Dataset Information

Layer-specific strain in patients with heart failure using cardiovascular magnetic resonance: not all layers are the same.

ABSTRACT: Background: Global longitudinal strain (GLS), most commonly measured at the endocardium, has been shown to be superior to left ventricular (LV) ejection fraction (LVEF) for the identification of systolic dysfunction and prediction of outcomes in heart failure (HF). We hypothesized that strains measured at different myocardial layers (endocardium?=?ENDO, epicardium?=?EPI, average?=?AVE) will have distinct diagnostic and predictive performance for patients with HF.

Methods: Layer-specific GLS, layer-specific global circumferential strain (GCS) and global radial strain (GRS) were evaluated by cardiovascular magnetic resonance imaging (CMR) feature tracking in the Alberta HEART study. A total of 453 subjects consisted of healthy controls (controls, n?=?77), at-risk for HF (at-risk, n?=?143), HF with preserved ejection fraction (HFpEF, n?=?87), HF with mid-range ejection fraction (HFmrEF, n?=?88) and HF with reduced ejection fraction (HFrEF, n?=?58). For outcomes analysis, CMR-derived imaging parameters were adjusted with a base model that included age and N-terminal prohormone of b-type natriuretic peptide (NT-proBNP) to test their independent association with 5-year all-cause mortality.

Results: GLS_EPI distinguished all groups with preserved LVEF (controls -?16.5?±?2.4% vs. at-risk -?15.5?±?2.7% vs. HFpEF -?14.1?±?3.0%, p?
Conclusion: Global strains measured on endocardium, epicardium or averaged across the wall thickness are not equivalent for the identification of systolic dysfunction or outcomes prediction in HF. The endocardium-specific strains were shown to have poorest all-around performance. GLS_AVE and GRS were the only CMR parameters to be significantly associated with 5-year all-cause mortality in multivariable analysis. GLS_EPI and GRS, as well as the difference in endocardial and epicardial strains, were sensitive to systolic dysfunction among HF patients with normal LVEF (>?55%), in whom lower strains were associated with increased concentricity.

SUBMITTER: Xu L

PROVIDER: S-EPMC7713324 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Layer-specific strain in patients with heart failure using cardiovascular magnetic resonance: not all layers are the same.

Xu Lingyu L Pagano Joseph J JJ Haykowksy Mark J MJ Ezekowitz Justin A JA Oudit Gavin Y GY Mikami Yoko Y Howarth Andrew A White James A JA Dyck Jason R B JRB Anderson Todd T Paterson D Ian DI Thompson Richard B RB

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 20201203 1

<h4>Background</h4>Global longitudinal strain (GLS), most commonly measured at the endocardium, has been shown to be superior to left ventricular (LV) ejection fraction (LVEF) for the identification of systolic dysfunction and prediction of outcomes in heart failure (HF). We hypothesized that strains measured at different myocardial layers (endocardium = ENDO, epicardium = EPI, average = AVE) will have distinct diagnostic and predictive performance for patients with HF.<h4>Methods</h4>Layer-spec ...[more]

PMID: 33267877

Similar Datasets

Project description:BACKGROUND: Regional myocardial function is typically evaluated by visual assessment by experienced users, or by methods requiring substantial post processing time. Visual assessment is subjective and not quantitative. Therefore, the purpose of this study is to develop and validate a simple method to derive quantitative measures of regional wall function from velocity encoded cardiovascular magnetic resonance (CMR), and provide associated normal values for longitudinal strain. METHOD: Both fast field echo (FFE) and turbo field echo (TFE) velocity encoded CMR images were acquired in three long axis planes in 36 healthy volunteers (13 women, 23 men), age 35±12 years. Strain was also quantified in 10 patients within one week after myocardial infarction. The user manually delineated myocardium in one time frame and strain was calculated as the myocardium was tracked throughout the cardiac cycle using an optimization formulation and mechanical a priori assumptions. A phantom experiment was performed to validate the method with optical tracking of deformation as an independent gold standard. RESULTS: There was an excellent agreement between longitudinal strain measured by optical tracking and longitudinal strain measured with TFE velocity encoding. Difference between the two methods was 0.0025 ± 0.085 (ns). Mean global longitudinal strain in the 36 healthy volunteers was -0.18 ± 0.10 (TFE imaging). Intra-observer variability for all segments was 0.00 ± 0.06. Inter-observer variability was -0.02 ± 0.07 (TFE imaging). The intra-observer variability for radial strain was high limiting the applicability of radial strain. Mean longitudinal strain in patients was significantly lower (-0.15± 0.12) compared to healthy volunteers (p<0.05). Strain (expressed as percentage of normal strain) in infarcted regions was lower compared to remote areas (p<0.01). CONCLUSION: In conclusion, we have developed and validated a robust and clinically applicable technique that can quantify longitudinal strain and regional myocardial wall function and present the associated normal values for longitudinal strain.

Dataset Information

Layer-specific strain in patients with heart failure using cardiovascular magnetic resonance: not all layers are the same.

Publications

Layer-specific strain in patients with heart failure using cardiovascular magnetic resonance: not all layers are the same.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets