION RVSI is a quantitative method with good performance for the diagnosis of definite ARVC.
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Affiliation(s)
- Ko-Ying Huang
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fa-Po Chung
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chao-Yu Guo
- Institute of Public Health, College of Medicine, National Yang Ming Chiao Tung University, Taipei Taiwan, ROC
| | - Jui-Han Chiu
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling Kuo
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ying-Chi Lee
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ching-Yao Weng
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Yueh Chang
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yenn-Jiang Lin
- Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cardiovascular Research Center, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chun-Ku Chen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
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Sun Y, Zhang C, He B, Wang L, Tian D, Kang Z, Chen L, Li R, Ren J, Guo Y, Zhang Y, Duojie D, Zhang Q, Gao F. Left ventricular strain changes at high altitude in rats: a cardiac magnetic resonance tissue tracking imaging study. BMC Cardiovasc Disord 2024; 24:223. [PMID: 38658849 PMCID: PMC11040916 DOI: 10.1186/s12872-024-03886-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Long-term exposure to a high altitude environment with low pressure and low oxygen could cause abnormalities in the structure and function of the heart. Myocardial strain is a sensitive indicator for assessing myocardial dysfunction, monitoring myocardial strain is of great significance for the early diagnosis and treatment of high altitude heart-related diseases. This study applies cardiac magnetic resonance tissue tracking technology (CMR-TT) to evaluate the changes in left ventricular myocardial function and structure in rats in high altitude environment. METHODS 6-week-old male rats were randomized into plateau hypoxia rats (plateau group, n = 21) as the experimental group and plain rats (plain group, n = 10) as the control group. plateau group rats were transported from Chengdu (altitude: 360 m), a city in a plateau located in southwestern China, to the Qinghai-Tibet Plateau (altitude: 3850 m), Yushu, China, and then fed for 12 weeks there, while plain group rats were fed in Chengdu(altitude: 360 m), China. Using 7.0 T cardiac magnetic resonance (CMR) to evaluate the left ventricular ejection fraction (EF), end-diastolic volume (EDV), end-systolic volume (ESV) and stroke volume (SV), as well as myocardial strain parameters including the peak global longitudinal (GLS), radial (GRS), and circumferential strain (GCS). The rats were euthanized and a myocardial biopsy was obtained after the magnetic resonance imaging scan. RESULTS The plateau rats showed more lower left ventricular GLS and GRS (P < 0.05) than the plain rats. However, there was no statistically significant difference in left ventricular EDV, ESV, SV, EF and GCS compared to the plain rats (P > 0.05). CONCLUSIONS After 12 weeks of exposure to high altitude low-pressure hypoxia environment, the left ventricular global strain was partially decreased and myocardium is damaged, while the whole heart ejection fraction was still preserved, the myocardial strain was more sensitive than the ejection fraction in monitoring cardiac function.
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Affiliation(s)
- Yanqiu Sun
- Department of Radiology, Qinghai Provincial People's Hospital, Xining, China
| | - Chenhong Zhang
- Department of Radiology, Qinghai Provincial People's Hospital, Xining, China
| | - Bo He
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Lei Wang
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China
| | - Dengfeng Tian
- Department of Radiology, Qinghai Provincial People's Hospital, Xining, China
| | - Zhiqiang Kang
- Department of Radiology, Qinghai Provincial People's Hospital, Xining, China
| | - Lixin Chen
- Medical Equipment Management Office, Qinghai Provincial People's Hospital, Xining, China
| | - Ruiwen Li
- Medical Equipment Management Office, Qinghai Provincial People's Hospital, Xining, China
| | - Jialiang Ren
- Wuxi National Hi-tech Industrial Development Zone, GE Healthcare, 19 Changjiang Road, Wuxi, China
| | - Yong Guo
- Department of Radiology, People's Hospital of Yushu Tibetan Autonomous Prefecture, Qinghai, China
| | - Yonghai Zhang
- Department of Radiology, The Fifth People's Hospital of Qinghai Province, Qinghai, China
| | - Dingda Duojie
- Department of Radiology, People's Hospital of Yushu Tibetan Autonomous Prefecture, Qinghai, China
| | - Qiang Zhang
- Department of neurosurgery, Qinghai Provincial People's Hospital, Xining, China.
| | - Fabao Gao
- Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
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Wen X, Gao Y, Guo Y, Zhang Y, Zhang Y, Shi K, Li Y, Yang Z. Assessing right ventricular peak strain in myocardial infarction patients with mitral regurgitation by cardiac magnetic resonance feature tracking. Quant Imaging Med Surg 2024; 14:3018-3032. [PMID: 38617148 PMCID: PMC11007518 DOI: 10.21037/qims-23-1360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/22/2024] [Indexed: 04/16/2024]
Abstract
Background Although it is known that mitral regurgitation (MR) in patients with myocardial infarction (MI) may increase the right ventricular (RV) afterload, leading to RV dysfunction, the exact detrimental effects on RV function and myocardial peak strain remain unresolved. In this study, we assessed the impact of MR on the impairment of RV myocardial deformation in patients with MI and explored the independent influential factors of RV peak strain. Methods A total of 199 MI participants without or with MR were retrospectively assessed in this study. The cardiovascular magnetic resonance examination protocol included a late gadolinium-enhanced (LGE) imaging technique and a cine-balanced steady-state free precession sequence. Statistical tests, including two independent sample t-test or Mann-Whitney U-test, analysis of variance, Kruskal-Wallis test, and multiple linear regression analysis models were performed. Results The MI (MR+) group exhibited significantly lower RV strain parameters in the radial, circumferential and longitudinal directions when compared to the control and the MI (MR-) groups (both P<0.05). The RV global longitudinal peak strain (GLPS) in the MI group significantly decreased when compared with that in the control group (P<0.05). As moderate-severe MR worsened in patients with MI, RV myocardial global peak strain and the peak systolic strain rate (PSSR) gradually decreased. Multiple linear regression analysis revealed that left ventricular (LV) GLPS, triglycerides, and age were independently correlated with RV GLPS (all P<0.05). RV end-systolic volume (RVESV) acted as an independent association factor for RV global peak strain. Conclusions MR may exacerbate the impairment of RV peak strain and functions in patients with MI. LV GLPS was positively correlated with RV GLPS. However, RVESV, triglycerides, and age acted as independent risk factors associated with worsening RV GLPS.
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Affiliation(s)
- Xiaoling Wen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
- Department of Radiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Gao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yingkun Guo
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yi Zhang
- Department of Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Zhang
- Department of Radiology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhigang Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Yang W, Xu J, Zhu L, Zhang Q, Wang Y, Zhao S, Lu M. Myocardial Strain Measurements Derived From MR Feature-Tracking: Influence of Sex, Age, Field Strength, and Vendor. JACC Cardiovasc Imaging 2024; 17:364-379. [PMID: 37480906 DOI: 10.1016/j.jcmg.2023.05.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Cardiac magnetic resonance feature tracking (CMR-FT) is a novel technique for assessing myocardial deformation and dysfunction. However, a comprehensive assessment of normal values of strain parameters in all 4 cardiac chambers using different vendors is lacking. OBJECTIVES This study aimed to characterize the normal values for myocardial strain in all 4 cardiac chambers and identify factors that contribute to variations in FT strain through a systematic review and meta-analysis of the CMR-FT published reports. METHODS The investigators searched PubMed, Embase, and Scopus for myocardial strains of all 4 chambers measured by CMR-FT in healthy adults. The pooled means of all strain parameters were generated using a random-effects model. Subgroup analyses and meta-regressions were performed to identify the sources of variations. RESULTS This meta-analysis included 44 studies with a total of 3,359 healthy subjects. The pooled means of left ventricular global longitudinal strain (LV-GLS), LV global radial strain, and LV global circumferential strain (GCS) were -18.4% (95% CI: -19.2% to -17.6%), 43.7% (95% CI: 40.0%-47.4%), and -21.4% (95% CI: -22.3% to -20.6%), respectively. The pooled means of left atrial (LA)-GLS (corresponding to total strain, passive strain, and active strain) were 34.9% (95% CI: 29.6%-40.2%), 21.3% (95% CI: 16.6%-26.1%) and 14.3% (95% CI: 11.8%-16.8%), respectively. The pooled means of right ventricular (RV)-GLS and right atrial global longitudinal total strain were -24.0% (95% CI: -25.8% to -22.1%) and 36.3% (95% CI: 15.5%-57.0%), respectively. Meta-regression identified field strength (P < 0.001; I2 = 98.6%) and FT vendor (P < 0.001; I2 = 98.5%) as significant confounders contributing to heterogeneity of LV-GLS. The variations of LA-GLSactive were associated with regional distribution (P < 0.001; I2 = 97.3%) and FT vendor (P < 0.001; I2 = 97.4%). Differences in FT vendor were attributed to variations of LV-GCS and RV-GLS (P = 0.02; I2 = 98.8% and P = 0.01; I2 = 93.8%). CONCLUSIONS This study demonstrated the normal values of CMR-FT strain parameters in all 4 cardiac chambers in healthy subjects. Differences in FT vendor contributed to the heterogeneity of LV-GLS, LV-GCS, LA-GLSactive, and RV-GLS, whereas sex, age, and MR vendor had no effect on the normal values of CMR-FT strain measurements.
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Affiliation(s)
- Wenjing Yang
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Xu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Leyi Zhu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiang Zhang
- Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, National Institute for Health Research Oxford Biomedical Research Centre, Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | - Yining Wang
- Department of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, Beijing, China.
| | - Shihua Zhao
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minjie Lu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Imaging (Cultivation), Chinese Academy of Medical Sciences, Beijing, China.
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Hohneck A, Ansari U, Natale M, Wittig K, Overhoff D, Riffel P, Boettcher M, Akin I, Duerschmied D, Papavassiliu T. Description of a new clinical syndrome: thoracic constriction without evidence of the typical funnel-shaped depression-the "invisible" pectus excavatum. Sci Rep 2023; 13:12036. [PMID: 37491452 PMCID: PMC10368685 DOI: 10.1038/s41598-023-38739-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/13/2023] [Indexed: 07/27/2023] Open
Abstract
Pectus excavatum (PE) is a congenital malformation with a funnel-shaped depression of the sternum that can lead to cardiac symptoms. However, there are patients with thoracic constriction (defined as elevated Haller-Index > 3.25 determined by cardiac magnetic resonance imaging (CMR)) without visible evidence of PE, leading to similar complaints. Between January 2004 till June 2020, patients who underwent CMR for further evaluation of the heart, due to cardiac symptoms were enrolled and compared to controls. Biventricular global strain analysis was assessed using feature tracking (CMR-FT). ECG and/or Holter recordings were performed to detect rhythm events. Cardiac symptoms were evaluated in detail using a questionnaire. Finally, 88 patients (male 35, female 53) with elevated Haller-Index (3.9 ± 0.8) were included and compared to CMR data from 25 individuals with confirmed PE and 25 healthy controls (HC). Mean age at time of CMR was 35 ± 16 years. The most common symptoms at presentation were palpitations (41%), followed by dyspnea (24%) and atypical chest pain (14%). Three patients (3%) had atrial fibrillation or atrial flutter. Concomitant phenomena were pericardial effusion in 39% and mitral valve prolapse (MVP) in 27% of the study cohort. While there were no differences in left ventricular function or volumes, right ventricular function (RVEF) was significantly lower in patients with internal PE compared to HC (RVEF (%) 50 ± 5 vs 59 ± 4, p < 0.01). Strain analysis revealed only discrete changes in RV strain, implying a purely mechanical problem in the absence of structural changes. RV dimensions were negatively correlated with the size of thoracic indices (r = 0.41), reflecting the extent of thoracic constriction. MVP was more prevalent in patients with greater thoracic indices (r = 0.24). The described cohort, referred to as internal PE because of the absence of external changes, showed similar CMR morphologic findings as patients with real PE (especially altered dimensions of the right heart and a lower RVEF). In addition, there was a high incidence of rhythm disturbances, such as extrasystoles or arrhythmias. In one-third of the study cohort additional abnormalities such as pericardial effusion or MVP were present, with MVP being found more frequently in patients with larger thoracic indices, suggesting a possible common pathogenesis.Trial registration: ISRCTN registry, ISRCTN15355937, retrospectively registered 03.06.2022, https://www.isrctn.com/ISRCTN15355937?q=15355937&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10 .
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Affiliation(s)
- Anna Hohneck
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany.
| | - Uzair Ansari
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Michèle Natale
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Karsten Wittig
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Daniel Overhoff
- Department of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Philipp Riffel
- Department of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michael Boettcher
- Department of Pediatric Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ibrahim Akin
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Daniel Duerschmied
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Theano Papavassiliu
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
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Zhang X, Guo X, Zhang B, Yang Q, Gong J, Yang S, Li J, Kuang T, Miao R, Yang Y. The Role of Strain by Cardiac Magnetic Resonance Imaging in Predicting the Prognosis of Patients with Chronic Thromboembolic Pulmonary Hypertension. Clin Appl Thromb Hemost 2023; 29:10760296231176253. [PMID: 37700697 PMCID: PMC10501068 DOI: 10.1177/10760296231176253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/13/2023] [Accepted: 04/28/2023] [Indexed: 09/14/2023] Open
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by thrombotic obstruction of the pulmonary arteries, and right ventricular (RV) dysfunction is a major cause of death. Cardiac magnetic resonance (CMR) is the gold standard for assessing heart wall deformation; therefore, we aimed to determine the prognostic value of CMR strain in patients with CTEPH. Strain derived by CMR was measured at the time of diagnosis in 45 patients with CTEPH, and the relationship between RV strain and prognosis was determined through follow-up. The value of RV strain in the prognostic model was compared with that of pulmonary arterial hypertension (PAH) risk stratification. The RV global peak longitudinal strain (GLS) and global peak circumferential strain (GCS) in CTEPH patients were lower than the normal references of RV strain in the control group. GLS and longitudinal strain in the basal segment were independent risk factors for adverse events (P < .050). Adding CMR parameters to PAH risk stratification improved its predictive power in patients with CTEPH. GLS and GCS scores were impaired in patients with chronic RV overload. RV strain derived by CMR imaging is a promising noninvasive tool for the follow-up of patients with CTEPH.
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Affiliation(s)
- Xuefei Zhang
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Institute of Respiratory Medicine, Beijing, China
| | - Xiaojuan Guo
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Bowen Zhang
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Qi Yang
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
| | - Juanni Gong
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Institute of Respiratory Medicine, Beijing, China
| | - Suqiao Yang
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Institute of Respiratory Medicine, Beijing, China
| | - Jifeng Li
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Institute of Respiratory Medicine, Beijing, China
| | - Tuguang Kuang
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Institute of Respiratory Medicine, Beijing, China
| | - Ran Miao
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Institute of Respiratory Medicine, Beijing, China
| | - Yuanhua Yang
- Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Medical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China
- Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Institute of Respiratory Medicine, Beijing, China
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Li G, Zhang Z, Gao Y, Zhu C, Zhou S, Cao L, Zhao Z, Zhao J, Ordovas K, Lou M, Li K, Pohost GM. Age- and sex-specific reference values of biventricular strain and strain rate derived from a large cohort of healthy Chinese adults: a cardiovascular magnetic resonance feature tracking study. J Cardiovasc Magn Reson 2022; 24:63. [PMID: 36404299 PMCID: PMC9677678 DOI: 10.1186/s12968-022-00881-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND As a noninvasive tool, myocardial deformation imaging may facilitate the early detection of cardiac dysfunction. However, normal reference ranges of myocardial strain and strain rate (SR) based on large-scale East Asian populations are still lacking. This study aimed to provide reference values of left ventricular (LV) and right ventricular (RV) strain and SR based on a large cohort of healthy Chinese adults using cardiovascular magnetic resonance (CMR) feature tracking (FT). METHODS Five hundred and sixty-six healthy Chinese adults (55.1% men) free of hypertension, diabetes, and obesity were included. On cine CMR, biventricular global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS), and the peak radial, circumferential, and longitudinal systolic, and diastolic SRs (PSSRR, PSSRC, PSSRL, PDSRR, PDSRC, and PDSRL), and regional radial and circumferential strain at the basal, mid-cavity, and apical levels were measured. Associations of global and regional biventricular deformation indices with age and sex were investigated. RESULTS Women demonstrated greater magnitudes of LV GRS (37.6 ± 6.1% vs. 32.1 ± 5.3%), GCS (- 20.7 ± 1.9% vs. - 18.8 ± 1.9%), GLS (- 17.8 ± 1.8% vs. - 15.6 ± 1.8%), RV GRS (25.1 ± 7.8% vs. 22.1 ± 6.7%), GCS (- 14.4 ± 3.6% vs. - 13.2 ± 3.2%), GLS (- 22.4 ± 5.2% vs. - 20.2 ± 4.6%), and biventricular peak systolic and diastolic SR in all three coordinate directions (all P < 0.05). For the LV, aging was associated with increasing amplitudes of GRS, GCS, and decreasing amplitudes of PDSRR, PDSRC, PDSRL (all P < 0.05). For the RV, aging was associated with an increase in the magnitudes of GRS, GCS, GLS, PSSRR, PSSRC, PSSRL, and a decrease in the magnitude of PDSRR, PDSRC (all P < 0.05). Biventricular radial and circumferential strain measurements at the basal, mid-cavity, and apical levels were all significantly related to age and sex in both sexes (all P < 0.05). CONCLUSIONS We provide age- and sex-specific normal values of biventricular strain and SR based on a large sample of healthy Chinese adults with a broad age range. These results may be served as a reference standard for cardiac function assessment, especially for the Chinese population.
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Affiliation(s)
- Gengxiao Li
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Zhen Zhang
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- The Third People's Hospital of Longgang District, Shenzhen, China
| | - Yiyuan Gao
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, USA
| | - Shanshan Zhou
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Lizhen Cao
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhiwei Zhao
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China
| | - Jun Zhao
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China
| | - Karen Ordovas
- Department of Radiology, University of Washington, Seattle, USA
| | - Mingwu Lou
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.
| | - Kuncheng Li
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China.
| | - Gerald M Pohost
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Li Z, Liang Y, Cheng S, Xie B, Zhang S, Liu X, Wang J, Zhao H, Wang C. Evaluation of right ventricular myocardial strain in pulmonary arterial hypertension associated with atrial septal defect by cardiac magnetic resonance feature tracking. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022; 38:2035-2045. [PMID: 37726610 DOI: 10.1007/s10554-022-02591-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/03/2022] [Indexed: 11/05/2022]
Abstract
We aimed to research the role of right ventricular strain parameters (RVSP) quantified by cardiac magnetic resonance feature tracking (CMR-FT) in the early assessment of right ventricular (RV) function in patients with pulmonary arterial hypertension associated with atrial septal defect (PAH-ASD). From September 2017 to May 2021, we retrospectively enrolled 41 patients with PAH-ASD and 20 healthy controls. All subjects underwent CMR-FT, and right heart catheterization was conducted in patients with PAH-ASD. The relationship between RVSP and RV functional parameters was subjected to correlation analysis, and intragroup correlation coefficient (ICC) and Bland-Altman plots were used to assess the consistency. The subjects were divided into three groups: Group A (controls; n = 20), Group B (PAH-ASD, RVEF ≥ 45%; n = 14), and Group C (PAH-ASD, RVEF < 45%; n = 27). Compared with healthy controls, the RV global longitudinal strain (GLS) in Group B was significantly decreased (- 19.68 ± 2.72% vs. - 25.21 ± 3.6%, P < 0.05). In RVEF-preserved PAH-ASD patients (Group B), compared with patients with GLS ≤ - 20%, patients with GLS > - 20% also had significantly elevated right ventricular end-diastolic pressure (RVEDP) [8 (6.5-8.25) mmHg vs. 4.5 ± 1.64 mmHg, P < 0.05]. RV GLS had a moderate to strong correlation with RVEF, RVESVi, RVEDVi, RVEDP, and NT-proBNP (P < 0.05). ICC and Bland-Altman plots showed good intragroup and intergroup consistency in radial, circumferential and longitudinal strains of RV. In conclusion, it is feasible to quantify RV strain in patients with PAH-ASD by CMR-FT, and GLS is valuable for the early assessment of RV dysfunction in patients with PAH-ASD.
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Affiliation(s)
- Zhiqiang Li
- Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu Province, China
| | - Yan Liang
- Intensive Care Unit, Traditional Chinese Medicine Hospital of Kunshan, Suzhou, Jiangsu Province, China
| | - Shouquan Cheng
- Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu Province, China
| | - Bing Xie
- Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu Province, China
| | - Shiwen Zhang
- Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu Province, China
| | - Xin Liu
- Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu Province, China
| | - Jiali Wang
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Haishan Zhao
- Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Cheng Wang
- Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu Province, China.
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Chen X, Pan J, Hu Y, Hu H, Pan Y. Feasibility of one breath-hold cardiovascular magnetic resonance compressed sensing cine for left ventricular strain analysis. Front Cardiovasc Med 2022; 9:903203. [PMID: 36035944 PMCID: PMC9411808 DOI: 10.3389/fcvm.2022.903203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo investigate the feasibility of 3D left ventricular global and regional strain by using one breath-hold (BH) compressed sensing cine (CSC) protocol and determine the agreement between CSC and conventional cine (CC) protocols.MethodsA total of 30 volunteers were enrolled in this study. Cardiovascular magnetic resonance (CMR) images were acquired using a 1.436 T magnetic resonance imaging (MRI) system. The CSC protocols included one BH CSC and the shortest BH CSC protocols with different parameters and were only performed in short-axis (SA) view following CC protocols. Left ventricular (LV) end-diastole volume (EDV), end-systole volume (ESV), stroke volume (SV), and ejection fraction (EF) global and regional strain were calculated by CC, one BH CSC, and shortest BH CSC protocols. The intraclass correlation coefficient (ICC) and coefficient of variance (CV) of these parameters were used to determine the agreement between different acquisitions.ResultsThe agreement of all volumetric variables and EF between the CC protocol and one BH CSC protocol was excellent (ICC > 0.9). EDV, ESV, and SV between CC and shortest BH CSC protocols also had a remarkable coherence (ICC > 0.9). The agreement of 3D LV global strain assessment between CC protocol and one BH CSC protocol was good (ICC > 0.8). Most CVs of variables were also good (CV < 15%). ICCs of all variables were lower than 0.8. CVs of all parameters were higher than 15% except global longitudinal strain (GLS) between CC and shortest BH CSC protocols. The agreement of regional strain between CC and BH CSC protocols was heterogeneous (-0.2 < ICC < 0.7). Many variables of CVs were poor.ConclusionNotably, one BH CSC protocol can be used for 3D global strain analysis, along with a good correlation with the CC protocol. The regional strain should continue to be computed by the CC protocol due to poor agreement and a remarkable variation between the protocols. The shortest BH CSC protocol was insufficient to replace the CC protocol for 3D global and regional strain.
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Affiliation(s)
- Xiaorong Chen
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
- *Correspondence: Xiaorong Chen,
| | - Jiangfeng Pan
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
- Jiangfeng Pan,
| | - Yi Hu
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
| | - Hongjie Hu
- Sir Run Run Shaw Hospital, Hangzhou, China
| | - Yonghao Pan
- Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China
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12
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Li S, Mou A, Li X, Guo Y, Song Q, Liu A, Li Z. Myocardium microcirculation study in a healthy Chinese population using 3.0-T cardiac magnetic resonance intravoxel incoherent motion imaging. Acta Radiol 2022; 63:596-605. [PMID: 33887964 DOI: 10.1177/02841851211006311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Intravoxel incoherent motion imaging (IVIM) can non-invasively evaluate diffusion and microvascular perfusion. PURPOSE To explore the myocardium microcirculation of a healthy Chinese population by using cardiac magnetic resonance (CMR) IVIM. MATERIAL AND METHODS A total of 80 healthy volunteers (44 men, 36 women) who underwent 3.0-T CMR examination were enrolled. All participants had cardiac cine imaging and short-axis CMR-IVIM of the left ventricle (LV) using multiple b-values. The consistency of the IVIM parameters was assessed by intraclass correlation coefficient (ICC) and the Bland-Altman test. Spearman correlation analysis was performed between IVIM parameters and age, and body mass index (BMI). The differences of IVIM parameters were analyzed between gender and different ages. RESULTS LV end-diastolic volume (EDV), end-systolic volume (ESV), LVmass, cardiac output (CO), and BMI in the male group were higher than those in the female group (P<0.05). IVIM parameters had good intra-observer and inter-observer consistency (≥0.75). Bland-Altman analysis also showed good intra-observer and inter-observer consistency. ADCfast decreased with increasing female age (rs = -0.37; P = 0.01), while IVIM parameters had no correlation with BMI regardless of sex. ADCfast in the female group had a statistical difference between different age groups. The ADCslow and f in the male group were lower than those in the female group (P<0.05); however, there was no statistical difference in ADCfast between genders. CONCLUSION IVIM parameters in healthy Chinese volunteers provided good consistency. There was a negative correlation between ADCfast and age in the female group.
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Affiliation(s)
- Shilan Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Anna Mou
- Department of Radiology, Affiliated Hospital of Medical School, University of Electronic Science and Technology of China, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, PR China
| | - Xin Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Yan Guo
- GE Healthcare, Shenyang City, Liaoning Province, PR China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Ailian Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
| | - Zhiyong Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian City, Liaoning Province, PR China
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13
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Biventricular Myocardial Strain Analysis in Patients with Pulmonary Arterial Hypertension Using Cardiac Magnetic Resonance Tissue-Tracking Technology. J Clin Med 2022; 11:jcm11082230. [PMID: 35456323 PMCID: PMC9025312 DOI: 10.3390/jcm11082230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/07/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023] Open
Abstract
To evaluate both left and right ventricular (LV and RV) function in patients with pulmonary arterial hypertension (PAH) using cardiac magnetic resonance tissue-tracking (CMR-TT) technology and explore its clinical value. Methods: A total of 79 participants (including 47 patients with PAH and 32 healthy controls) underwent cardiac magnetic resonance imaging (CMRI) with a short-axis balanced steady-state free precession (SSFP) sequence. The biventricular cardiac function parameters and strain parameters were obtained by postprocessing with CVI42 software. A comparative analysis was performed between the LV and RV strain parameters in all PAH patients and in PAH patients with reduced or preserved cardiac function. Results: The results showed preferable repeatability of CMR-TT in analyzing the global radial strain (GRS), circumferential strain (GCS), and longitudinal strain (GLS) of the left and right ventricles in the PAH group. The GRS, GCS, and GLS of the left and right ventricles except for LV GRS (LVGRS) of PAH patients were significantly lower than those of healthy controls (p < 0.05 for all). The GRS and GCS of the left and right ventricles showed a moderate correlation in the PAH group (r = 0.323, p = 0.02; r = 0.301, p = 0.04, respectively). PAH patients with preserved RV function (n = 9) showed significantly decreased global and segmental RS, CS, and LS of the right ventricles than healthy controls (p < 0.05 for all), except for basal RVGCS (RVGCS-b, p = 0.996). Only the LVGLS was significantly different between the PAH patients with preserved LV function (n = 32) and the healthy controls (−14.23 ± 3.01% vs. −16.79 ± 2.86%, p < 0.01). Conclusions: As a nonradioactive and noninvasive technique, CMR-TT has preferable feasibility and repeatability in quantitatively evaluating LV and RV strain parameters in PAH patients and can be used to effectively detect early biventricular myocardial damage in patients with PAH.
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Wan Y, Zhu D, He B, Guo Y, Wang L, Dingda D, Laji A, Wang C, Zhang Y, Gao F. Protective effect of a chronic hypobaric hypoxic environment at high altitude on cardiotoxicity induced by doxorubicin in rats: a 7 T magnetic resonance study. Quant Imaging Med Surg 2022; 12:711-725. [PMID: 34993113 DOI: 10.21037/qims-21-360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/06/2021] [Indexed: 02/05/2023]
Abstract
Background Doxorubicin (DOX)-induced cardiotoxicity (DIC), a major clinical problem, has no effective preventive therapies. We hypothesized that left ventricular (LV) systolic function would be improved in a chronic hypobaric hypoxia environment at high altitude. The purpose of this study was to investigate whether cardiovascular magnetic resonance could reveal the cardioprotective effect of chronic hypobaric hypoxia on DIC. Methods In total, 60 rats were randomly assigned to 1 of 6 groups (n=10 per group): the P group (plain), PD group (plain + DOX), HH group (high altitude), HHD4 group (high altitude + DOX for 4 weeks), HHD8 group (high altitude + DOX for 8 weeks), and HHD12 group (high altitude + DOX for 12 weeks). The rats were transported to either Yushu (altitude: 4,250 m) or Chengdu (altitude: 500 m) where they underwent intraperitoneal injection of DOX (5 mg/kg/week for 3 weeks) or saline. Preclinical 7 T cardiovascular magnetic resonance was performed at weeks 4, 8, and 12. Tissue tracking was used to measure LV cardiac function and to analyze global and segmental strains. Subsequently, histological and oxidative stress tests were performed to evaluate the protective effect of a high-altitude environment on DIC. Results The left ventricular ejection fraction (LVEF) and global and regional strains in the middle, apical, anterior, septal, inferior, and lateral segments (all P<0.05) were improved in the HHD4 group compared with the PD group. The global strain was significantly greater in absolute value in the HHD8 and HHD12 groups than in the HHD4 group (all P<0.05). Additionally, histological and enzyme-linked immunosorbent assay evaluations supported the in vivo results. Conclusions A chronic hypobaric and hypoxic environment at high altitude partially prevented cardiac dysfunction and increased global and regional strain in DIC rat models, thereby minimizing myocardial injury and fibrosis. In addition, by increasing the total duration of chronic hypobaric hypoxia, the global strain was further increased, which was likely due to reduced oxidative stress.
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Affiliation(s)
- Yixuan Wan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Dongyong Zhu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bo He
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Guo
- Department of Radiology, Yushu People's Hospital, Qinghai, China
| | - Lei Wang
- Molecular Imaging Center, West China Hospital, Sichuan University, Chengdu, China
| | - Duojie Dingda
- Department of Radiology, Yushu People's Hospital, Qinghai, China
| | - Angwen Laji
- Department of Clinical Laboratory, Yushu People's Hospital, Yushu, China
| | - Chunhua Wang
- Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu, China
| | - Yonghai Zhang
- Department of Radiology, The Fifth People's Hospital of Qinghai Province, Xining, China
| | - Fabao Gao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Srinivasan R, Faerber JA, DeCost G, Zhang X, DiLorenzo M, Goldmuntz E, Fogel M, Mercer-Rosa L. Right Ventricular Strain Is Associated With Increased Length of Stay After Tetralogy of Fallot Repair. J Cardiovasc Imaging 2022; 30:50-58. [PMID: 35086170 PMCID: PMC8792718 DOI: 10.4250/jcvi.2021.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Little is known regarding right ventricular (RV) remodeling immediately after Tetralogy of Fallot (TOF) repair. We sought to describe myocardial deformation by cardiac magnetic resonance imaging (CMR) after TOF repair and investigate associations between these parameters and early post-operative outcomes. METHODS Fifteen infants underwent CMR without sedation as part of a prospective pilot study after undergoing complete TOF repair, prior to hospital discharge. RV deformation (strain) was measured using tissue tracking, in addition to RV ejection fraction (EF), volumes, and pulmonary regurgitant fraction. Pearson correlation coefficients were used to determine associations between both strain and CMR measures/clinical outcomes. RESULTS Most patients were male (11/15, 73%), with median age at TOF repair 53 days (interquartile range, 13,131). Most patients had pulmonary stenosis (vs. atresia) (11/15, 73%) and 7 (47%) received a transannular patch as part of their repair. RV function was overall preserved with mean RV EF of 62% (standard deviation [SD], 9.8). Peak radial and longitudinal strain were overall diminished (mean ± SD, 33.80 ± 18.30% and −15.50 ± 6.40%, respectively). Longer hospital length of stay after TOF repair was associated with worse RV peak radial ventricular strain (correlation coefficient (r), −0.54; p = 0.04). Greater pulmonary regurgitant fraction was associated with shorter time to peak radial RV strain (r = −0.55, p = 0.03). CONCLUSIONS In this small study, our findings suggest presence of early decrease in RV strain after TOF repair and its association with hospital stay when changes in EF and RV size are not yet apparent.
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Affiliation(s)
- Ranjini Srinivasan
- Division of Pediatric Cardiology, Hassenfeld Children's Hospital, New York University Grossman School of Medicine, New York, NY, USA
| | - Jennifer A. Faerber
- Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Grace DeCost
- School of Public Health, Brown University, Providence, RI, USA
| | - Xuemei Zhang
- Department of Biomedical and Health Informatics, Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michael DiLorenzo
- Division of Cardiology, Morgan Stanley Children's Hospital of New York, Columbia University, New York, NY, USA
| | - Elizabeth Goldmuntz
- Division of Cardiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mark Fogel
- Division of Cardiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Laura Mercer-Rosa
- Division of Cardiology, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Heart failure with preserved ejection fraction assessed by cardiac magnetic resonance: From clinical uses to emerging techniques. Trends Cardiovasc Med 2021; 33:141-147. [PMID: 34933114 DOI: 10.1016/j.tcm.2021.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/07/2021] [Accepted: 12/15/2021] [Indexed: 12/30/2022]
Abstract
Patients with heart failure with preserved ejection fraction (HFpEF) account for approximately 50% of those with heart failure (HF) and have increased morbidity and mortality when compared to those with HF with reduced ejection fraction. Currently, the pathophysiology and diagnostic criteria for HFpEF remain unclear, contributing significantly to delays in creating a beneficial and tailored treatment that can improve the prognosis of HFpEF. A multitude of studies have exclusively tested and illustrated the diagnostic value of echocardiography imaging in HFpEF; however, a widely-accepted criterion to identify HFpEF using cardiovascular magnetic resonance (CMR) imaging has not been established. As the gold standard for cardiac structural, functional measurement, and tissue characterization, CMR holds great potential for the early discovery of the pathophysiology, diagnosis, and risk stratification of HFpEF. This review aims to comprehensively discuss the diagnostic and prognostic role of CMR parameters in the setting of HFpEF through validated routine and prospective emerging techniques, and provide clinical perspectives for CMR imaging application in HFpEF.
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Li H, Qu Y, Metze P, Sommerfeld F, Just S, Abaei A, Rasche V. Quantification of Biventricular Myocardial Strain Using CMR Feature Tracking: Reproducibility in Small Animals. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8492705. [PMID: 33553431 PMCID: PMC7847329 DOI: 10.1155/2021/8492705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/16/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022]
Abstract
Myocardial strain is a well-validated parameter for evaluating myocardial contraction. Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a novel method for the quantitative measurements of myocardial strain from routine cine acquisitions. In this study, we investigated the influence of temporal resolution on tracking accuracy of CMR-FT and the intraobserver, interobserver, and interstudy reproducibilities for biventricular strain analysis in mice from self-gated CMR at 11.7 T. 12 constitutive nexilin knockout (Nexn-KO) mice, heterozygous (Het, N = 6) and wild-type (WT, N = 6), were measured with a well-established self-gating sequence twice within two weeks. CMR-FT measures of biventricular global and segmental strain parameters were derived. Interstudy, intraobserver, and interobserver reproducibilities were investigated. For the assessment of the impact of the temporal resolution for the outcome in CMR-FT, highly oversampled semi-4 chamber and midventricular short-axis data were acquired and reconstructed with 10 to 80 phases per cardiac cycle. A generally reduced biventricular myocardial strain was observed in Nexn-KO Het mice. Excellent intraobserver and interobserver reproducibility was achieved in all global strains (ICC range from 0.76 to 0.99), where global right ventricle circumferential strain (RCSSAX) showed an only good interobserver reproducibility (ICC 0.65, 0.11-0.89). For interstudy reproducibility, left ventricle longitudinal strain (LLSLAX) was the most reproducible measure of strain (ICC 0.90, 0.71-0.97). The left ventricle radial strain (LRSSAX) (ICC 0.50, 0.10-0.83) showed fair reproducibility and RCSSAX (ICC 0.36, 0.14-0.74) showed only poor reproducibility. In general, compared with global strains, the segmental strains showed relatively lower reproducibility. A minimal temporal resolution of 20 phases per cardiac cycle appeared sufficient for CMR-FT strain analysis. The analysis of myocardial strain from high-resolution self-gated cine images by CMR-FT provides a highly reproducible method for assessing myocardial contraction in small rodent animals. Especially, global LV longitudinal and circumferential strain revealed excellent reproducibility of intra- and interobserver and interstudy measurements.
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Affiliation(s)
- Hao Li
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany
| | - Yangyang Qu
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Patrick Metze
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | | | - Steffen Just
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Alireza Abaei
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany
| | - Volker Rasche
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany
- Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
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Zhu J, Chen Y, Xu Z, Wang S, Wang L, Liu X, Gao F. Non-invasive assessment of early and acute myocarditis in a rat model using cardiac magnetic resonance tissue tracking analysis of myocardial strain. Quant Imaging Med Surg 2020; 10:2157-2167. [PMID: 33139995 DOI: 10.21037/qims-20-122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Myocardial strain analysis can provide diagnostic and prognostic information for myocarditis. The aim of the present study was to assess early and acute myocarditis in a rat model using cardiac magnetic resonance tissue tracking (CMR-TT) for myocardial strain analysis. We compared the strain's findings with the histological and immunohistochemical results. Methods Experimental autoimmune myocarditis (EAM) was induced by footpad injections of porcine cardiac myosin. The rats were examined by 7.0T preclinical CMR at day 14 (n=15) and day 21 (n=16) after EAM induction and the two control groups (each n=15) were also examined at day 14 and day 21, respectively. Using CMR-TT, we found a global peak systolic radial strain (ErrSAX) and a circumferential strain (EccSAX) from the short-axis cine views and a radial strain (ErrLAX) and a longitudinal strain (EllLAX) from the long-axis cine views, which were calculated by dedicated TT software. Subsequently, histological and immunohistochemical evaluations were performed. Results EllLAX significantly decreased in early myocarditis compared with the control (-23.40%±1.48% vs. -22.02%±0.81%, P<0.05). ErrSAX, EccSAX, ErrLAX, and EllLAX values significantly reduced in acute myocarditis compared with the controls (ErrSAX: 34.27%±9.80% vs. 49.76%±4.97%, EccSAX: -18.98%±3.69% vs. -24.13±1.23, ErrLAX: 33.21%±10.24% vs. 49.59%±5.69%, and EllLAX: -17.75%±3.58% vs. -23.39%±1.48%; P<0.001, respectively). The receiver operating characteristic curve showed that myocardial strain analysis had a good diagnostic performance in early and acute myocarditis. The pathological evaluation revealed that inflammatory lesions began to appear in early myocarditis and peaked in acute myocarditis. Conclusions The CMR-TT strain analysis allowed accurate and reliable evaluation of early and acute myocarditis in a rat model, and has the potential to serve as a diagnostic indicator for the assessment of myocardial dysfunction in myocarditis.
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Affiliation(s)
- Jing Zhu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yushu Chen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ziqian Xu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Shiyu Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Wang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaoxin Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Fabao Gao
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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Ma Q, Ma Y, Wang X, Li S, Yu T, Duan W, Wu J, Wen Z, Jiao Y, Sun Z, Hou Y. Circulating miR-1 as a potential predictor of left ventricular remodeling following acute ST-segment myocardial infarction using cardiac magnetic resonance. Quant Imaging Med Surg 2020; 10:1490-1503. [PMID: 32676367 DOI: 10.21037/qims-19-829] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The identification of patients with a high likelihood of left ventricular (LV) remodeling with a high-risk prognosis has critical implications for risk stratification after acute ST-segment elevation myocardial infarction (STEMI). This study aimed to evaluate the relationship between circulating miR-1 and 6-month post-infarct LV remodeling based on cardiac magnetic resonance (CMR) imaging. Methods A total of 80 patients with a first STEMI treated with primary percutaneous coronary intervention (PCI) who underwent CMR imaging 1 week and 6 months after STEMI were evaluated. The percentage changes of LV ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-systolic volume index (LVESV) at 1 week and 6 months after PCI (%ΔLVEF, %ΔLVEDV and %ΔLVESV) were calculated. miR-1 was measured using polymerase chain reaction (PCR)-based technologies in plasma samples that were collected at admission. The study group was divided into two groups based on a 10% cutoff value for the percentage of change in the LV end-diastolic volume (%ΔLVEDV): remodeling at high risk of major adverse cardiac events (MACEs) (%ΔLVEDV ≥10%, termed the LV remodeling group) and remodeling at lower risk of MACEs (%ΔLVEDV <10%, termed the non-LV remodeling group). The associations of miR-1 expression with the %ΔLVEDV, percentage change in the LV end-systolic volume (%ΔLVESV), and percentage change in the LV ejection fraction at follow-up were estimated. Results Twenty-two patients (27.5%) showed adverse LV remodeling, and 58 patients (72.5%) did not show adverse LV remodeling at the 6-month follow-up of CMR. The mean LVEF, LVEDV index, and LVESV index values at 1 week were 50.6%±8.2%, 74.6±12.8 mL/m2, and 37.2±10.2 mL/m2, respectively. Mean LVEF at follow-up (53.5%±10.6%) was increased compared with baseline (P<0.001). There were significant decreases in LVEDV index and LVESV index values at follow-up (72.0±14.9 mL/m2 and 33.7±11.0 mL/m2, respectively; P=0.009 and P<0.001, respectively). The expression of miR-1 at admission was positively correlated with the %ΔLVEDV (r=0.611, P<0.001) and %ΔLVESV (r=0.268, P=0.016). Receiver operating characteristic (ROC) analysis showed that miR-1 expression predicted LV remodeling with an area under the curve (AUC) value of 0.68 (95% CI: 0.56-0.78). Compared with the clinical factors of peak creatine kinase-myocardial band (CK-MB) and peak troponin T level, peak logNT-proBNP showed the highest predictive power, with an AUC value of 0.75 (95% CI: 0.64-0.84). A model including the clinical, CMR, and miR-1 factors showed greater predictive power (P=0.034) than a model including only clinical and CMR factors, with AUCs of 0.89 (95% CI: 0.80-0.95) and 0.81 (95% CI: 0.71-0.89), respectively. Conclusions Circulating miR-1 at admission is an independent predictor of LV remodeling 6 months after STEMI. miR-1 showed incremental value in predicting LV remodeling compared with the clinical and CMR measurements.
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Affiliation(s)
- Quanmei Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Ma
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaonan Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shanshan Li
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tongtong Yu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Weili Duan
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiake Wu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zongyu Wen
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yundi Jiao
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Hou
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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Qu YY, Li H, Rottbauer W, Ma GS, Buckert D, Rasche V. Right ventricular free wall longitudinal strain and strain rate quantification with cardiovascular magnetic resonance based tissue tracking. Int J Cardiovasc Imaging 2020; 36:1985-1996. [PMID: 32462446 PMCID: PMC7497525 DOI: 10.1007/s10554-020-01895-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 05/21/2020] [Indexed: 12/24/2022]
Abstract
Cardiovascular magnetic resonance based tissue tracking (CMR-TT) was reported to provide detailed insight into left ventricular mechanical features. However, inadequate knowledge of the right ventricle (RV) mechanical deformation has been acquired by this advanced technique so far. It was the aim of this study to establish reference values of RV free wall (RVFW) global, regional and segmental longitudinal peak strain and strain rate (LS and LSR), and to investigate the gender- and age-related difference as well as the base-to-apex gradient of RVFW-LS and LSR with CMR-TT. 150 healthy volunteers (75 males/females) were retrospectively and continuously recruited and subdivided into three age groups (G20–40, G41–60 and G61–80). RVFW global, regional (basal, middle-cavity and apical) and segmental LS (GLS, RLS, SLS) along with systolic and diastolic LSR were generated by post-hoc CMR-TT analysis of standard steady-state free precession long-axis four-chamber view cine images acquired at 1.5T field strength. The reference value of myocardial RVFW-GLS was − 24.9 ± 5.2%. We found that females showed more negative GLS than males except in the youngest group, and no age-related difference of GLS was observed in both gender groups. RLS and SLS presented with the same age-related tendency as GLS. The basal and middle-cavity LS were similar between each other and significantly larger than apical LS. RVFW-GLSR resulted as − 1.73 ± 0.58 s−1 and 1.69 ± 0.65 s−1 during systolic and diastolic phases, respectively. The diastolic GLSR of males tended to decline with the ageing and was significantly lower than that of females in G61–80 group. Regional and segmental LSR showed significant gender-related differences in certain basal and apical region/segments without any age-related effects. CMR-TT overcomes the difficulty in measuring RV global and segmental deformation. The establishment of the vendor-, gender- and segment-specific reference values of RVFW-LS and LSR is essential for the rapid and efficient utilization of CMR-TT modality in the clinical routine.
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Affiliation(s)
- Yang-Yang Qu
- Internal Medicine II, Ulm University Medical Center, Ulm, Germany.,Medical School of Southeast University, Nanjing, China
| | - Hao Li
- Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | | | - Gen-Shan Ma
- Medical School of Southeast University, Nanjing, China.,Department of Cardiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Dominik Buckert
- Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
| | - Volker Rasche
- Internal Medicine II, Ulm University Medical Center, Ulm, Germany.
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