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Li G, Zhang Z, Gao Y, Zhu C, Zhou S, Cao L, Zhao Z, Zhao J, Ordovas K, Lou M, Li K, Pohost GM. Age- and sex-specific reference values of biventricular strain and strain rate derived from a large cohort of healthy Chinese adults: a cardiovascular magnetic resonance feature tracking study. J Cardiovasc Magn Reson 2022; 24:63. [PMID: 36404299 PMCID: PMC9677678 DOI: 10.1186/s12968-022-00881-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/26/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND As a noninvasive tool, myocardial deformation imaging may facilitate the early detection of cardiac dysfunction. However, normal reference ranges of myocardial strain and strain rate (SR) based on large-scale East Asian populations are still lacking. This study aimed to provide reference values of left ventricular (LV) and right ventricular (RV) strain and SR based on a large cohort of healthy Chinese adults using cardiovascular magnetic resonance (CMR) feature tracking (FT). METHODS Five hundred and sixty-six healthy Chinese adults (55.1% men) free of hypertension, diabetes, and obesity were included. On cine CMR, biventricular global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS), and the peak radial, circumferential, and longitudinal systolic, and diastolic SRs (PSSRR, PSSRC, PSSRL, PDSRR, PDSRC, and PDSRL), and regional radial and circumferential strain at the basal, mid-cavity, and apical levels were measured. Associations of global and regional biventricular deformation indices with age and sex were investigated. RESULTS Women demonstrated greater magnitudes of LV GRS (37.6 ± 6.1% vs. 32.1 ± 5.3%), GCS (- 20.7 ± 1.9% vs. - 18.8 ± 1.9%), GLS (- 17.8 ± 1.8% vs. - 15.6 ± 1.8%), RV GRS (25.1 ± 7.8% vs. 22.1 ± 6.7%), GCS (- 14.4 ± 3.6% vs. - 13.2 ± 3.2%), GLS (- 22.4 ± 5.2% vs. - 20.2 ± 4.6%), and biventricular peak systolic and diastolic SR in all three coordinate directions (all P < 0.05). For the LV, aging was associated with increasing amplitudes of GRS, GCS, and decreasing amplitudes of PDSRR, PDSRC, PDSRL (all P < 0.05). For the RV, aging was associated with an increase in the magnitudes of GRS, GCS, GLS, PSSRR, PSSRC, PSSRL, and a decrease in the magnitude of PDSRR, PDSRC (all P < 0.05). Biventricular radial and circumferential strain measurements at the basal, mid-cavity, and apical levels were all significantly related to age and sex in both sexes (all P < 0.05). CONCLUSIONS We provide age- and sex-specific normal values of biventricular strain and SR based on a large sample of healthy Chinese adults with a broad age range. These results may be served as a reference standard for cardiac function assessment, especially for the Chinese population.
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Affiliation(s)
- Gengxiao Li
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Zhen Zhang
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- The Third People's Hospital of Longgang District, Shenzhen, China
| | - Yiyuan Gao
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, USA
| | - Shanshan Zhou
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
| | - Lizhen Cao
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhiwei Zhao
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China
| | - Jun Zhao
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China
| | - Karen Ordovas
- Department of Radiology, University of Washington, Seattle, USA
| | - Mingwu Lou
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.
| | - Kuncheng Li
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China.
| | - Gerald M Pohost
- Zhouxin Medical Imaging and Healthy Screening Centre, Xiamen, China
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Shang Y, Zhang Y, Leng W, Lei X, Chen L, Zhou X, Liang Z, Wang J. Assessment of right ventricular function using cardiovascular magnetic resonance in patients with type 2 diabetes mellitus. Quant Imaging Med Surg 2022; 12:1539-1548. [PMID: 35111646 DOI: 10.21037/qims-21-376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/24/2021] [Indexed: 11/06/2022]
Abstract
Background Accurate evaluation of right ventricular (RV) function is always difficult due to its irregular shape and movement. Many indices have been proposed to assess RV function, but none have been universally accepted. This study evaluated RV function in type 2 diabetes mellitus (T2DM) patients using long-axis strain (LAS) and other traditional indices. Methods Fifty-seven patients with T2DM and 39 healthy controls were prospectively enrolled. Four-chamber cardiovascular magnetic resonance (CMR) and RV short-axis cine images were obtained from all participants to measure the tricuspid annular plane systolic excursion (TAPSE), RV ejection fraction (EF), peak longitudinal strain (PLS) and four LAS indices. The inter-and intraobserver variabilities were also calculated. Results Compared with healthy controls, T2DM was associated with a decreased LAS (apex/lateral wall) (-17.4%±4.2% vs. control, -19.7%±3.7%, P=0.008) and LAS (apex/middle point) (-17.5%±4.5% vs. control, -19.5%±3.9%, P=0.026), but both groups had a similar LAS (RV/lateral wall) and LAS (RV/middle point) (all P>0.05). After adjustments for age and body mass index, a significant difference was observed only for LAS (apex/lateral wall) (P=0.028). There were no significant differences in the TAPSE, RVEF and PLS (all P>0.05). LAS (apex/lateral wall) correlated with the TAPSE (r=-0.723, P<0.001), RVEF (r=-0.270, P=0.008) and PLS (r=0.210, P=0.040). The inter- and intraobserver variability of the LAS (apex/lateral wall) were lower than the other three LAS indices. Conclusions Compared with traditional RV function indices, such as the TAPSE, RVEF and PLS, LAS is easy to obtain and shows high repeatability. LAS (apex/lateral wall) may provide a more sensitive T2DM-related RV dysfunction index.
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Affiliation(s)
- Yongning Shang
- Department of Ultrasound, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.,Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yulin Zhang
- Department of Cardiology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Weiling Leng
- Department of Endocrinology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xiaotian Lei
- Department of Endocrinology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Liu Chen
- Department of Endocrinology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | | | - Ziwen Liang
- Department of Endocrinology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
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Myocardial Mechanics Parameters That Predict Left Ventricular Outflow Tract Obstruction in Patients With Hypertrophic Cardiomyopathy: A Cardiovascular Magnetic Resonance Feature Tracking Analysis. J Comput Assist Tomogr 2021; 45:65-72. [PMID: 32168083 DOI: 10.1097/rct.0000000000000977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify left ventricular (LV) myocardial mechanics predictors of LV outflow tract obstruction (LVOTO) in patients with hypertrophic cardiomyopathy (HCM). METHODS Thirty-nine adults with HCM and 21 controls underwent cardiovascular magnetic resonance. The feature tracking (FT) analysis results of HCM patients with and without LVOTO and controls were compared. RESULTS Global radial strain measured on the short-axis slice (GRS-SAX) (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.02-1.15; P < 0.01), global longitudinal strain measured on the long-axis slice (GLS-LAX) (OR, 1.81; 95% CI, 1.21-2.73; P < 0.01) and GRS measured on the long-axis slice (GRS-LAX) (OR, 1.07; 95% CI, 1.01-1.13; P = 0.02) were independent predictors of LVOTO. The combination of GRS-SAX plus GLS-LAX and GRS-LAX showed great discriminatory power for identifying LVOTO with an area under the receiver operating characteristic curve value of 0.91 (95% CI: 0.81-1.00). CONCLUSIONS In adult HCM patients, GRS-SAX, GLS-LAX, and GRS-LAX were independent predictors of LVOTO. The combination of GRS-SAX plus GLS-LAX and GRS-LAX showed great discriminatory power for identifying LVOTO.
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Pezel T, Viallon M, Croisille P, Sebbag L, Bochaton T, Garot J, Lima JAC, Mewton N. Imaging Interstitial Fibrosis, Left Ventricular Remodeling, and Function in Stage A and B Heart Failure. JACC Cardiovasc Imaging 2020; 14:1038-1052. [PMID: 32828781 DOI: 10.1016/j.jcmg.2020.05.036] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/11/2020] [Accepted: 05/29/2020] [Indexed: 02/07/2023]
Abstract
Myocardial interstitial fibrosis is part of the advanced disease stage of most cardiovascular pathologies. It has been characterized histologically in various disease settings from hypertensive heart disease and diabetic cardiomyopathy to severe aortic stenosis. It is also involved in the process of aging. In cardiovascular medicine, myocardial interstitial fibrosis is associated with several adverse outcomes, especially heart failure (HF) and sudden cardiac death. Until recently, clinical measures of interstitial fibrosis could only be made by invasive myocardial biopsy. The availability of cardiac magnetic resonance (CMR) T1 mapping techniques allows for the indirect measurement of interstitial space characteristics and extracellular volume size, which is closely correlated with collagen content and interstitial infiltration by amyloid and other molecules. There has been significant improvement in the accuracy and reproducibility of T1 acquisition sequences in the last decade; however, the correct use of this technique requires a solid CMR expertise in daily imaging practice. CMR has become the gold standard to assess left ventricular (LV) remodeling and functional features associated with interstitial fibrosis. These features can be detected in the early stages of HF. The main objective of this paper is to review the relevant results of preclinical and clinical observational studies that demonstrate the prognostic impact of interstitial fibrosis assessed by T1 mapping, as well as adverse left ventricular remodeling, as determinants of HF. Therefore, this review focuses on the pathological mechanisms underlying LV remodeling and interstitial fibrosis, in addition to the technical considerations involved in the assessment of interstitial LV fibrosis by CMR. It provides a thorough review of clinical evidence that demonstrates the association of interstitial fibrosis and other-CMR derived LV phenotypes with Stages A and B HF.
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Affiliation(s)
- Theo Pezel
- Department of Cardiology, Paris University, Lariboisiere Hospital, AP-HP, INSERM, UMRS 942, Paris, France; Division of Cardiology, Johns Hopkins University, Baltimore, Maryland
| | - Magalie Viallon
- University Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, Saint-Etienne, France
| | - Pierre Croisille
- University Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, Saint-Etienne, France
| | - Laurent Sebbag
- Heart Failure and Transplant Department, Hospices Civils de Lyon, Hôpital Louis Pradel, Bron, France
| | - Thomas Bochaton
- Hospices Civils de Lyon, Hôpital Louis Pradel, Cardiac Intensive Care Unit, Bron, France
| | - Jerome Garot
- Institut Cardiovasculaire Paris Sud, Cardiovascular Magnetic Resonance Laboratory, Hôpital Privé Jacques Cartier, Ramsay-Générale de Santé, Massy, France
| | - Joao A C Lima
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland
| | - Nathan Mewton
- Cardiovascular Hospital Louis Pradel, Clinical Investigation Center and Heart Failure Department, INSERM 1407, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France.
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Shao G, Cao Y, Cui Y, Han X, Liu J, Li Y, Li N, Liu T, Yu J, Shi H. Early detection of left atrial and bi-ventricular myocardial strain abnormalities by MRI feature tracking in normotensive or hypertensive T2DM patients with preserved LV function. BMC Cardiovasc Disord 2020; 20:196. [PMID: 32326882 PMCID: PMC7178728 DOI: 10.1186/s12872-020-01469-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/06/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Previous studies have found that impaired global myocardial systolic strain is associated with cardiovascular events in T2DM patients. However, the effect of hypertension (HT) on left atrial (LA), right ventricular (RV) and left ventricular (LV) myocardial deformation in hypertensive T2DM patients has not been fully studied by cardiac magnetic resonance feature tracking (CMR-FT). Our aim was to assess LA, RV and LV strain in T2DM patients with T2DM-HT and without hypertension using CMR-FT and to determine the underlying relationships with clinical parameters. METHODS A total of 27 T2DM patients, 23 T2DM-HT patients and 31 controls were studied. LA, LV and RV strain was evaluated using CMR-FT. The clinical and biochemical parameters of the patients were collected. RESULTS The T2DM patients had reduced LA global circumferential strain (LAGCS), radial strain (LAGRS), longitudinal strain (LAGLS) and right ventricular longitudinal strain (RVGLS) compared with the controls (LAGCS: 27.2 ± 2.1% vs 33.5 ± 2.4%; LAGRS: - 28.6 ± 1.1% vs - 31.9 ± 1.3%; LAGLS: 24.3 ± 1.3% vs 31.4 ± 1.5; RVGLS: - 21.4 ± 1.2% vs - 26.3 ± 1.1%, p < 0.05 for all). The T2DM-HT patients had greater LAGCS, LAGRS and LAGLS than the T2DM patients (LAGCS: 40.4 ± 3.8% vs 27.2 ± 2.1%; LAGRS: - 36.8 ± 2.0% vs - 28.6 ± 1.1%; LAGLS: 32.3 ± 2.4% vs 24.3 ± 1.3%, p < 0.05 for all). In the diabetic patients, LAGCS was associated with microalbuminuria levels (standardized ß = - 0.289, p = 0.021), and LAGCS, LAGRS and LAGLS were correlated with diuretic treatment (standardized ß =0.440, - 0.442, and 0.643, p < 0.05 for all). CONCLUSIONS CMR-FT may be considered a promising tool for the early detection of abnormal LA and RV myocardial strain. LA and RV strain values are impaired in T2DM patients. The amelioration of LA strain might be associated with hypertensive compensation or antihypertensive treatment, which requires to be confirmed in larger trials.
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Affiliation(s)
- Guozhu Shao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Yukun Cao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Yue Cui
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Xiaoyu Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Jia Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Yumin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Na Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Tong Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China
| | - Jie Yu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. .,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China.
| | - Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. .,Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, P.R. China.
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Liu H, Wang J, Pan Y, Ge Y, Guo Z, Zhao S. Early and Quantitative Assessment of Myocardial Deformation in Essential Hypertension Patients by Using Cardiovascular Magnetic Resonance Feature Tracking. Sci Rep 2020; 10:3582. [PMID: 32107428 PMCID: PMC7046638 DOI: 10.1038/s41598-020-60537-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/13/2020] [Indexed: 01/19/2023] Open
Abstract
The aims of the study were to identify subclinical global systolic function abnormalities and evaluate influencing factors associated with left ventricular (LV) strain parameters in hypertensive subjects using cardiovascular magnetic resonance imaging feature tracking (CMR-FT). The study enrolled 57 patients with essential hypertension (mean age: 43.04 ± 10.90 years; 35 males) and 26 healthy volunteers (mean age: 38.69 ± 10.44 years; 11 males) who underwent clinical evaluation and CMR examination. Compared with controls, hypertensive patients had significantly impaired myocardial strain values while ejection fraction (EF) did not differ. After multivariate regression analyses adjustment for confounders, the global radial strains (GRS) was independently associated with the mean arterial pressure (MAP) and left ventricular mass index (LVMI) (β = -0.219, p = 0.009 and β = -0.224, p = 0.015, respectively; Adjusted R2 = 0.4); the global circumferential strains (GCS) was also independently associated with the MAP and LVMI (β = 0.084, p = 0.002 and β = 0.073, p = 0.01, respectively; Adjusted R2 = 0.439); the global longitudinal strains (GLS) was independently associated with the Age and MAP (β = 0.065, p = 0.021 and β = 0.077, p = 0.009, respectively; Adjusted R2 = 0.289). Myocardial strain can early detect the myocardial damage and may be an appropriate target for preventive strategies before abnormalities of EF.
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Affiliation(s)
- Huina Liu
- Department of Radiology, Zhengzhou University People's Hospital, Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, People's Republic of China
| | - Jiajia Wang
- Department of Radiology, Zhengzhou University People's Hospital, Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, People's Republic of China
| | - Yukun Pan
- Department of Radiology, Zhengzhou University People's Hospital, Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, People's Republic of China
| | - Yinghui Ge
- Department of Radiology, Zhengzhou University People's Hospital, Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, People's Republic of China.
| | - Zhiping Guo
- Department of Radiology, Zhengzhou University People's Hospital, Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, People's Republic of China.
| | - Shihua Zhao
- Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, People's Republic of China
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Reiber JHC, Pereira GTR, Bezerra HG, De Sutter J, Schoenhagen P, Stillman AE, Van de Veire NRL. Cardiovascular imaging 2018 in the International Journal of Cardiovascular Imaging. Int J Cardiovasc Imaging 2019; 35:1175-1188. [DOI: 10.1007/s10554-019-01579-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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