Age- and gender-related normal left ventricular deformation assessed by cardiovascular magnetic resonance feature tracking

André, Florian; Steen, Henning; Matheis, Philipp; Westkott, Maria; Breuninger, Kristin; Sander, Yannick; Kämmerer, R; Galuschky, Christian; Giannitsis, Evangelos; Korosoglou, Grigorios; Katus, Hugo A.; Buss, Sebastian J.

doi:10.1186/s12968-015-0123-3

Cited by 174 publications

(192 citation statements)

References 22 publications

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“…The authors found higher strain values in women than in men and a decrease of peak left and right atrial strain with age, findings generally in line with the literature, 8,9 and new for the right atrium. Time-to-peak strain measurements from all chambers are also reported.…”

Section: See Article By Addetia Et Alsupporting

confidence: 79%

“…From Figure 1 of Addetia et al (the only one with an electrocardiographic tracing), it seems that LV and left atrial strain curves both start at zero at the end of the electrocardiographic QRS complex. However, physiologically, left atrial (LA) expansion in sinus rhythm starts at the onset or even before the QRS complex 5,7 (see Figure), and LV longitudinal shortening also starts during QRS.The authors found higher strain values in women than in men and a decrease of peak left and right atrial strain with age, findings generally in line with the literature, 8,9 and new for the right atrium. Time-to-peak strain measurements from all chambers are also reported.…”

supporting

confidence: 80%

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Simultaneous 4-Chamber Strain

Baron

Flachskampf

2016

Circ: Cardiovascular Imaging

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A nalysis of myocardial deformation, or strain imaging, is becoming part of routine echocardiography. 1 The most widely accepted parameter to date has been global longitudinal strain as a measure of global left ventricular (LV) function. Global longitudinal strain (LS) of the LV, in (negative) percent, is the average of the maximal shortening (in percent) in the apicobasal direction of each of 18 LV segments visualized in the 3 standard apical views. The strain curves are computed using speckle tracking to determine myocardial velocity in a region of interest from which local strain is derived. LS is defined as deformation (shortening or lengthening) along the midline of LV walls, that is, in an apico-basal direction, but following the curvature of the LV walls.2 Similarly, global left or right atrial or right ventricular LS can be obtained as average of segmental peak LS. Strain data are highly dependent on image quality and frame rate, as well as physiological parameters as blood pressure. See Article by Addetia et alThe article of Addetia et al 3 in this issue of Circulation: Cardiovascular Imaging explores LS values from all 4 chambers obtained simultaneously from the 4-chamber view of the same cardiac cycle using a software (Epsilon Imaging, Ann Arbor MI) that can accommodate data acquired with echo machines from different echo manufacturers, although for this article, only echos acquired with one brand of echo machines were used. LS analysis was based on speckle tracking in 21 segments per patient (6 for the LV, 3 for the right ventricle, and 6 each for left and right atrium, using the same 3 septal segments for both); for each chamber, a global strain curve was calculated by averaging the segmental LS of the pertinent segments. Less than 1% of segments were excluded because of bad quality, which is a remarkably high success rate. For unclear reasons, the size of individual segments presented in Figure 1 of Addetia et al is somewhat variable, most conspicuously for the small basal right ventricular free wall segment. Global peak LS and heart rate-corrected time-topeak LS were measured for each chamber, and data from 259 healthy individuals, stratified by sex and age, are presented.Peak LV LS values, calculated from the 6 segments of the 4-chamber view, were −18±2%. This is lower than a recent meta-regression from the published literature reported for classic global LS (calculated from the 18 segments of the 3 apical views), namely −19.7%; 95% confidence interval, −20.4% to −18.9%. 4 Although the reduction compared with published values may seem low, 1.7% absolute percent difference corresponds to 9% relative change. Because strain measurements are typically used to detect small, subtle, subclinical changes, this is not a negligible difference.Peak left atrial strain values reported in the study of Addetia (+38±13%) are close to the published values. 5,6 For the right ventricular free wall, a normal range of −23±6% was found, again lower than currently recommended normal values from (−29±4.5%).1 Given the s...

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Section: See Article By Addetia Et Alsupporting

confidence: 79%

supporting

confidence: 80%

Simultaneous 4-Chamber Strain

Baron

Flachskampf

2016

Circ: Cardiovascular Imaging

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“…Similar trend was observed in healthy human volunteers [17]. Coronary interventions were associated with acute LV dysfunction.…”

Section: Functionsupporting

confidence: 62%

MRI monitoring of function, perfusion and viability in microembolized moderately ischemic myocardium

Wilson

Krug

et al. 2015

Int J Cardiovasc Imaging

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Assessment of microembolization after coronary interventions is clinically challenging, thus we longitudinally investigated microemboli effects on moderately ischemic myocardium using MRI and histopathology. Twenty-four pigs (8/group) were divided into: group I (no intervention), group II (45 min LAD occlusion) and group III (45 min LAD occlusion with microembolization). Cine, perfusion and delayed contrast enhanced MRI (DE-MRI), using 1.5T MRI, were used for assessment at 3 days and 5 weeks. Triphenyltetrazolium-chloride (TTC) and Masson-trichrome were used as gold standard references for macro and microscopic quantification of myocardial infarction (MI). Cine MRI showed differential increase in end systolic volume (1.3 ± 0.08 ml/kg group II and 1.6 ± 0.1 ml/kg group III) and decrease in ejection fraction (45 ± 2 and 36 ± 2%, respectively) compared with controls at 3 days (2.1 ± 0.1 ml ESV and 50 ± 1% EF, P < 0.05). At 5 weeks group III, but not II, showed persistent perfusion deficits, wall thinning in the LAD territory and compensatory hypertrophy in remote myocardium. DE-MRI MI at 3 days was significantly smaller in group II (3.3 ± 2.2 g) than III (9.8 ± 0.6 g), at 5 weeks, MI were smaller by 60% (1.3 ± 0.9 g) and 22% (7.7 ± 0.5 g), respectively. TTC MI was similar to DE-MRI in group II (1.6 ± 1.0 g) and III (9.2 ± 1.6 g), but not microscopy (2.8 ± 0.4 and 10.5 ± 1.5 g, respectively). The effects of moderate ischemia with and without microembolization on myocardium could be differentiated using multiple MRI sequences. MRI demonstrated that microemboli in moderately ischemic myocardium, but not solely ischemia, prolonged ventricular dysfunction, created perfusion deficits, poor infarct resorption and enhanced compensatory hypertrophy, while moderate ischemia alone caused minor LV changes.

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“…Strain and strain rate were obtained using standard cine SSFP sequences with the settings noted above for the short axis stack and CMR feature-tracking (FT, '2D CPA MR' software, TomTec, Unterschleissheim, Germany), as previously described (15,16): Endocardial borders were contoured on mid-systolic frames.…”

Section: Cardiac Magnetic Resonancementioning

confidence: 99%