Longitudinal Deformation of the Right Ventricle in Hypoplastic Left Heart Syndrome: A Comparative Study of 2D-Feature Tracking Magnetic Resonance Imaging and 2D-Speckle Tracking Echocardiography

Abstract

In hypoplastic left heart syndrome (HLHS), long-term outcome is closely related to right ventricular function. Echocardiography and magnetic resonance imaging (MRI) are routinely used for functional assessment. MRI 2D-tissue feature tracking (2D-FT) allows quantification of myocardial deformation but has not yet been applied to HLHS patients. We sought to investigate the feasibility of this technique and to compare the results to 2D-speckle tracking echocardiography (2D-STE). In routine MRI 2D anatomical four chamber view, cine images were recorded in 55 HLHS patients (median age 4.9 years [1.6, 17.0]). Regional and global peak systolic longitudinal strain (LS) and strain rate (LSR) were determined using 2D-FT software. Echocardiographic four chamber view was analyzed with 2D-STE. Visualization of all myocardial segments with MRI was excellent, regional, and global LS and LSR could be assessed in all data sets. In 2D-STE, 28% of apical segments could not be analyzed due to poor image quality. Agreement of 2D-FT MRI and 2D-STE was acceptable for global LS, but poor for global LSR. In MRI, regional LS was lower in the septal segments, while LSR was not different between the segments. GLS and GLSR correlated with ejection fraction (GLS: r = - 0.45 and r < 0.001, GLSR: r = - 0.34 and p = 0.01). With new post-processing options, the assessment of regional and global LS and LSR is feasible in routine MRI of HLHS patients. For LS, results were comparable with 2D-STE. The agreement was poor for LSR, which might relate to differences in temporal resolution between the two imaging modalities.

Right ventricular free wall longitudinal strain and strain rate quantification with cardiovascular magnetic resonance based tissue tracking

“…We did not find any age-related difference of RVFW-GLS and systolic GLSR in neither gender groups and no correlation between age and RVFW-GLS or systolic GLSR. This finding was in line with the finding of previous studies [22,33,37]. This finding may simplify the establishment of reference values and clinical use of these two parameters.…”

Simultaneous Volumetric and Functional Assessment of the Right Ventricle in Hypoplastic Left Heart Syndrome After Fontan Palliation, Utilizing 3-Dimensional Speckle-Tracking Echocardiography

“…Volume measurement is an essential parameter in the Previous studies demonstrated good agreement of conventional strains with CMRI in both functionally single LV (SLV) and SRV after Fontan palliation. 17, 18 Moreover, Satriano et al showed good correlation of not only CS and LS but also PS between 3D-STE and CMRI in the LV. 14 However, because PS is a very new concept, so far there have not been any studies demonstrating correlation of PS and CMRI in children.…”

Myocardial deformation in patients with a single left ventricle using 2D cardiovascular magnetic resonance feature tracking: a case-control study

“…The data analysis was performed using dedicated STE software (EchoPac, version 113, General Electric Healthcare, Wisconsin, USA) as previously described by our group. 15…”

“…11,12 Beside traditional techniques, tissue tracking methods such as 2-dimensional (2D) CMR feature tracking (2D-CMR-FT) and 2D speckle tracking echocardiography (2D-STE) have gained popularity to assess global and regional myocardial deformation of the SV. [13][14][15] However, most studies have assessed a mixed cohort of single left (SLV) and single right ventricle (SRV) patients but only few assessed a uniform population of only SLV patients using 2D-STE. 16,17 A comparison to healthy controls was only performed in a small cohort in 2 studies.…”