“…By dividing the circumferential strain measurements to apical, mid, and basal regions, we noticed that the strain values increased from base to apex in all study groups. Strain in our normal controls was similar at basal and mid-level, and highest (on average 2.5% higher) in the apical plane, as described previously [27]. These cardiac planes functioned more uniformly in healthy individuals, while the increase in peak strain was significantly higher in mid-level and apical planes in the TOF subgroups.…”
Objectives Postoperative patients with tetralogy of Fallot (TOF) are often compromised by chronic pulmonary regurgitation and chronic right ventricular volume load. We sought to determine whether pulmonary regurgitation (PR) would affect right and left ventricle (RV and LV) strain. Materials and methods This cross-sectional analysis included 40 patients who had TOF with surgical repair, with an average follow-up period of 11.8 ± 3.0 years. Altogether, 44 healthy volunteers with similar age and gender distribution were recruited. A cardiovascular magnetic resonance imaging study with feature tracking analysis was performed on all patients and controls. Results RV peak longitudinal strain was increased in TOF patients with PR > 30 ml/m 2 when compared to those with PR < 30 ml/m 2 (− 22.5% ± 2.7% vs − 19.7% ± 3.5%, p = 0.018) and controls (p = 0.007). PR volume correlated with peak RV longitudinal strain (R = − 0.37, p = 0.030) and peak RV longitudinal strain rate (systolic: R = 0.37, p = 0.03; diastolic: R = 0.39, p = 0.021). The peak RV circumferential strain, from base to apex, increased more than in healthy controls (apexbase difference 7.6% ± 4.2% vs 3.3% ± 2.4%, p < 0.0001). Conclusions Pediatric patients with TOF and a severe pulmonary regurgitation show an enhanced longitudinal strain when compared to patients with milder regurgitation or to control subjects. In addition, mean RV circumferential strain of the patients is significantly enhanced compared to healthy individuals.
“…By dividing the circumferential strain measurements to apical, mid, and basal regions, we noticed that the strain values increased from base to apex in all study groups. Strain in our normal controls was similar at basal and mid-level, and highest (on average 2.5% higher) in the apical plane, as described previously [27]. These cardiac planes functioned more uniformly in healthy individuals, while the increase in peak strain was significantly higher in mid-level and apical planes in the TOF subgroups.…”
Objectives Postoperative patients with tetralogy of Fallot (TOF) are often compromised by chronic pulmonary regurgitation and chronic right ventricular volume load. We sought to determine whether pulmonary regurgitation (PR) would affect right and left ventricle (RV and LV) strain. Materials and methods This cross-sectional analysis included 40 patients who had TOF with surgical repair, with an average follow-up period of 11.8 ± 3.0 years. Altogether, 44 healthy volunteers with similar age and gender distribution were recruited. A cardiovascular magnetic resonance imaging study with feature tracking analysis was performed on all patients and controls. Results RV peak longitudinal strain was increased in TOF patients with PR > 30 ml/m 2 when compared to those with PR < 30 ml/m 2 (− 22.5% ± 2.7% vs − 19.7% ± 3.5%, p = 0.018) and controls (p = 0.007). PR volume correlated with peak RV longitudinal strain (R = − 0.37, p = 0.030) and peak RV longitudinal strain rate (systolic: R = 0.37, p = 0.03; diastolic: R = 0.39, p = 0.021). The peak RV circumferential strain, from base to apex, increased more than in healthy controls (apexbase difference 7.6% ± 4.2% vs 3.3% ± 2.4%, p < 0.0001). Conclusions Pediatric patients with TOF and a severe pulmonary regurgitation show an enhanced longitudinal strain when compared to patients with milder regurgitation or to control subjects. In addition, mean RV circumferential strain of the patients is significantly enhanced compared to healthy individuals.
“…RV strain parameters are typically regarded as markers of myocardial deformation and can be measured by many CMR myocardial tracking technologies. CMR-TT makes use of the near incompressibility of the myocardium and allows for the assessment of myocardial deformation by tracking both endocardial and epicardial boundary voxels 20 . It precludes the use of complex post-processing procedure in CMR tagging technology 22 ; in addition, the intra-observer reproducibility of CMR-TT strain analysis is independent of magnetic field intensity 23 .…”
Section: Discussionmentioning
confidence: 99%
“…deformation without the use of contrast media. Previous studies have applied CMR-TT technique with good intra-and inter-observer variability for determining the global and regional left ventricular (LV) deformation in the early stages of HCM 20,21 . However, to the best of our knowledge, information pertaining to RV strain in patients with HCM by CMR-TT is limited.…”
to assess the global and regional right ventricular (RV) deformation in hypertrophic cardiomyopathy (HCM) patients with preserved right ventricular ejection fraction (RVEF) using 3.0-T cardiovascular magnetic resonance tissue tracking (CMR-TT). Eighty-two HCM patients and 32 age-and sex-matched healthy controls were enrolled. HCM patients were divided into groups depending on the presence or absence of right ventricular hypertrophy (RVH), RV late gadolinium enhancement (RV-LGE), and left ventricular outflow tract obstruction (LVOTO), respectively. The RV global and apical longitudinal peak strain (LPS) in HCM patients with RVH were significantly lower than that in HCM patients without RVH and controls (p < 0.05). The global, apical and mid-ventricular LPS in HCM patients with RV-LGE were significantly lower than that in HCM patients without RV-LGE and controls (P < 0.05). Lower LPS was demonstrated in HCM patients without RV-LGE compared with controls in apical and mid-ventricular levels (p < 0.05). No significant difference was found regarding global and regional LPS in HCM patients with LVoto compared without LVoto (all p > 0.05). CMR-TT was able to detect subclinical RV myocardial deformation prior to RVEF impairment, which was more severe in the presence of RVH and RV-LGE. Hypertrophic cardiomyopathy (HCM) is a primary and genetically transmitted cardiovascular disease with a prevalence of 1:500 in the general population. The condition is associated with a risk of adverse cardiac events such as severe arrhythmias, progressive heart failure, and sudden cardiac death 1-3. It is also one of the most common causes of sudden cardiac death in young individuals and athletes 4. In previous studies, increased right ventricular (RV) wall thickness and RV dysfunction in patients with HCM were shown to predict severe symptomatic HCM and poor prognosis 5,6. RV ejection fraction (RVEF) has been typically used to assess the RV systolic function and has been shown to predict clinical outcomes of patients with cardiomyopathy 7. However, the RVEF of patients with HCM tends to be within the "normal" range 8. Currently, RV strain parameters are considered as more valuable markers of myocardium dysfunction than RVEF. RV strain parameters have been used for prognostic evaluation of multiple cardiovascular diseases and RV deformation in the healthy population 9-13. The global and regional RV deformation in HCM patients with preserved RVEF is not well characterized 14-18. Cardiovascular magnetic resonance (CMR) is the standard reference modality for evaluation of RV structure and function 9,19. CMR tissue tracking (TT) technology is a non-invasive method to assess myocardial
“…A recent study used the newer FT technique to determine normal values for RV myocardial strain; it estimates radial and circumferential strain from the short-axis images and longitudinal strain from cine long-axis images (Fig. 3; [73]): similarly to the left ventricle, female showed to have higher peak circumferential basal and mid-cavity strain values, with no correlation found between myocardial strain and age and body mass index, and the apex showed the highest circumferential strain values, as compared to base and mid-cavity. Using FT, mid-cavity peak circumferential strain offered the best interobserver reproducibility, while the worst reproducibility was found for basal and mid-cavity circumferential strain.Fig.…”
Section: Right Ventricular Strain Imaging and Clinical Applicationsmentioning
The objective assessments of left ventricular (LV) and right ventricular (RV) ejection fractions (EFs) are the main important tasks of routine cardiovascular magnetic resonance (CMR). Over the years, CMR has emerged as the reference standard for the evaluation of biventricular morphology and function. However, changes in EF may occur in the late stages of the majority of cardiac diseases, and being a measure of global function, it has limited sensitivity for identifying regional myocardial impairment. On the other hand, current wall motion evaluation is done on a subjective basis and subjective, qualitative analysis has a substantial error rate. In an attempt to better quantify global and regional LV function; several techniques, to assess myocardial deformation, have been developed, over the past years. The aim of this review is to provide a comprehensive compendium of all the CMR techniques to assess myocardial deformation parameters as well as the application in different clinical scenarios.
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