Additional diagnostic value of cardiac magnetic resonance feature tracking in patients with biopsy-proven arrhythmogenic cardiomyopathy

Muscogiuri, Giuseppe; Fusini, Laura; Ricci, Francesca; Sicuso, Rita; Guglielmo, Marco; Baggiano, Andrea; Gasperetti, Alessio; Casella, Michela; Mushtaq, Saima; Conte, Edoardo; Annoni, Andrea; Formenti, Alberto; Mancini, Maria Elisabetta; Babbaro, Mario; Mollace, Vincenzo; Collevecchio, Ada; Scafuri, Stefano; Kukavica, Deni; Andreini, Daniele; Basso, Cristina; Rizzo, Stefania; Gaspari, Monica De; Priori, Silvia G.; Russo, Antonio Dello; Tondo, Claudio; Pepi, Mauro; Sommariva, Elena; Rabbat, Mark; Guaricci, Andrea Igoren

doi:10.1016/j.ijcard.2021.06.052

Cited by 11 publications

(7 citation statements)

References 27 publications

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“…Finally, CMR is the gold standard for measuring RV and atrial volumes and function ( 80 ). RV systolic dysfunction is highly prevalent in HFpEF, and is associated with worse symptoms and prognosis ( 100 , 101 ).…”

Section: Cardiac Magnetic Resonancementioning

confidence: 99%

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

Torto

Guaricci²,

Pomarico³

et al. 2022

Front. Cardiovasc. Med.

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Heart failure with preserved ejection fraction (HFpEF) is a syndrome defined by the presence of heart failure symptoms and increased levels of circulating natriuretic peptide (NP) in patients with preserved left ventricular ejection fraction and various degrees of diastolic dysfunction (DD). HFpEF is a complex condition that encompasses a wide range of different etiologies. Cardiovascular imaging plays a pivotal role in diagnosing HFpEF, in identifying specific underlying etiologies, in prognostic stratification, and in therapeutic individualization. Echocardiography is the first line imaging modality with its wide availability; it has high spatial and temporal resolution and can reliably assess systolic and diastolic function. Cardiovascular magnetic resonance (CMR) is the gold standard for cardiac morphology and function assessment, and has superior contrast resolution to look in depth into tissue changes and help to identify specific HFpEF etiologies. Differently, the most important role of nuclear imaging [i.e., planar scintigraphy and/or single photon emission CT (SPECT)] consists in the screening and diagnosis of cardiac transthyretin amyloidosis (ATTR) in patients with HFpEF. Cardiac CT can accurately evaluate coronary artery disease both from an anatomical and functional point of view, but tissue characterization methods have also been developed. The aim of this review is to critically summarize the current uses and future perspectives of echocardiography, nuclear imaging, CT, and CMR in patients with HFpEF.

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Section: Cardiac Magnetic Resonancementioning

confidence: 99%

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

Torto

Guaricci²,

Pomarico³

et al. 2022

Front. Cardiovasc. Med.

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“…The incongruity of the luminal canal configuration and wall due to cardiomyopathy and valvular disease affects the formation and movement of vortex flow, thus increasing the level of EL. Abnormal changes in EL can lead to changes in the overall structure and function of the myocardium, so the location, morphology and extent of vortex formation are highly relevant to the structure and function of the left ventricle, and in addition patients with arrhythmias have significantly abnormal blood flow velocity indicators [ 21 , 22 ]. The rate of change in vortex area, mean blood flow velocity and mean EL in patients with HCM complicated by arrhythmia were also consistent with the results of this study.…”

Section: Discussionmentioning

confidence: 99%

The predictive value of deep learning-based cardiac ultrasound flow imaging for hypertrophic cardiomyopathy complicating arrhythmias

Huang

Liu

et al. 2023

Eur J Med Res

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Objective To investigate the predictive value of deep learning-based cardiac ultrasound flow imaging for hypertrophic cardiomyopathy (HCM) complicated by arrhythmias. Methods The clinical data of 158 patients with hypertrophic cardiomyopathy were retrospectively collected from July 2019 to December 2021, and additionally divided into training group 106 cases, validation group 26 cases and test group 26 cases according to the ratio of 4:1:1, and divided into concurrent and non-concurrent groups according to whether they were complicated by arrhythmia or not, respectively. General data of patients (age, gender, BMI, systolic blood pressure, diastolic blood pressure, HR) were collected, a deep learning model for cardiac ultrasound flow imaging was established, and image data, LVEF, LAVI, E/e', vortex area change rate, circulation intensity change rate, mean blood flow velocity, and mean EL value were extracted. Results The differences in general data (age, gender, BMI, systolic blood pressure, diastolic blood pressure, HR) between the three groups were not statistically significant, P > 0.05. The differences in age, gender, BMI, systolic blood pressure, diastolic blood pressure, HR between the patients in the concurrent and non-concurrent groups in the training group were not statistically significant, P > 0.05. Conclusions Deep learning-based cardiac ultrasound flow imaging can identify cardiac ultrasound images more accurately and has a high predictive value for arrhythmias complicating hypertrophic cardiomyopathy, and vortex area change rate, circulation intensity change rate, mean flow velocity, mean EL, LAVI, and E/e' are all risk factors for arrhythmias complicating hypertrophic cardiomyopathy.

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“…The literature regarding the significance of right ventricular involvement in TM remains scant. Due to the right ventricle’s complicated anatomy and muscle patterns, cardiovascular magnetic resonance (CMR) has been regarded as the gold standard for evaluating the right ventricle’s dependable function and chamber size [ 6 , 15 , 16 , 17 ]. We have demonstrated that CMR-derived FT-strain can detect changes in right ventricular myocardial strain induced by subclinical right ventricular dysfunction caused by MIO.…”

Section: Discussionmentioning

confidence: 99%

“…Recent research indicates that myocardial iron deposition is significantly linked to RV dysfunction, corroborating the decline in LV function associated with increased cardiac iron overload [ 13 , 14 ]. A progressive and significant decrease in RVEF was observed when myocardial T2* was <20 ms. Due to the anatomy and muscle patterns of the right ventricular complex, cardiovascular magnetic resonance (CMR) has been deemed superior to echocardiography for determining the precise RVEF function and chamber size [ 15 , 16 , 17 ]. To our knowledge, CMR-FT has not been utilized to assess right ventricular dysfunction in TM.…”

Section: Introductionmentioning

confidence: 99%

Significance of Cardiac Magnetic Resonance Feature Tracking of the Right Ventricle in Predicting Subclinical Dysfunction in Patients with Thalassemia Major

et al. 2022

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In patients with thalassemia major (TM), cardiac magnetic resonance feature-tracking (CMR-FT) has been shown to be an effective method for diagnosing subclinical left ventricular (LV) dysfunction. This study aimed to determine whether CMR-FT could detect abnormal RV dysfunction in patients with a normal right ventricular ejection fraction (RVEF). We performed a retrospective analysis of TM patients admitted to Dubai’s Rashid Hospital between July 2019 and March 2021. The inclusion criteria were TM patients with SSFP cine with T2* (T2*-weighted imaging), while exclusion criteria included any other cardiovascular disease. When there was no myocardial iron overload (MIO) (T2* ≥ 20 ms) and when there was significant MIO (T2* < 20 ms), the CMR-FT was used to correlate with EF. Among the 89 participants, there were 46 men (51.7%) and 43 women (48.3%), with a mean age of 26.14 ± 7.4 years (range from 10 to 48 years). Forty-six patients (51.69%) did not have MIO, while 43 individuals did (48.31%). Thirty-nine patients (32.6%) were diagnosed with severe MIO, while seventeen (19.1%) were diagnosed with mild to moderate MIO. A significant correlation existed between RVEF and T2* values (r = 0.274, p = 0.014) and between left ventricular ejection fraction (LVEF) and T2* values (r = 0.256, p = 0.022). Using a multiple logistic regression model with predictors such as right ventricular longitudinal strain (RVGLS), LV ejection fraction (LV EF), and hemoglobin, abnormal myocardial iron overload can be predicted. This model demonstrates an AUC of 78.3%, a sensitivity of 72%, and a specificity of 76%. In the group with preserved RVEF > 53%, the left ventricular radial strain (LVGRS) (p = 0.001), right ventricular radial strain (RVGRS) (p = 0.000), and right ventricular basal circumferential strain (RVGCS-basal) (p = 0.000) CMR-FT strain values are significantly lower than those of the control group (p > 0.05). There was no significant correlation between the LVGLS and T2*. RVGLS was ranked among the most accurate predictors of abnormal myocardial iron overload. The LVGRS, RVGRS, and RVGCS-basal CMR-FT strain values were the best predictors of subclinical RV dysfunction in the group with preserved RVEF. The most accurate way to diagnose MIO is still T2*, but FT-strain can help us figure out how MIO affects the myocardium from a pathophysiological point of view.

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Additional diagnostic value of cardiac magnetic resonance feature tracking in patients with biopsy-proven arrhythmogenic cardiomyopathy

Cited by 11 publications

References 27 publications

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

Advances in Multimodality Cardiovascular Imaging in the Diagnosis of Heart Failure With Preserved Ejection Fraction

The predictive value of deep learning-based cardiac ultrasound flow imaging for hypertrophic cardiomyopathy complicating arrhythmias

Significance of Cardiac Magnetic Resonance Feature Tracking of the Right Ventricle in Predicting Subclinical Dysfunction in Patients with Thalassemia Major

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