Myocardial Strain and Torsion Quantified by Cardiovascular Magnetic Resonance Tissue Tagging

Abstract

Accurate quantification and timing of regional myocardial function allows early identification of dysfunction, and therefore becomes increasingly important for clinical risk assessment, patient management, and evaluation of therapeutic efficacy. For this purpose, the application of tissue Doppler echocardiography has rapidly increased. However, echocardiography has some major inherent limitations. Cardiovascular magnetic resonance imaging with tissue tagging provides highly reproducible data on myocardial function, not only in longitudinal and radial directions, but also in the circumferential direction. Because of the development of faster imaging protocols, improved temporal resolution, less time-consuming postprocessing procedures, and the potential of quantifying myocardial deformation in 3 dimensions at any point in the heart, this technique may serve as an alternative for tissue Doppler echocardiography and is now ready for more widespread clinical use. This review discusses the clinical use of cardiovascular magnetic resonance tissue tagging for quantitative assessment of regional myocardial function, thereby underlining the specific features and emerging role of this technique.

Longitudinal Strain and Torsion Assessed by Two-Dimensional Speckle Tracking Correlate with the Serum Level of Tissue Inhibitor of Matrix Metalloproteinase-1, a Marker of Myocardial Fibrosis, in Patients with Hypertension

“…There have been some studies demonstrating the paradoxically increased LV torsion with normal EF in patients with diabetes, aortic stenosis, and hypertrophic cardiomyopathy. [22][23][24][25][26] Because the changes in torsion occur far before irreversible tissue damage, this may be considered as an early indicator of systolic dysfunction. We found that the increase in basal-to-apical torsion was mainly derived from the increase in basal rotation.…”

Determinants of myocardial energetics and efficiency in symptomatic hypertrophic cardiomyopathy

“…Cine imaging with myocardial tagging was applied to create non-invasive markers (tags) within the myocardium for calculation of strain [11]. Three short-axis tagged images with complementary spatial modulation of magnetization tagging for improved strain calculations were acquired as previously described [17].…”

“…Insights into the mechanism and causative factors of altered energy metabolism could therefore be of clinical importance in risk stratification and the development and application of (new) therapeutic approaches. Recent advances in imaging techniques offer the possibility to accurately assess myocardial oxygen consumption (MVO 2 ), regional mechanical work and tissue characteristics non-invasively using dynamic positron emission tomography (PET) [9,10] and cardiac magnetic resonance imaging (CMR) [11][12][13], respectively. The present study was conducted to identify the determinants of impaired myocardial energetics and efficiency in patients with symptomatic HCM with the use of these currently available advanced imaging techniques.…”

Two-Dimensional Strain Imaging: Basic principles and Technical Consideration

“…In the 1990s, studies performed by a different type of magnetic resonance imaging (MRI), tagged MRI, [14][15][16] allowed for visualization of the movements of the heart on different axes by non-invasive methods [14,[17][18][19][20][21][22]. Although the temporal resolution of MRI is low, it was used in pilot studies to describe the rotation mechanics and has an important place in the validation of tissue Doppler-based (23,24) or speckle tracking-based echocardiography studies [20][21][22]25] bCurrently, tagged MRI is generally used for research purposes, and in particular, speckle tracking-based echocardiography techniques make it possible to perform practical and reproducible measurements for current research in a cost effective manner [26,27].…”