Dataset Information

Comparison of left ventricular strains and torsion derived from feature tracking and DENSE CMR.

ABSTRACT:

Background

Cardiovascular magnetic resonance (CMR) feature tracking is increasingly used to quantify cardiac mechanics from cine CMR imaging, although validation against reference standard techniques has been limited. Furthermore, studies have suggested that commonly-derived metrics, such as peak global strain (reported in 63% of feature tracking studies), can be quantified using contours from just two frames - end-diastole (ED) and end-systole (ES) - without requiring tracking software. We hypothesized that mechanics derived from feature tracking would not agree with those derived from a reference standard (displacement-encoding with stimulated echoes (DENSE) imaging), and that peak strain from feature tracking would agree with that derived using simple processing of only ED and ES contours.

Methods

We retrospectively identified 88 participants with 186 pairs of DENSE and balanced steady state free precession (bSSFP) image slices acquired at the same locations across two institutions. Left ventricular (LV) strains, torsion, and dyssynchrony were quantified from both feature tracking (TomTec Imaging Systems, Circle Cardiovascular Imaging) and DENSE. Contour-based strains from bSSFP images were derived from ED and ES contours. Agreement was assessed with Bland-Altman analyses and coefficients of variation (CoV). All biases are reported in absolute percentage.

Results

Comparison results were similar for both vendor packages (TomTec and Circle), and thus only TomTec Imaging System data are reported in the abstract for simplicity. Compared to DENSE, mid-ventricular circumferential strain (Ecc) from feature tracking had acceptable agreement (bias: -?0.4%, p =?0.36, CoV: 11%). However, feature tracking significantly overestimated the magnitude of Ecc at the base (bias: -?4.0% absolute, p ConclusionCompared to DENSE as a reference standard, feature tracking was inaccurate for quantification of apical and basal LV circumferential strains, longitudinal strain, torsion, and dyssynchrony. Feature tracking was only accurate for quantification of mid LV circumferential strain. Moreover, feature tracking is unnecessary for quantification of whole-slice strains (e.g. base, apex), since simplified processing of only ED and ES contours yields very similar results to those derived from feature tracking. Current feature tracking technology therefore has limited utility for quantification of cardiac mechanics.

SUBMITTER: Wehner GJ

PROVIDER: S-EPMC6136226 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Comparison of left ventricular strains and torsion derived from feature tracking and DENSE CMR.

Wehner Gregory J GJ Jing Linyuan L Haggerty Christopher M CM Suever Jonathan D JD Chen Jing J Hamlet Sean M SM Feindt Jared A JA Dimitri Mojsejenko W W Fogel Mark A MA Fornwalt Brandon K BK

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 20180913 1

<h4>Background</h4>Cardiovascular magnetic resonance (CMR) feature tracking is increasingly used to quantify cardiac mechanics from cine CMR imaging, although validation against reference standard techniques has been limited. Furthermore, studies have suggested that commonly-derived metrics, such as peak global strain (reported in 63% of feature tracking studies), can be quantified using contours from just two frames - end-diastole (ED) and end-systole (ES) - without requiring tracking software. ...[more]

PMID: 30208894

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Project description:ObjectivesThe study aimed to investigate the alterations of myocardial deformation responding to long-standing pressure overload and the effects of focal myocardial fibrosis using feature-tracking cardiac magnetic resonance (FT-CMR) in patients with resistant hypertension (RH).MethodsConsecutive RH patients were prospectively recruited and underwent CMR at a single institution. FT-CMR analyses based on cine images were applied to measure left ventricular (LV) peak systolic global longitudinal (GLS), radial (GRS), and circumferential strain (GCS). Functional and morphological CMR variables, and late gadolinium enhancement (LGE) imaging were also obtained.ResultsA total of 50 RH patients (63 ± 12 years, 32 men) and 18 normotensive controls (57 ± 8 years, 12 men) were studied. RH patients had a higher average systolic blood pressure than controls (166 ± 21 mmHg vs. 116 ± 8 mmHg, p < 0.001) with the intake of 5 ± 1 antihypertensive drugs. RH patients showed increased LV mass index (78 ± 15 g/m2 vs. 61 ± 9 g/m2, p < 0.001), decreased GLS (- 16 ± 3% vs. - 19 ± 2%, p = 0.001) and GRS (41 ± 12% vs. 48 ± 8%, p = 0.037), and GCS was reduced by trend (- 17 ± 4% vs. - 19 ± 4%, p = 0.078). Twenty-one (42%) RH patients demonstrated a LV focal myocardial fibrosis (LGE +). LGE + RH patients had higher LV mass index (85 ± 14 g/m2 vs. 73 ± 15 g/m2, p = 0.007) and attenuated GRS (37 ± 12% vs. 44 ± 12%, p = 0.048) compared to LGE - RH patients, whereas GLS (p = 0.146) and GCS (p = 0.961) were similar.ConclusionAttenuation of LV GLS and GRS, and GCS decline by tendency, might be adaptative changes responding to chronic pressure overload. There is a high incidence of focal myocardial fibrosis in RH patients, which is associated with reduced LV GRS.Clinical relevance statementFeature-tracking CMR-derived myocardial strain offers insights into the influence of long-standing pressure overload and of a myocardial fibrotic process on cardiac deformation in patients with resistant hypertension.Key points• Variations of left ventricular strain are attributable to the degree of myocardial impairment in resistant hypertensive patients. • Focal myocardial fibrosis of the left ventricle is associated with attenuated global radial strain. • Feature-tracking CMR provides additional information on the attenuation of myocardial deformation responding to long-standing high blood pressure.

Project description:AIMS:A multitude of cardiac magnetic resonance (CMR) techniques are used for myocardial strain assessment; however, studies comparing them are limited. We sought to compare global longitudinal (GLS), circumferential (GCS), segmental longitudinal (SLS), and segmental circumferential (SCS) strain values, as well as reproducibility between CMR feature tracking (FT), tagging (TAG), and fast-strain-encoded (fast-SENC) CMR techniques. METHODS AND RESULTS:Eighteen subjects (11 healthy volunteers and seven patients with heart failure) underwent two CMR scans (1.5T, Philips) with identical parameters. Global and segmental strain values were measured using FT (Medis), TAG (Medviso), and fast-SENC (Myocardial Solutions). Friedman's test, linear regression, Pearson's correlation coefficient, and Bland-Altman analyses were used to assess differences and correlation in measured GLS and GCS between the techniques. Two-way mixed intra-class correlation coefficient (ICC), coefficient of variance (COV), and Bland-Altman analysis were used for reproducibility assessment. All techniques correlated closely for GLS (Pearson's r: 0.86-0.92) and GCS (Pearson's r: 0.85-0.94). Intra-observer and inter-observer reproducibility was excellent in all techniques for both GLS (ICC 0.92-0.99, CoV 2.6-10.1%) and GCS (ICC 0.89-0.99, CoV 4.3-10.1%). Inter-study reproducibility was similar for all techniques for GLS (ICC 0.91-0.96, CoV 9.1-10.8%) and GCS (ICC 0.95-0.97, CoV 7.6-10.4%). Combined segmental intra-observer reproducibility was good in all techniques for SLS (ICC 0.914-0.953, CoV 12.35-24.73%) and SCS (ICC 0.885-0.978, CoV 10.76-19.66%). Combined inter-study SLS reproducibility was the worst in FT (ICC 0.329, CoV 42.99%), while fast-SENC performed the best (ICC 0.844, CoV 21.92%). TAG had the best reproducibility for combined inter-study SCS (ICC 0.902, CoV 19.08%), while FT performed the worst (ICC 0.766, CoV 32.35%). Bland-Altman analysis revealed considerable inter-technique biases for GLS (FT vs. fast-SENC 3.71%; FT vs. TAG 8.35%; and TAG vs. fast-SENC 4.54%) and GCS (FT vs. fast-SENC 2.15%; FT vs. TAG 6.92%; and TAG vs. fast-SENC 2.15%). Limits of agreement for GLS ranged from ±3.1 (TAG vs. fast-SENC) to ±4.85 (FT vs. TAG) for GLS and ±2.98 (TAG vs. fast-SENC) to ±5.85 (FT vs. TAG) for GCS. CONCLUSIONS:We found significant differences in measured GLS and GCS between FT, TAG, and fast-SENC. Global strain reproducibility was excellent for all techniques. Acquisition-based techniques had better reproducibility than FT for segmental strain.

Dataset Information

Comparison of left ventricular strains and torsion derived from feature tracking and DENSE CMR.

Background

Methods

Results

Publications

Comparison of left ventricular strains and torsion derived from feature tracking and DENSE CMR.

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