Myocardial Viability Mapping by Magnetic Resonance-Based Multiparametric Systolic Strain Analysis

Cupps, Brian P.; Bree, Douglas R.; Wollmuth, Jason; Howells, Analyn; Voeller, Rochus K.; Rogers, Joseph G.; Pasque, Michael K.

doi:10.1016/j.athoracsur.2008.06.072

Cited by 21 publications

(46 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 In other words, not only is normal human left ventricular strain heterogeneous, 13 but most LV strain injury also occurs in a heterogeneous distribution. These studies establish the critical necessity of utilizing normalized strain metrics (by way of comparison to a normal human strain database 9, 14 ) in the analysis of regional myocardial contractile function.…”

Section: Introductionmentioning

confidence: 72%

Quantifying “normalized” regional left ventricular contractile function in ischemic coronary artery disease

Henn

Cupps

Kar

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

Self Cite

View full text Add to dashboard Cite

Objective When significant coronary lesions are identified by angiography, regional left ventricular (LV) contractile function often plays a role in determining candidacy for revascularization. To improve upon current subjective and non-quantitative metrics of regional LV function, we tested a z-score “normalization” of regional strain information quantified from clinically acquired high-resolution LV geometric datasets. Methods Test subjects (n=120) underwent cardiac MRI with multiple 3D strain parameters calculated from tissue tag-plane displacement data. Sixty normal volunteers contributed strain parameter data at each of 15,300 LV grid points to form a normal human strain database. Point-specific database comparisons were then made in 60 patients with documented coronary artery disease (CAD) by angiography. Patient-specific color-coded 3D LV maps of z-score normalized contractile function were generated. Results Upon blinded clinical review, 55% (33/60) of the CAD patients had significant regional contractile abnormalities by one of three “gold standard” criteria 1) Q waves on ECG; 2) infarct on radionuclide SPECT; or 3) akinesia or dyskinesia on echocardiography. Consistency between all gold standard metrics was found in only 19% (6/31) of CAD patients who had at least two available metrics. Blinded MRI-based multi-parametric strain z-score localization of contractile abnormalities was accurate in 89% (ECG), 97% (SPECT), and 95% (echocardiography). Conclusions Non-subjective normalization of regional LV contractile function by z-score calculation from a normal human strain database can localize and quantitatively display regional wall motion abnormalities in CAD patients. This high-resolution localization of regional wall motion abnormalities may help improve the accuracy of therapeutic intervention in CAD patients.

show abstract

Section: Introductionmentioning

confidence: 72%

Quantifying “normalized” regional left ventricular contractile function in ischemic coronary artery disease

Henn

Cupps

Kar

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Quantitative analysis off-line can provide a reproducible measure of regional myocardial strain and can be used for detailed analysis of regional ventricular function with high accuracy [75,76]. In one study evaluating multiparametric strain in a chronic ischaemic cardiomyopathy cohort, high diagnostic accuracy was observed [77]. The utility of myocardial strain assessment with grid-tagged CMR has also been extended to diastolic function evaluation [78] as well as characterisation of peri-infarct dysfunction [76].…”

Section: Assessment Of Myocardial Viabilitymentioning

confidence: 97%

The role of cardiac magnetic resonance imaging following acute myocardial infarction

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Cupps et al previously determined that strain >1.5 standard deviations (SD) from the mean value in normal patients was correlated with non-viable regions detected on PET and SPECT [13]. However, this strain method has not been validated in patients with IMR, and to date there have been no direct comparisons of strain-based viability studies with transmural MI on LGE.…”

Section: Introductionmentioning

confidence: 99%

Ischemic Mitral Regurgitation: Abnormal Strain Overestimates Nonviable Myocardium

Morgan

Zhang

Tartibi

et al. 2018

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Objective Therapy for moderate ischemic mitral regurgitation (IMR) remains unclear. Determination of myocardial viability, a necessary pre-requisite for an improvement in regional contractility, is a likely key factor in determining response to revascularization alone. Myocardial strain has been proposed as a viability measure but has not been compared to late gadolinium enhancement (LGE) cardiac (c)MRI. We hypothesized that abnormal strain overestimates non-viable LV segments measured using LGE and that ischemia and mechanical tethering by adjacent transmural myocardial infarction (TMI) also decreases strain in viable segments. Methods Sixteen patients with ≥ mild IMR and seven healthy volunteers underwent cMRI with non-invasive tags (CSPAMM), LGE and stress perfusion. CSPAMM images were post-processed with HARP and circumferential and longitudinal strains were calculated. Viability was defined as the absence of TMI on LGE (hyperenhancement >50% of wall thickness). The borderzone was defined as any segment bordering TMI. Abnormal strain thresholds (±1–2.5 SD from normal mean) were compared to TMI, ischemia and borderzone. Results 7.4% of LV segments had TMI on LGE while >14.5% of LV segments were non-viable by strain thresholds (p<0.005). In viable segments, ischemia impaired longitudinal strain (least perfused 1/3 of LV segments −.18±.08 vs. most perfused −.22±.1 p=01) and circumferential strain (−.12±.1 vs−.16±.08 p<0.05). In addition, infarct proximity impaired longitudinal strain (−.16±.11 borderzone vs −.18±.09 remote p=.05). Conclusions Impaired LV strain overestimates non-viable myocardium when compared to TMI on LGE. Ischemia and infarct proximity also decrease strain in viable segments.

show abstract

Myocardial Viability Mapping by Magnetic Resonance-Based Multiparametric Systolic Strain Analysis

Abstract: Background-Regional myocardial contractility can be characterized by three-dimensional (3D) left ventricular (LV) multiparametric strain maps generated from sequential magnetic resonance imaging of radiofrequency tissue tagging grid point displacements.

Cited by 21 publications

References 16 publications

Quantifying “normalized” regional left ventricular contractile function in ischemic coronary artery disease

Quantifying “normalized” regional left ventricular contractile function in ischemic coronary artery disease

The role of cardiac magnetic resonance imaging following acute myocardial infarction

Ischemic Mitral Regurgitation: Abnormal Strain Overestimates Nonviable Myocardium

Contact Info

Product

Resources

About