MRI feature tracking strain is prognostic for all-cause mortality in AL amyloidosis

Illman, Jeffery E.; Arunachalam, Shivaram P.; Arani, Arvin; Chang, Ian C; Glockner, James F.; Dispenzieri, Angela; Grogan, Martha; Araoz, Philip A.

doi:10.1080/13506129.2018.1465406

Cited by 18 publications

(16 citation statements)

References 28 publications

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“…Subtle changes in the structure and geometry of the LV and RV myocardium may lead to changes in LV/RV deformation that may not be detectable calculating LV/RV ejection fractions. Especially the determination of GLS is of additional prognostic value because a worsening of GLS has been associated with higher mortality even in patients with preserved ejection fraction [12][13][14][21][22][23][24]. In a recent study by Fröjdh et al of consecutive adult patients who were referred to their center for standard CMR, a GLS > − 16% was associated with a higher mortality [25].…”

Section: Discussionmentioning

confidence: 99%

Myocardial strain analysis using cardiac magnetic resonance in patients with calpainopathy

Quick

Winkler

Speiser

et al. 2021

Orphanet J Rare Dis

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Background Limb–girdle muscular dystrophy (LGMD) is a genetically and clinically heterogeneous group of rare muscular dystrophies. Subtype 2A (LGMD2A) also known as “calpainopathy” is an inherited autosomal recessive gene defect. Cardiac dysfunction is common in several forms of LGMD. Cardiac involvement in LGMD2A, however, is not clear. The aim of this study was to perform cardiac magnetic resonance (CMR)-based strain analysis in LGMD2A patients, as this is a diagnostic parameter of subclinical cardiac involvement and a powerful independent predictor of mortality. We conducted the largest prospective cardiac magnetic resonance study to date, including 11 genetically verified LGMD2A patients and 11 age- and sex-matched control subjects and performed CMR-based strain analysis of the left and right ventricles. Results Left and right global longitudinal strain (GLS) were not significantly different between the two groups and within normal reference ranges (left ventricle: control − 21.8 (5.1) % vs. patients − 22.3 (3.2) %, p = 0.38; right ventricle: control − 26.3 (7.2) % vs. patients − 26.8 (5.8) %, p = 0.85). Also, global circumferential and radial strains did not significantly differ between the two groups (p = 0.95 and p = 0.86, respectively). LGMD2A patients did not show relevant amounts of late gadolinium enhancement (LGE) or malignant ventricular arrhythmias. Conclusions No evidence of even subtle cardiac dysfunction is evident form CMR-based strain analysis in LGMD2A patients. Malignant ventricular arrhythmias were not detected. Thus, in case of non-pathological initial echocardiographic and electrocardiographic examination, a less frequent or even no cardiac follow-up may be acceptable in these patients. However, if there are signs and symptoms that suggest an underlying cardiac condition (e.g. palpitations, angina, shortness of breath), this approach needs to be individualized to account for the unknown.

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Section: Discussionmentioning

confidence: 99%

Myocardial strain analysis using cardiac magnetic resonance in patients with calpainopathy

Quick

Winkler

Speiser

et al. 2021

Orphanet J Rare Dis

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“…Myocardial strain allows quantitative measurement of global but also regional myocardial function and deformation offering additional information beyond ejection fraction [2,3]. It enables early detection of subclinical myocardial dysfunction in patients with ischemic and non-ischemic heart disease and in preserved ejection fraction without wall motion abnormalities [2,[4][5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Quantification of myocardial strain assessed by cardiovascular magnetic resonance feature tracking in healthy subjects—influence of segmentation and analysis software

et al. 2020

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Objectives Quantification of myocardial deformation by feature tracking is of growing interest in cardiovascular magnetic resonance. It allows the assessment of regional myocardial function based on cine images. However, image acquisition, post-processing, and interpretation are not standardized. We aimed to assess the influence of segmentation procedure such as slice selection and different types of analysis software on values and quantification of myocardial strain in healthy adults. Methods Healthy volunteers were retrospectively analyzed. Post-processing was performed using CVI42 and TomTec. Longitudinal and radialLong axis (LAX) strain were quantified using 4-chamber-view, 3-chamber-view, and 2-chamber-view. Circumferential and radialShort axis (SAX) strain were assessed in basal, midventricular, and apical short-axis views and using full coverage. Global and segmental strain values were compared to each other regarding their post-processing approach and analysis software package. Results We screened healthy volunteers studied at 1.5 or 3.0 T and included 67 (age 44.3 ± 16.3 years, 31 females). Circumferential and radialSAX strain values were different between a full coverage approach vs. three short slices (− 17.6 ± 1.8% vs. − 19.2 ± 2.3% and 29.1 ± 4.8% vs. 34.6 ± 7.1%). Different analysis software calculated significantly different strain values. Within the same vendor, different field strengths (− 17.0 ± 2.1% at 1.5 T vs. − 17.0 ± 1.7% at 3 T, p = 0.845) did not influence the calculated global longitudinal strain (GLS), and were similar in gender (− 17.4 ± 2.0% in females vs. − 16.6 ± 1.8% in males, p = 0.098). Circumferential and radial strain were different in females and males (circumferential strain − 18.2 ± 1.7% vs. − 17.1 ± 1.8%, p = 0.029 and radial strain 30.7 ± 4.7% vs. 27.8 ± 4.6%, p = 0.047). Conclusions Myocardial deformation assessed by feature tracking depends on segmentation procedure and type of analysis software. CircumferentialSAX and radialSAX depend on the number of slices used for feature tracking analysis. As known from other imaging modalities, GLS seems to be the most stable parameter. During follow-up studies, standardized conditions should be warranted. Trial registration Retrospectively registered Key Points • Myocardial deformation assessed by feature tracking depends on the segmentation procedure. • Global myocardial strain values differ significantly among vendors. • Standardization in post-processing using CMR feature tracking is essential.

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“…Subtle changes in the structure and geometry of the LV myocardium may lead to changes in LV deformation that may not be detectable with LV ejection fraction. Especially the determination of GLS is of practical value, because a worsening of GLS has been associated with a higher mortality, even in patients with preserved ejection fraction [ 11 , 12 , 13 , 16 , 17 , 18 , 19 ]. We could show that GLS was not altered in WD patients compared to controls.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Myocardial Strain Using Cardiac Magnetic Resonance in Patients with Wilson’s Disease

Zhang

Reuner

Hempel

et al. 2021

JCM

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(1) Background: Wilson’s disease (WD) is an inherited autosomal recessive disorder with the excessive deposition of copper into different organs, including the heart. Previous studies showed structural cardiac changes even in patients with no signs of heart failure. The aim of this study was to perform cardiac magnetic resonance-based strain analysis in WD patients, as it is a powerful independent predictor of mortality. (2) Methods: We conducted a prospective cardiac magnetic resonance study that included 61 patients and 61 age and sex-matched controls, and performed strain analysis of the left and right ventricle. (3) Results: Left ventricular global longitudinal strain (GLS) as a prognostic marker of increased mortality was not altered (control −22.8 (4.8) % vs. WD patients −21.8 (5.1) %, p = 0.124). However, 4 of the 61 patients had a markedly reduced GLS. Global circumferential strain did not significantly differ between the groups either (p = 0.534). WD patients had significantly reduced global radial strain (p = 0.002). Right ventricular GLS was also significantly reduced in WD patients (p = 0.01). (4) Conclusions: Strain analysis revealed functional impairment of the left and right ventricle in a small number of patients as a potential early sign of cardiac manifestation in asymptomatic WD patients.

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MRI feature tracking strain is prognostic for all-cause mortality in AL amyloidosis

Cited by 18 publications

References 28 publications

Myocardial strain analysis using cardiac magnetic resonance in patients with calpainopathy

Myocardial strain analysis using cardiac magnetic resonance in patients with calpainopathy

Quantification of myocardial strain assessed by cardiovascular magnetic resonance feature tracking in healthy subjects—influence of segmentation and analysis software

Evaluation of Myocardial Strain Using Cardiac Magnetic Resonance in Patients with Wilson’s Disease

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