Noninvasive Measurement of Shortening in the Fiber and Cross-Fiber Directions in the Normal Human Left Ventricle and in Idiopathic Dilated Cardiomyopathy

MacGowan, Guy A.; Shapiro, Edward P.; Azhari, Haim; Siu, Cynthia; Hees, Paul S.; Hutchins, Grover M.; Weiss, James L.; Rademakers, Frank

doi:10.1161/01.cir.96.2.535

Cited by 170 publications

(109 citation statements)

References 28 publications

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“…22 However, the development of MR myocardial tagging has facilitated the detailed evaluation of abnormalities in regional LV myocardial function not only in the setting of HCM, 2,5 but also in hypertensive heart disease, 4 ischemic heart disease 8 and dilated cardiomyopathy. 9 Three-dimensional MR imaging is a recent development. 7 The refinement of MR SPAMM myocardial tagging is expected to facilitate the understanding of the pathophysiology in cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8][9] In particular, the spatial modulation of magnetization (SPAMM) method uses noninvasive recognition of markers for specific myocardial regions for analyzing the myocardial thickening or thinning during the cardiac cycle. 2,5,8 Previous studies have reported that left ventricular (LV) contractility is impaired in the hypertrophied regions in patients with hypertrophic cardiomyopathy (HCM).…”

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confidence: 99%

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Regional Left Ventricular Myocardial Contraction Abnormalities and Asynchrony in Patients With Hypertrophic Cardiomyopathy Evaluated by Magnetic Resonance Spatial Modulation of Magnetization Myocardial Tagging

et al. 1999

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agnetic resonance (MR) myocardial tagging has permitted the analysis of intramyocardial segmental function in normal volunteers 1 and patients with myocardial disease. [2][3][4][5][6][7][8][9] In particular, the spatial modulation of magnetization (SPAMM) method uses noninvasive recognition of markers for specific myocardial regions for analyzing the myocardial thickening or thinning during the cardiac cycle. 2,5,8 Previous studies have reported that left ventricular (LV) contractility is impaired in the hypertrophied regions in patients with hypertrophic cardiomyopathy (HCM). 10-14 However, there is controversy concerning whether contractility in the nonhypertrophied regions is impaired because some studies 12,15 have reported that contractility is normal and other studies 13,14 have reported decreased contractility. The present study therefore used MR SPAMM myocardial tagging to analyze regional myocardial contraction in the hypertrophied and nonhypertrophied regions of the LV wall in patients with HCM. In addition, we characterized the systolic LV wall asynchrony that occurs in this disease. Methods Patient PopulationThe study population consisted of 20 patients with asymmetric septal hypertrophy (HCM group; 12 men, 8 women; age range: 42±14 years) and 16 age-matched normal patients (control group; 10 men, 6 women; age range: 38±12 years). We enrolled the patients in sinus rhythm who met the following inclusion criteria: (1) normal coronary anatomy determined by coronary angiography, (2) no evidence of hypertension or moderate to severe valvular heart disease, (3) heart rate between 60 and 100 beats/min, (4) QT interval ≤420 ms, and (5) LV outflow obstruction <20 mmHg determined by continuous-wave Doppler echocardiography. The 16 normal patients visited hospital with the chief complaints of chest pain, palpitations, dyspnea or heart murmurs. Phonocardiography, routine echocardiography and cardiac catheterization Jpn Circ J 1999; 63: 442 -446 (Received December 4, 1998; revised manuscript received March 5, 1999; accepted March 9, 1999) Global left ventricular (LV) pump function is generally preserved in patients with hypertrophic cardiomyopathy (HCM). However, it is unknown whether regional myocardial contractility is impaired, especially in nonhypertrophied regions. The purpose of this study was to evaluate regional LV myocardial contraction in patients with HCM using magnetic resonance (MR) spatial modulation of magnetization (SPAMM) myocardial tagging. The study group comprised 20 patients with asymmetric septal hypertrophy (HCM group) and 16 age-matched normal patients (control group), and data were collected using transthoracic M-mode and 2-dimensional echocardiography, and MR SPAMM myocardial tagging. The systolic strain ratio, maximum systolic strain velocity, and time from end-diastole to maximum systolic strain (∆T) in the anterior, ventricular septal, inferior and lateral regions for 2 LV short-axis sections at the levels of the chordae tendineae and papillary muscles were measured at 50-ms int...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Regional Left Ventricular Myocardial Contraction Abnormalities and Asynchrony in Patients With Hypertrophic Cardiomyopathy Evaluated by Magnetic Resonance Spatial Modulation of Magnetization Myocardial Tagging

et al. 1999

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“…To obtain LV mass, images were postprocessed using Cardiac Image Processing System, previously used in published studies from our group. 22,23 The endocardial margin was detected visually and contoured manually. The area of the LV cavity in the slice was calculated, and volume was estimated by factoring the known slice thickness, which assumed boundaries that were orthogonal to the imaging plane.…”

Section: Mass By Magnetic Resonance Imagingmentioning

confidence: 99%

Exercise blood pressure response is related to left ventricular mass

et al. 2003

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An exaggerated SBP response to exercise has been associated with increased left ventricular (LV) mass in some but not all studies. A total of 43 women and 34 men, aged 55-75 years, without evidence of cardiovascular disease, with a mean resting BP of 142 7 9/ 77 7 8 mmHg had their BP measured at rest and during maximal treadmill exercise. LV mass was measured using magnetic resonance imaging. LV mass was adjusted for lean body mass, which was assessed by dual energy X-ray absorptiometry. LV mass was within the normal range for the majority of the subjects. Among the resting and exercise BP indices, maximal SBP was the strongest correlate of LV mass (r ¼ 0.41, Po0.05). In multivariate analysis, maximal SBP was independently associated with LV mass after adjustment for lean body mass and gender, explaining 3% of the variance (Po0.05). Maximal exercise SBP is a modest but still independent predictor of LV mass in older persons with normal LV mass. These results raise the possibility that the SBP response to maximal exercise is an early marker of LV hypertrophy.

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“…The new axes were radial (R) using the perpendicular direction to the wall; fiber (F), tangent to the surface and parallel to the local fiber orientation at either the epicardium or endocardium; or cross fiber (X), tangent to the surface and perpendicular to F. Fiber directions were obtained from histological fiber angle data in cadaver studies. [13][14][15] Normal and shear strains were computed from the displacements from end diastole to end systole. Positive radial strains represented wall thickening; negative strains, wall thinning; and negative fiber strains, quantified shortening of the myocardium along the local direction of the actively contracting fibers.…”

Section: Strain Computationsmentioning

confidence: 99%

Functional Recovery of Subepicardial Myocardial Tissue in Transmural Myocardial Infarction After Successful Reperfusion

Bogaert¹,

Maes²,

Werf³

et al. 1999

Circulation

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Background-The transmural extent of myocardial necrosis after an acute coronary artery occlusion can vary considerably.The contribution of residual subepicardial viable myocardium to global left ventricular function is largely unknown. Methods and Results-We studied 12 patients with single-vessel disease 1 week after successful reperfusion of a first transmural anterior myocardial infarction (MI). With PET, myocardial blood flow (MBF) and glucose metabolism were measured regionally, and the viability was graded as normal, mismatch, or match with severely (Ͻ50% of normal) or intermediately (50% to 80% of normal) impaired MBF. Magnetic resonance tagging was used to regionally quantify fiber strains, wall thickening, and ejection fraction in patients 1 week and 3 months after the MI and in age-matched healthy volunteers. From 1 week to 3 months, subepicardial fiber shortening improved significantly in the match region (MBF Ͻ50%, Ϫ5.1Ϯ7.0% to Ϫ9.9Ϯ8.7%; MBF of 50% to 80%, Ϫ7.1Ϯ7.6% to Ϫ14.9Ϯ7.9%). This was associated with an improvement in regional ejection fraction in the infarcted myocardium (

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Noninvasive Measurement of Shortening in the Fiber and Cross-Fiber Directions in the Normal Human Left Ventricle and in Idiopathic Dilated Cardiomyopathy

Cited by 170 publications

References 28 publications

Regional Left Ventricular Myocardial Contraction Abnormalities and Asynchrony in Patients With Hypertrophic Cardiomyopathy Evaluated by Magnetic Resonance Spatial Modulation of Magnetization Myocardial Tagging

Regional Left Ventricular Myocardial Contraction Abnormalities and Asynchrony in Patients With Hypertrophic Cardiomyopathy Evaluated by Magnetic Resonance Spatial Modulation of Magnetization Myocardial Tagging

Exercise blood pressure response is related to left ventricular mass

Functional Recovery of Subepicardial Myocardial Tissue in Transmural Myocardial Infarction After Successful Reperfusion

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