Heart deformation analysis for automated quantification of cardiac function and regional myocardial motion patterns: A proof of concept study in patients with cardiomyopathy and healthy subjects

Abstract

Objective To test the performance of HDA in characterizing left ventricular (LV) function and regional myocardial motion patterns in the context of cardiomyopathy based on cine cardiovascular magnetic resonance (CMR). Materials and methods Following the approval of the institutional review board (IRB), standard cine images of 45 subjects, including 15 healthy volunteers, 15 patients with hypertrophic cardiomyopathy (HCM) and 15 patients with dilated cardiomyopathy (DCM) were retrospectively analyzed using HDA. The variations of LV ejection fraction (LVEF), LV mass (LVM), and regional myocardial motion indices, including radial (Drr), circumferential (Dcc) displacement, radial (Vrr) and circumferential (Vcc) velocity, radial (Err), circumferential (Ecc) and shear (Ess) strain and radial (SRr) and circumferential (SRc) strain rate, were calculated and compared among subject groups. Inter-study reproducibility of HDA-derived myocardial motion indices were tested on 15 volunteers by using intra-class correlation coefficient (ICC) and coefficient of variation (CoV). Results HDA identified significant differences in cardiac function and motion indices between subject groups. DCM patients had significantly lower LVEF (33.5 ± 9.65%), LVM (105.88 ± 21.93g), peak Drr (0.29 ± 0.11cm), Vrr-sys (2.14 ± 0.72cm/s), Err (0.17 ± 0.08), Ecc (−0.08 ± 0.03), SRr-sys (0.91 ± 0.44s−1) and SRc-sys (−0.64 ± 0.27s−1) compared to the other two groups. HCM patients demonstrated increased LVM (171.69 ± 34.19) and lower peak Vcc-dia (0.78 ± 0.30 cm/s) than other subjects. Good inter-study reproducibility was found for all HDA-derived myocardial indices in healthy volunteers (ICC = 0.664 - 0.942, CoV = 15.1% - 37.1%). Conclusion Without the need for operator interaction, HDA is a reproducible method for the automated characterization of global and regional LV function in the context of cardiomyopathy.

Improved segmental myocardial strain reproducibility using deformable registration algorithms compared with feature tracking cardiac MRI and speckle tracking echocardiography

“…Currently, GLS is the most widely used strain parameter for clinical echocardiographic studies Therefore, it is important to investigate if a single technique can robustly assess both longitudinal strain, where STE is an established technique, as well as circumferential strain, where tagging is an established technique. Previous results have demonstrated that GLS by DRA analysis showed a significant correlation with STE ( r = 0.47; P = 0.006) . Our results were consistent with these findings.…”

“…The robust segmentation approach is likely one of the major reasons that contribute to the outstanding reproducibility without operator interaction. A previous study demonstrated that the reproducibility of global longitudinal, circumferential, and radial strains derived from DRA was superior to FT . Our study further confirmed this finding.…”

“…The deformation registration algorithm (DRA) is a pixel‐based strain analysis tool, which has demonstrated better global strain reproducibility than FT‐MRI and has better correlation with STE‐derived strains . Heart deformation analysis (HDA) using the DRA technique has been proposed and applied to describe global and regional myocardial motion and function . In the present study we aimed to evaluate the reproducibility of left ventricle (LV) segmental myocardial strain measured by DRA.…”

Regional myocardial motion in patients with mild cognitive impairment: a pilot study

“…Recently, quantitative biomechanical indices acquired using magnetic resonance imaging (MRI), such as strain, strain rate, displacement and velocity, have been adopted to comprehensively describe abnormal myocardial motion patterns [ 7 ]. Compared with global indices, regional myocardial motion indices seem to be more appropriate candidates for describing subtle cardiac changes affiliated with subclinical CVDs.…”

Heart deformation analysis: the distribution of regional myocardial motion patterns at left ventricle

“…Based on deformable imaging registration (DIR), heart deformation analysis (HDA) is a recently developed myocardial motion tracking technique that is able to calculate regional and global myocardial displacement, velocity, strain and strain rate on existing cine images without extra MRI scans (8–10). Using HDA, we measured displacement, velocity strain and strain rate on a per-segment basis (mapped on a standard 16-segment AHA LV model) at 21 healthy volunteers, and investigated the regional distributions of magnitudes for each myocardial index on the LV.…”