Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

Abstract

Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

Role of Strain in the Early Diagnosis of Diabetic Cardiomyopathy

“…17,23,24,37 Apesar de ser uma nova tecnologia e ainda requerer mais estudos, pretendem-se localizar a lesão no miocárdio e detectar precocemente possíveis alterações. 38 Em estudo envolvendo controles saudáveis, Tadic et al revelaram indivíduos com DM2 e/ou hipertensão arterial sistêmica (HAS) os seguintes achados: alteração multidirecional no strain; hipertensão como fator para deterioração da mecânica do VE; acometimento de todas as camadas miocárdicas pelo DM e HAS; e, por fim, correlação entre controle glicêmico (glicemia de jejum e HbA1c) com SGL e strain layer-specific do VE. Nos últimos 5 anos, apenas três estudos realizaram acompanhamento dos participantes.…”

Left Ventricular Responses during Exercise in Highly Trained Youth Athletes: Echocardiographic Insights on Function and Adaptation

“…LV and RV structures have been documented in paediatric athletes using CMR [39], which may present some advantages to 2D echocardiography, owing to greater spatial resolutions [9]. LV and RV mechanics have also been assessed in pre-adolescent soccer players [40], and with good inter-modality correlation between CMR feature tracking and STE [41]. Nevertheless, it may not be feasible to use modalities interchangeably due to underestimation in the former [41], and differences in values of the athlete's heart structure derived from echocardiography and CMR [9].…”

“…LV and RV mechanics have also been assessed in pre-adolescent soccer players [40], and with good inter-modality correlation between CMR feature tracking and STE [41]. Nevertheless, it may not be feasible to use modalities interchangeably due to underestimation in the former [41], and differences in values of the athlete's heart structure derived from echocardiography and CMR [9]. Underestimation of LV mechanics with CMR could be related to temporal resolution [41], which may become more problematic during exercise with high heart rates, particularly when phases of the cardiac cycle, such as isovolumic contraction and relaxation, shorten.…”

“…Nevertheless, it may not be feasible to use modalities interchangeably due to underestimation in the former [41], and differences in values of the athlete's heart structure derived from echocardiography and CMR [9]. Underestimation of LV mechanics with CMR could be related to temporal resolution [41], which may become more problematic during exercise with high heart rates, particularly when phases of the cardiac cycle, such as isovolumic contraction and relaxation, shorten. Indeed, temporal as opposed to spatial resolution impacts strain and strain rate values [42].…”

Heart Rate related to Accuracy of left ventricular strain parameters derived from the single-shot compressed sensing cine CMR images of patients with cardiovascular disease

“…Myocardial strain, a more sensitive marker of LV functional abnormalities, easily detects changes in LV function and subclinical myocardial dysfunction in a broad spectrum of cardiac conditions (6). Feature tracking (FT) techniques allow for quantitative assessment of myocardial strain based on segmented cine images (7). CS provides cine images with reduced the edge sharpness due to its characteristics of acquisition and imaging (4).…”