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Li XM, Shi R, Shen MT, Yan WF, Jiang L, Min CY, Liu XJ, Guo YK, Yang ZG. Impact of Type 2 Diabetes Mellitus on Left Atrioventricular Coupling and Left Atrial Deformation in Patients with Essential Hypertension: An MRI Feature Tracking Study. J Magn Reson Imaging 2024. [PMID: 38703135 DOI: 10.1002/jmri.29427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are both associated with left ventricular (LV) and left atrial (LA) structural and functional abnormalities; however, the relationship between the left atrium and ventricle in this population is unclear. PURPOSE To identify differences between hypertensive patients with and without T2DM as the basis for further investigation the atrioventricular coupling relationship. STUDY TYPE Cross-sectional, retrospective study. POPULATION 89 hypertensive patients without T2DM [HTN (T2DM-)] (age: 58.4 +/- 11.9 years, 48 male), 62 hypertensive patients with T2DM [HTN (T2DM+)] (age: 58.5 +/- 9.1 years, 32 male) and 70 matched controls (age: 55.0 +/- 9.6 years, 37 male). FIELD STRENGTH/SEQUENCE 2D balanced steady-state free precession cine sequence at 3.0 T. ASSESSMENT LA reservoir, conduit, and booster strain (εs, εe, and εa) and strain rate (SRs, SRe, and SRa), LV radial, circumferential and longitudinal peak strain (PS) and peak systolic strain rate and peak diastolic strain rate (PSSR and PDSR) were derived from LA and LV cine images and compared between groups. STATISTICAL TESTS Chi-square or Fisher's exact test, one-way analysis of variance, analysis of covariance, Pearson's correlation, multivariable linear regression analysis, and intraclass correlation coefficient. A P value <0.05 was considered significant. RESULTS Compared with controls, εs, εe, SRe and PS-longitudinal, PDSR-radial, and PDSR-longitudinal were significantly lower in HTN (T2DM-) group, and they were even lower in HTN (T2DM+) group than in both controls and HTN (T2DM-) group. SRs, εa, SRa, as well as PS-radial, PS-circumferential, PSSR-radial, and PSSR-circumferential were significantly lower in HTN (T2DM+) compared with controls. Multivariable regression analyses demonstrated that: T2DM and PS-circumferential and PS-longitudinal (β = -4.026, -0.486, and -0.670, respectively) were significantly associated with εs; T2DM and PDSR-radial and PDSR-circumferential were significantly associated with εe (β = -3.406, -3.352, and -6.290, respectively); T2DM and PDSR-radial were significantly associated with SRe (β = 0.371 and 0.270, respectively); T2DM and PDSR-longitudinal were significantly associated with εa (β = -1.831 and 5.215, respectively); and PDSR-longitudinal was significantly associated with SRa (β = 1.07). DATA CONCLUSION In hypertensive patients, there was severer LA dysfunction in those with coexisting T2DM, which may be associated with more severe LV dysfunction and suggests adverse atrioventricular coupling. EVIDENCE LEVEL 3. TECHNICAL EFFICACY Stage 3.
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Affiliation(s)
- Xue-Ming Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Meng-Ting Shen
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Feng Yan
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Jiang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chen-Yan Min
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiao-Jing Liu
- Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Gao Y, Shi J, Shi Y, Guo L, Zhou S, Zhang F, Guo Y, Gao C, Kong N, Xiang P, Lou M, Xu M. Feasibility and reproducibility of cardiovascular magnetic resonance-feature tracking for quantitative right atrial function in dilated cardiomyopathy patients. Quant Imaging Med Surg 2024; 14:3312-3325. [PMID: 38720832 PMCID: PMC11074740 DOI: 10.21037/qims-23-1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/17/2024] [Indexed: 05/12/2024]
Abstract
Background The importance of right heart assessment in dilated cardiomyopathy (DCM) is increasingly recognized. The development of cardiovascular magnetic resonance-feature tracking (CMR-FT) has provided a novel approach to quantify myocardial deformation and evaluate cardiac function. In this study, we aimed to evaluate the feasibility and reproducibility of CMR-FT for the quantitative derivation of right atrial (RA) strain and strain rate (SR) in patients with DCM. Methods A total of 68 DCM patients (84% male; aged 50.6±13.2 years) and 58 healthy controls (81% male; aged 48.4±11.2 years) were retrospectively enrolled from September 2018 to August 2022 at the First Affiliated Hospital of Zhejiang Chinese Medical University and Shenzhen Clinical Medical College of Guangzhou University of Chinese Medicine. RA reservoir, conduit, and booster strain (εs, εe, and εa) and peak positive, peak early negative, and peak late negative SR (SRs, SRe, and SRa) were measured using CMR-FT and compared between 2 groups using Student's t-test. Intra- and inter-observer reproducibility was evaluated using intraclass correlation coefficients (ICC) and Bland-Altman plots. Results Compared to healthy controls, DCM patients showed significantly lower RA strain (εs: 19.7%±9.0% vs. 44.4%±9.7%; εe: 7.9%±5.3% vs. 25.8%±8.6%; εa: 11.8%±6.2% vs. 18.6%±5.1%, all P<0.001) and SR (SRs: 1.17±0.48 vs. 1.92±0.62 s-1; SRe: -0.85±0.56 vs. -1.94±0.63 s-1; SRa: -1.39±0.71 vs. -2.01±0.65 s-1, all P<0.001). There was no significant difference in RA maximum volume index between the 2 groups. Simple linear regression analysis demonstrated a significant correlation between N-terminal B-type natriuretic peptide (NT-proBNP), RA emptying fraction passive (RAEF passive), and RA εe [(NT-proBNP and εe): r=-0.48, P<0.001, 95% confidence interval (CI): -0.64 to -0.26; and (RAEF passive and εe): r=0.41, P=0.001, 95% CI: 0.22 to 0.56, respectively] in DCM patients. Intra- and inter-observer reproducibility was excellent (all ICCs >0.85) for RA deformation measurements. Conclusions CMR-FT is a promising, noninvasive approach for the quantitative assessment of RA phasic function in patients with DCM. DCM patients exhibit impaired RA reservoir, conduit, and booster pump function prior to visible RA enlargement.
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Affiliation(s)
- Yiyuan Gao
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jingjing Shi
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yujing Shi
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
- Department of Medical Ultrasound, Guangzhou First People’s Hospital, Guangzhou, China
| | - Lingnan Guo
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shanshan Zhou
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
- Medical Imaging Research Institute of Longgang, The Third People’s Hospital of Longgang District, Shenzhen, China
| | - Fan Zhang
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yifan Guo
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Chen Gao
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ning Kong
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ping Xiang
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
| | - Mingwu Lou
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Maosheng Xu
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, China
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Yang Y, Lu M, Guan X, Zhao S, Long L. Left Atrial Dysfunction in Apical Hypertrophic Cardiomyopathy: Assessed by Cardiovascular Magnetic Resonance Feature-tracking. J Thorac Imaging 2024; 39:157-164. [PMID: 37341629 PMCID: PMC11027970 DOI: 10.1097/rti.0000000000000722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
PURPOSE To evaluate the left atrial (LA) function in participants with apical hypertrophic cardiomyopathy (AHCM) by cardiovascular magnetic resonance feature tracking (CMR-FT). MATERIALS AND METHODS Thirty typical AHCM (TAHCM) patients, 23 subclinical AHCM (SAHCM) patients and 32 normal healthy volunteers who underwent CMR exam were retrospectively analyzed. LA reservoir, conduit, and contractile function were quantified by volumetric and CMR-FT derived strain and strain rate (SR) parameters from 2-chamber and 4-chamber cine imaging. RESULTS Compared with healthy participants, both TAHCM and SAHCM patients had impaired LA reservoir function (total strain [%]: TAHCM 31.3±12.2, SAHCM 31.8±12.3, controls 40.4±10.7, P <0.01; total SR [/s]: TAHCM 1.1±0.4, SAHCM 1.1±0.5, controls 1.4 ± 0.4, P <0.01) and conduit function (passive strain [%]: TAHCM 14.4±7.6, SAHCM 16.4±8.8, controls 23.3±8.1, P <0.01; passive SR [/s]: TAHCM -0.5±0.3, SAHCM -0.6±0.3, controls -1.0±0.4, P <0.01). Regarding contraction function, although TAHCM and SAHCM patients had preserved active emptying fraction and strain (all P >0.05), patients with TAHCM had the lowest active SR value among the 3 groups ( P= 0.03). LA reservoir and conduit strain were both significantly associated with left ventricular mass index and maximal wall thickness (all P <0.05). A moderate correlation between LA passive SR and left ventricular cardiac index ( P <0.01). CONCLUSIONS The LA reservoir and conduit function are predominately impaired and appeared in both SAHCM and TAHCM patients.
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Affiliation(s)
- Yingxia Yang
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University
- Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning
| | - Minjie Lu
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Beijing, China
| | - Xuechun Guan
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University
| | - Shihua Zhao
- Department of Magnetic Resonance Imaging, Fuwai Hospital and National Center for Cardiovascular Diseases, Beijing, China
| | - Liling Long
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University
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Gao Y, Pu C, Li Q, Guo Y, Shi J, Zhang Z, Xiang P, Hu X, Wu Y, Zeng Q, Yu R, Hu H, Xu M. Assessment of Right Atrial Function Measured with Cardiac MRI Feature Tracking for Predicting Outcomes in Patients with Dilated Cardiomyopathy. Radiology 2024; 310:e232388. [PMID: 38470238 DOI: 10.1148/radiol.232388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Background Right atrial (RA) function strain is increasingly acknowledged as an important predictor of adverse events in patients with diverse cardiovascular conditions. However, the prognostic value of RA strain in patients with dilated cardiomyopathy (DCM) remains uncertain. Purpose To evaluate the prognostic value of RA strain derived from cardiac MRI (CMR) feature tracking (FT) in patients with DCM. Materials and Methods This multicenter, retrospective study included consecutive adult patients with DCM who underwent CMR between June 2010 and May 2022. RA strain parameters were obtained using CMR FT. The primary end points were sudden or cardiac death or heart transplant. Cox regression analysis was used to determine the association of variables with outcomes. Incremental prognostic value was evaluated using C indexes and likelihood ratio tests. Results A total of 526 patients with DCM (mean age, 51 years ± 15 [SD]; 381 male) were included. During a median follow-up of 41 months, 79 patients with DCM reached the primary end points. At univariable analysis, RA conduit strain was associated with the primary end points (hazard ratio [HR], 0.82 [95% CI: 0.76, 0.87]; P < .001). In multivariable Cox analysis, RA conduit strain was an independent predictor for the primary end points (HR, 0.83 [95% CI: 0.77, 0.90]; P < .001). A model combining RA conduit strain with other clinical and conventional imaging risk factors (C statistic, 0.80; likelihood ratio, 92.54) showed improved discrimination and calibration for the primary end points compared with models with clinical variables (C statistic, 0.71; likelihood ratio, 37.12; both P < .001) or clinical and imaging variables (C statistic, 0.75; likelihood ratio, 64.69; both P < .001). Conclusion CMR FT-derived RA conduit strain was an independent predictor of adverse outcomes among patients with DCM, providing incremental prognostic value when combined in a model with clinical and conventional CMR risk factors. Published under a CC BY 4.0 license. Supplemental material is available for this article.
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Affiliation(s)
- Yiyuan Gao
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Cailing Pu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Qian Li
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Yifan Guo
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Jingjing Shi
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Zhen Zhang
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Ping Xiang
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Xi Hu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Yan Wu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Qingze Zeng
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Risheng Yu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Hongjie Hu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
| | - Maosheng Xu
- From the Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), The First School of Clinical Medicine of Zhejiang Chinese Medical University, No. 54 Youdian Rd, Hangzhou 310006, China (Y. Gao, Y. Guo, J.S., P.X., M.X.); Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (C.P., X.H., Y.W., H.H.); Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China (C.P.); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Q.L., Q.Z., R.Y.); and Medical Imaging Research Institute of Longgang, The Third People's Hospital of Longgang District, Shenzhen, China (Z.Z.)
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Schmidt-Rimpler J, Backhaus SJ, Hartmann FP, Schaten P, Lange T, Evertz R, Schulz A, Kowallick JT, Lapinskas T, Hasenfuß G, Kelle S, Schuster A. Impact of temporal and spatial resolution on atrial feature tracking cardiovascular magnetic resonance imaging. Int J Cardiol 2024; 396:131563. [PMID: 37926379 DOI: 10.1016/j.ijcard.2023.131563] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/27/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Myocardial deformation assessment by cardiovascular magnetic resonance-feature tracking (CMR-FT) has incremental prognostic value over volumetric analyses. Recently, atrial functional analyses have come to the fore. However, to date recommendations for optimal resolution parameters for accurate atrial functional analyses are still lacking. METHODS CMR-FT was performed in 12 healthy volunteers and 9 ischemic heart failure (HF) patients. Cine sequences were acquired using different temporal (20, 30, 40 and 50 frames/cardiac cycle) and spatial resolution parameters (high 1.5 × 1.5 mm in plane and 5 mm slice thickness, standard 1.8 × 1.8 × 8 mm and low 3.0 × 3.0 × 10 mm). Inter- and intra-observer reproducibility were calculated. RESULTS Increasing temporal resolution is associated with higher absolute strain and strain rate (SR) values. Significant changes in strain assessment for left atrial (LA) total strain occurred between 20 and 30 frames/cycle amounting to 2,5-4,4% in absolute changes depending on spatial resolution settings. From 30 frames/cycle onward, absolute strain values remained unchanged. Significant changes of LA strain rate assessment were observed up to the highest temporal resolution of 50 frames/cycle. Effects of spatial resolution on strain assessment were smaller. For LA total strain a general trend emerged for a mild decrease in strain values obtained comparing the lowest to the highest spatial resolution at temporal resolutions of 20, 40 and 50 frames/cycle (p = 0.006-0.046) but not at 30 frames/cycle (p = 0.140). CONCLUSION Temporal and to a smaller extent spatial resolution affect atrial functional assessment. Consistent strain assessment requires a standard spatial resolution and a temporal resolution of 30 frames/cycle, whilst SR assessment requires even higher settings of at least 50 frames/cycle.
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Affiliation(s)
- Jonas Schmidt-Rimpler
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - Sören J Backhaus
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Finn P Hartmann
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany
| | - Philip Schaten
- Graz University of Technology, Institute of Biomedical Imaging, Graz, Austria
| | - Torben Lange
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Ruben Evertz
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Alexander Schulz
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Johannes T Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - Tomas Lapinskas
- German Heart Center Berlin (DHZB), University of Berlin, Department of Internal Medicine / Cardiology, Charité Campus Virchow Clinic, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany; Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gerd Hasenfuß
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Sebastian Kelle
- German Heart Center Berlin (DHZB), University of Berlin, Department of Internal Medicine / Cardiology, Charité Campus Virchow Clinic, Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Andreas Schuster
- University Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany.
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Lange T, Backhaus SJ, Schulz A, Evertz R, Schneider P, Kowallick JT, Hasenfuß G, Kelle S, Schuster A. Inter-study reproducibility of cardiovascular magnetic resonance-derived hemodynamic force assessments. Sci Rep 2024; 14:634. [PMID: 38182625 PMCID: PMC10770352 DOI: 10.1038/s41598-023-50405-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/19/2023] [Indexed: 01/07/2024] Open
Abstract
Cardiovascular magnetic resonance (CMR)-derived hemodynamic force (HDF) analyses have been introduced recently enabling more in-depth cardiac function evaluation. Inter-study reproducibility is important for a widespread clinical use but has not been quantified for this novel CMR post-processing tool yet. Serial CMR imaging was performed in 11 healthy participants in a median interval of 63 days (range 49-87). HDF assessment included left ventricular (LV) longitudinal, systolic peak and impulse, systolic/diastolic transition, diastolic deceleration as well as atrial thrust acceleration forces. Inter-study reproducibility and study sample sizes required to demonstrate 10%, 15% or 20% relative changes of HDF measurements were calculated. In addition, intra- and inter-observer analyses were performed. Intra- and inter-observer reproducibility was excellent for all HDF parameters according to intraclass correlation coefficient (ICC) values (> 0.80 for all). Inter-study reproducibility of all HDF parameters was excellent (ICC ≥ 0.80 for all) with systolic parameters showing lower coeffients of variation (CoV) than diastolic measurements (CoV 15.2% for systolic impulse vs. CoV 30.9% for atrial thrust). Calculated sample sizes to detect relative changes ranged from n = 12 for the detection of a 20% relative change in systolic impulse to n = 200 for the detection of 10% relative change in atrial thrust. Overall inter-study reproducibility of CMR-derived HDF assessments was sufficient with systolic HDF measurements showing lower inter-study variation than diastolic HDF analyses.
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Affiliation(s)
- Torben Lange
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Sören J Backhaus
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Alexander Schulz
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Ruben Evertz
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Patrick Schneider
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Johannes T Kowallick
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, Georg-August University, University Medical Center Göttingen, Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Sebastian Kelle
- Department of Internal Medicine/Cardiology, Charité Campus Virchow Clinic, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Robert-Koch-Str. 40, 37099, Göttingen, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany.
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Zhang J, Xiong Z, Tian D, Hu S, Song Q, Li Z. Compressed sensing cine imaging with higher temporal resolution for analysis of left atrial strain and strain rate by cardiac magnetic resonance feature tracking. Jpn J Radiol 2023; 41:1084-1093. [PMID: 37067751 DOI: 10.1007/s11604-023-01433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 04/10/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Cardiac magnetic resonance (CMR) feature tracking (FT) is more widely used in the measurement of left atrial (LA) strain and strain rate (SR). However, in recent years, researchers have attempted to improve the low temporal resolution of CMR-FT to better capture the subtle deformations of the myocardium. The technique of compressed sensing (CS) has been applied clinically, reducing scan time while increasing temporal resolution. The purpose of this study was to explore the effect of the increased temporal resolution of CS cine sequences on the analysis of LA longitudinal strain and SR. MATERIALS AND METHODS Twenty-nine healthy subjects were included in the study. They underwent CMR with a reference steady-state free precession cine sequence of conventional temporal resolution (standard SSFP sequence), a cine sequence of higher temporal resolution (HT sequence), and an HT cine sequence with CS (CS HT sequence) (temporal resolution: 22.1-44.3/24.9-47.1 ms, 11.1-19.4 ms, and 8.3-19.4 ms, respectively). The standard SSFP sequence, HT sequence, and CS HT sequence were acquired in all subjects during the same scanning session. LA longitudinal strain and SR, reflecting LA reservoir, conduit, and contraction booster-pump function, were measured by CMR-FT and compared among the three sequences. RESULTS The measurements of LASR reservoir, conduit, and booster-pump were significantly higher on the HT and CS HT sequences than on the standard SSFP sequence. The standard SSFP sequence was correlated significantly with the HT and CS HT sequences in terms of LA strain and SR analysis, respectively. The LA strain and SR measurements also showed excellent agreement between the HT and CS HT sequences. CONCLUSION Higher temporal resolution led to significantly higher measured LASR values in CMR-FT. Furthermore, the addition of CS reduced scan time and did not affect LA longitudinal strain or SR analysis.
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Affiliation(s)
- Jingyu Zhang
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Ziqi Xiong
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Di Tian
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Shuai Hu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Qingwei Song
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, China
| | - Zhiyong Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Xigang District, Dalian, 116011, China.
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Schulz A, Lange T, Evertz R, Kowallick JT, Hasenfuß G, Backhaus SJ, Schuster A. Sex-Specific Impairment of Cardiac Functional Reserve in HFpEF: Insights From the HFpEF Stress Trial. JACC. ADVANCES 2023; 2:100327. [PMID: 38938247 PMCID: PMC11198589 DOI: 10.1016/j.jacadv.2023.100327] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 06/29/2024]
Abstract
Background Heart failure with preserved ejection fraction (HFpEF) has been observed to have a twice as high prevalence in women compared to men with similar predisposing risk factors between both sexes. Objectives This study aimed to identify sex-specific pathophysiological features in HFpEF using rest and exercise stress right heart catheterization (RHC), echocardiography and cardiovascular magnetic resonance imaging (CMR). Methods Seventy-five patients with exertional dyspnea, preserved ejection fraction (EF) (≥50%), and signs of diastolic dysfunction on echocardiography were prospectively recruited in the HFpEF Stress Trial. Patients underwent RHC, echocardiography and CMR at rest and during exercise stress. Patients were diagnosed with HFpEF and noncardiac dyspnea according to RHC measurements. Results After exclusion, the final study cohort comprised 68 patients (females n = 44, males n = 24) with a mean age of 66.9 ± 9.7 years. Compared to men, women with HFpEF revealed lower right ventricular stroke volumes during exercise stress (females 38.1 vs males 50.4 mL/m2 BSA; P = 0.011). This was accompanied by a decreasing left atrial EF in women but not men comparing resting to exercise conditions (females -2.7% vs males 2.5%, P = 0.020) and impaired left ventricular filling (females 35.5 vs males 44.2 mL/m2 BSA, P = 0.017) in women with HFpEF during exercise stress. These sex-specific differences were not present in noncardiac dyspnea. Conclusions Women with HFpEF demonstrate sex-specific functional alterations of right ventricular, left atrial, and left ventricular function during exercise stress. This unique pathophysiology represents a sex-specific diagnostic target, which may allow early identification of women with HFpEF for future individualized therapeutic approaches.
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Affiliation(s)
- Alexander Schulz
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Torben Lange
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Ruben Evertz
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Johannes T. Kowallick
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Sören J. Backhaus
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Andreas Schuster
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
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Tondi L, Badano LP, Figliozzi S, Pica S, Torlasco C, Camporeale A, Florescu DR, Disabato G, Parati G, Lombardi M, Muraru D. The use of dedicated long-axis views focused on the left atrium improves the accuracy of left atrial volumes and emptying fraction measured by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2023; 25:10. [PMID: 36793062 PMCID: PMC9933380 DOI: 10.1186/s12968-022-00905-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 11/29/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND The use of apical views focused on the left atrium (LA) has improved the accuracy of LA volume evaluation by two-dimensional (2D) echocardiography. However, routine cardiovascular magnetic resonance (CMR) evaluation of LA volumes still uses standard 2- and 4-chamber cine images focused on the left ventricle (LV). To investigate the potential of LA-focused CMR cine images, we compared LA maximuml (LAVmax) and minimum (LAVmin) volumes, and emptying fraction (LAEF), calculated on both standard and LA-focused long-axis cine images, with LA volumes and LAEF obtained by short-axis cine stacks covering the LA. LA strain was also calculated and compared between standard and LA-focused images. METHODS LA volumes and LAEF were obtained from 108 consecutive patients by applying the biplane area-length algorithm to both standard and LA-focused 2- and 4-chamber cine images. Manual segmentation of a short-axis cine stack covering the LA was used as the reference method. In addition, LA strain reservoir (εs), conduit (εe) and booster pump (εa) were calculated using CMR feature-tracking. RESULTS Compared to the reference method, the standard approach significantly underestimated LA volumes (LAVmax: bias - 13 ml; LOA = + 11, - 37 ml; LAVmax i: bias - 7 ml/m2; LOA = + 7, - 21 ml/m2; LAVmin; bias - 10 ml, LOA: + 9, - 28 ml; LAVmin i: bias - 5 ml/m2, LOA: + 5, - 16 ml/m2), and overestimated LA-EF (bias 5%, LOA: + 23, - 14%). Conversely, LA volumes (LAVmax: bias 0 ml; LOA: + 10, - 10 ml; LAVmax i: bias 0 ml/m2; LOA: + 5, - 6 ml/m2; LAVmin: bias - 2 ml; LOA: + 7, - 10 ml; LAVmin i: bias - 1 ml/m2; LOA: + 3, - 5 ml/m2) and LAEF (bias 2%, LOA: + 11, - 7%) by LA-focused cine images were similar to those measured using the reference method. LA volumes by LA-focused images were obtained faster than using the reference method (1.2 vs 4.5 min, p < 0.001). LA strain (εs: bias 7%, LOA = 25, - 11%; εe: bias 4%, LOA = 15, - 8%; εa: bias 3%, LOA = 14, - 8%) was significantly higher in standard vs. LA-focused images (p < 0.001). CONCLUSION LA volumes and LAEF measured using dedicated LA-focused long-axis cine images are more accurate than using standard LV-focused cine images. Moreover, LA strain is significantly lower in LA-focused vs. standard images.
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Affiliation(s)
- Lara Tondi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
| | - Luigi P Badano
- Department of Cardiology, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy
| | - Stefano Figliozzi
- Clinical Echocardiography Diagnostic Service, Cardio Center, Humanitas Research Hospital IRCCS, Rozzano, Milan, Italy
| | - Silvia Pica
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Camilla Torlasco
- Department of Cardiology, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Antonia Camporeale
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Diana R Florescu
- Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy
- Department of Cardiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Giandomenico Disabato
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
- University of Pavia, Pavia, Italy
| | - Gianfranco Parati
- Department of Cardiology, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy
| | - Massimo Lombardi
- Multimodality Cardiac Imaging Section, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
| | - Denisa Muraru
- Department of Cardiology, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Medicine and Surgery, University Milano-Bicocca, Milan, Italy
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Yang S, Chen X, Zhao K, Yu S, Dong W, Wang J, Yang K, Yang Q, Ma X, Dong Z, Liu L, Song Y, Lu M, Wang S, Zhao S. Reverse remodeling of left atrium assessed by cardiovascular magnetic resonance feature tracking in hypertrophic obstructive cardiomyopathy after septal myectomy. J Cardiovasc Magn Reson 2023; 25:13. [PMID: 36775820 PMCID: PMC9923913 DOI: 10.1186/s12968-023-00915-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/05/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Assessing the structure and function of left atrium (LA) is crucial in hypertrophic obstructive cardiomyopathy (HOCM) because LA remodeling correlates with atrial fibrillation. However, few studies have investigated the potential effect of myomectomy on LA phasic remodeling in HOCM after myectomy using cardiovascular magnetic resonance (CMR) feature tracking (FT). This study aims to evaluate the LA structural and functional remodeling with HOCM after myectomy by CMR-FT and to further investigate the determinants of LA reverse remodeling. METHODS In this single-center study, we retrospectively studied 88 patients with HOCM who received CMR before and after myectomy between January 2011 and June 2021. Preoperative and postoperative LA parameters derived from CMR-FT were compared, including LA reservoir function (total ejection fraction [EF], total strain [εs], peak positive strain rate [SRs]), conduit function (passive EF, passive strain [εe], peak early negative strain rate [SRe]) and booster function (booster EF, active strain [εa], late peak negative strain rate [SRa]). Eighty-six healthy participants were collected for comparison. Univariate and multivariate linear regression identified variables associated with the rate of change of εa. RESULTS Compared with preoperative parameters, LA reservoir function (total EF, εs, SRs), booster function (booster EF, εa, SRa), and SRe were significantly improved after myectomy (all P < 0.05), while no significant differences were observed in passive EF and εe. Postoperative patients with HOCM still had larger LA and worse LA function than healthy controls (all P < 0.05). After analyzing the rates of change in LA parameters, LA boost function, especially εa, showed the most dramatic improvement beyond the improvements in reservoir function, conduit function, and volume. In multivariable regression analysis, minimum LA volume index (adjusted β = - 0.39, P < 0.001) and Δleft ventricular outflow tract (LVOT) pressure gradient (adjusted β = - 0.29, P = 0.003) were significantly related to the rate of change of εa. CONCLUSIONS Patients with HOCM after septal myectomy showed LA reverse remodeling with a reduction in LA size and restoration in LA reservoir and booster function but unchanged LA conduit function. Among volumetric and functional changes, booster function had the greatest improvement postoperatively. Besides, preoperative LAVmin index and ΔLVOT might be potential factors associated with the degree of improvement in εa.
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Affiliation(s)
- Shujuan Yang
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Xiuyu Chen
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Kankan Zhao
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, SZ University Town, Shenzhen, 518055, China
| | - Shiqin Yu
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Wenhao Dong
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Jiaxin Wang
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Kai Yang
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Qiulan Yang
- Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Xuan Ma
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Zhixiang Dong
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Lele Liu
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Yanyan Song
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Minjie Lu
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China
| | - Shuiyun Wang
- Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China.
| | - Shihua Zhao
- MR Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beilishi Rd 167, Xicheng District, Beijing, 100037, China.
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Zhou D, Li X, Yin G, Li S, Zhao S, Liu Z, Lu M. Risk Stratification and Outcomes in Patients With Pulmonary Hypertension: Insights into Right Ventricular Strain by MRI Feature tracking. J Magn Reson Imaging 2023; 57:545-556. [PMID: 35713378 DOI: 10.1002/jmri.28291] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Despite a recommended multidimensional approach for pulmonary hypertension (PH) risk stratification and guidance of treatment decisions, this may not always be achievable in patients with advanced disease. One issue is the lack of an imaging modality to assess right ventricular (RV) structure and function abnormalities. PURPOSE To explore the risk stratification and prognostic value of cardiac MR feature tracking (MR-FT)-derived RV strain. STUDY TYPE Retrospective. POPULATION A total of 80 patients with idiopathic pulmonary artery hypertension (N = 52) or chronic thromboembolic PH (N = 28). FIELD STRENGTH A 1.5 T or 3.0 T, balanced steady-state free precession sequence. ASSESSMENT All patients underwent laboratory testing, right heart catheterization, and MR imaging (and in 37 cases, a cardiopulmonary exercise test was also performed) within a 1-month period. Cardiac functional parameters and both global longitudinal strain (GLS) and global circumferential strain (GCS) were analyzed. Patients were stratified into low, intermediate, and high-risk groups by guideline suggested stratified values of risk factors. The combined endpoint was death or hospitalization for congestive heart failure assessed during follow-up since the date of MR examination. STATISTICAL TESTS Kolmogorov-Smirnov's test, independent-sample t-tests, Wilcoxon's rank-sum tests, one-way analysis of variance, χ2 tests or Fisher's exact test, receiver operating characteristic analysis, Kaplan-Meier survival analysis, and Cox regression analysis. A P value < 0.05 was considered statistically significant. RESULTS The median follow-up duration was 3.4 years. Thirty-five patients presented with combined endpoint including 10 cardiac deaths. RV structural and deformation impairments were significantly associated with combined endpoint (ejection fraction: 31.3% ± 13.2% vs. 38.0% ± 14.8%, hazard ratio [HR: 0.974; GLS: -14.5 [-18.6, -10.9] % vs. -20.4 [-26.0, -13.2] %, HR: 1.071; GCS: -9.8 [-14.5, -7.3] % vs. -12.3 [-19.9, -8.4] %, HR: 1.059). There were significant differences in RVGLS among low, intermediate, and high-risk groups (-19.3% ± 7.2% vs. -17.3% ± 9.4% vs. -11.5% ± 4.4% by cardiac functional class, -21.8% ± 7.3% vs. -19.4% ± 8.2% vs. -12.7 ± 5.3% by NT-proBNP, -19.7% ± 7.7 vs. -15.8% ± 6.5% vs. -12.6% ± 8.2% by cardiac index). DATA CONCLUSION RV deformation may aid risk stratification in patients with PH, providing crucial information for RV remodeling, pulmonary hemodynamic condition and exercise capacity. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Di Zhou
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Li
- Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gang Yin
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Li
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shihua Zhao
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhihong Liu
- Center for Pulmonary Vascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minjie Lu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Key Laboratory of Cardiovascular Imaging (Cultivation), Chinese Academy of Medical Sciences, Beijing, China
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12
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Yao B, Wu R, Chen BH, Wesemann LD, Xu JR, Zhou Y, Wu LM. Cardiovascular magnetic resonance myocardial feature tracking for the determination of left atrial strain in hypertensive left ventricular hypertrophy and hypertrophic cardiomyopathy. Clin Radiol 2023; 78:e409-e416. [PMID: 36746719 DOI: 10.1016/j.crad.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 07/07/2022] [Accepted: 12/28/2022] [Indexed: 01/23/2023]
Abstract
AIM To measure the left atrial (LA) function in patients with hypertrophic cardiomyopathy (HCM; with [OHCM] and without obstruction [NOHCM]) and hypertension-related left ventricular hypertrophy (H-LVH) using cardiovascular magnetic resonance imaging feature tracking (CMR-FT). MATERIALS AND METHODS Patients who met the criteria for HCM (n=68), H-LVH (n=46), and 30 healthy controls participated. Left atrial strain was analysed using CMR-FT in cine images with two and four chambers. RESULTS The strain rate and LA strain measurements showed that patients with HCM, and H-LVH had impaired conduit and reservoir functions (versus controls). These capacities were more severely impaired in OHCM than those seen in NOHCM and H-LVH. The LA volume parameters (LAVIpac, LAVImin and LAVImax) from the OHCM group were higher than both the NOHCM and H-LVH groups (all p<0.05). There were differences between the OHCM and H-LVH groups in terms of the parameters for LA reservoir function (εs), booster pump function (SRa), and conduit function (SRe, LA passive EF, εe; p<0.05). The strongest correlations included the associations between LA total EF and εs, εe and LA passive EF, and SRe and LA passive EF. CONCLUSION CMR-FT can reliably identify LA dysfunction and deformation in the early stages of HCM and H-LVH.
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Affiliation(s)
- B Yao
- Department of Radiology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou 215000, China
| | - R Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - B-H Chen
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - L D Wesemann
- Department of Radiology, School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - J-R Xu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Y Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - L-M Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
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13
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Chen Y, Zhao W, Zhang N, Liu J, Liu D, Sun Z, Xu L, Wen Z. Prognostic Significance of Cardiac Magnetic Resonance in Left Atrial and Biventricular Strain Analysis during the Follow-Up of Suspected Myocarditis. J Clin Med 2023; 12:jcm12020457. [PMID: 36675386 PMCID: PMC9862408 DOI: 10.3390/jcm12020457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/09/2022] [Accepted: 01/04/2023] [Indexed: 01/09/2023] Open
Abstract
To assess the variation in left atrial (LA) and biventricular strain and its prognostic value in the course of suspected myocarditis, this retrospective study included 55 patients with clinically suspected myocarditis who underwent cardiac magnetic resonance (CMR) examinations at baseline and follow-up periods. Cine images were used for feature tracking analysis. Paired Student's t test, McNemar's test, and Cox proportional hazard regression were used for statistical analysis. The LA total emptying fraction was the only functional index that showed a statistically significant improvement. The initial LA peak's late negative strain rate (SRa) was the only parameter with a significant predictive power of major adverse cardiac events under univariable (hazard ratio [HR] 2.396, 95% confidence interval [CI] 1.044-5.498, p = 0.039) and multivariable Cox survival analysis when adjusted by LA strain parameters (HR 5.072, 95% CI 1.478-17.404, p = 0.010), LA strain and functional parameters (HR 7.197, 95% CI 1.679-30.846, p = 0.008), and LA and biventricular strain and functional parameters (HR 10.389, 95% CI 2.250-47.977, p = 0.003). Thus, our findings indicate that CMR strain is useful for monitoring LA and ventricular function in suspected myocarditis, that LA function may recover preceding ventricular function changes, and that LA strain may serve as an incremental tool to predict adverse outcomes.
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Affiliation(s)
- Yan Chen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing 100029, China
| | - Wenjing Zhao
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing 100029, China
| | - Nan Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing 100029, China
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing 100029, China
| | - Dongting Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing 100029, China
| | - Zhonghua Sun
- Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth 6102, Australia
| | - Lei Xu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing 100029, China
- Correspondence: (L.X.); (Z.W.)
| | - Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, Beijing 100029, China
- Correspondence: (L.X.); (Z.W.)
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14
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Schuermans A, den Harink T, Raman B, Smillie RW, Alsharqi M, Mohamed A, Lapidaire W, van Deutekom AW, Leeson P, Lewandowski AJ. Differing Impact of Preterm Birth on the Right and Left Atria in Adulthood. J Am Heart Assoc 2022; 11:e027305. [PMID: 36453643 PMCID: PMC9851437 DOI: 10.1161/jaha.122.027305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 10/17/2022] [Indexed: 12/02/2022]
Abstract
Background Preterm birth affects 10% of live births and is associated with an altered left ventricular and right ventricular phenotype and increased cardiovascular disease risk in young adulthood. Because left atrial (LA) and right atrial (RA) volume and function are known independent predictors of cardiovascular outcomes, we investigated whether these were altered in preterm-born young adults. Methods and Results Preterm-born (n=200) and term-born (n=266) adults aged 18 to 39 years underwent cardiovascular magnetic resonance imaging. LA and RA maximal and minimal volumes (absolute, indexed to body surface area, and as a ratio to ventricular volumes) were obtained to study atrial morphology, while LA and RA stroke volume, strain, and strain rate were used to assess atrial function. Secondary analyses consisted of between-group comparisons based on degree of prematurity. Absolute RA volumes and RA volumes indexed to right ventricular volumes were significantly smaller in preterm-born compared with term-born adults. In addition, RA reservoir and booster strain were higher in preterm-born adults, possibly indicating functional compensation for the smaller RA volumes. LA volumes indexed to left ventricular volumes were significantly greater in preterm-born adults as compared with term-born adults, although absolute LA volumes were similar between groups. LA and RA changes were observed across gestational ages in the preterm group but were greatest in those born very-to-extremely preterm. Conclusions Preterm-born adults show changes in LA and RA structure and function, which may indicate subclinical cardiovascular disease. Further research into underlying mechanisms, opportunities for interventions, and their prognostic value is warranted.
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Affiliation(s)
- Art Schuermans
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Department of Cardiovascular SciencesKU LeuvenLeuvenBelgium
| | - Tamara den Harink
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Department of Epidemiology and Data Science, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
| | - Betty Raman
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Oxford University Hospitals NHS Foundation TrustOxfordUnited Kingdom
| | - Robert W. Smillie
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
| | - Maryam Alsharqi
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Department of Cardiac TechnologyCollege of Applied Medical Sciences, Imam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia
| | - Afifah Mohamed
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Department of Diagnostic Imaging & Applied Health Sciences, Faculty of Health SciencesUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Winok Lapidaire
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
| | - Arend W. van Deutekom
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Department of Paediatrics, Division of Paediatric CardiologyErasmus MC‐Sophia Children’s HospitalRotterdamThe Netherlands
| | - Paul Leeson
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Oxford University Hospitals NHS Foundation TrustOxfordUnited Kingdom
| | - Adam J. Lewandowski
- Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Oxford University Hospitals NHS Foundation TrustOxfordUnited Kingdom
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15
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Schneider JN, Jahnke C, Cavus E, Chevalier C, Bohnen S, Radunski UK, Riedl KA, Tahir E, Adam G, Kirchhof P, Blankenberg S, Lund GK, Müllerleile K. Feature tracking cardiovascular magnetic resonance reveals recovery of atrial function after acute myocarditis. Int J Cardiovasc Imaging 2022; 38:2003-2012. [PMID: 37726601 PMCID: PMC10509057 DOI: 10.1007/s10554-022-02576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/17/2022] [Indexed: 11/24/2022]
Abstract
Follow-up after acute myocarditis is important to detect persisting myocardial dysfunction. However, recovery of atrial function has not been evaluated after acute myocarditis so far. Thirty-five patients with strictly defined acute myocarditis underwent cardiovascular magnetic resonance (CMR, 1.5 T) in the acute stage at baseline (BL) and at 3 months follow-up (FU). The study population included 13 patients with biopsy-proven "cardiomyopathy-like" myocarditis (CLM) and 22 patients with "infarct-like" (ILM) clinical presentation. CMR feature tracking (FT) was performed on conventional cine SSFP sequences. Median LA-GLS increased from 33.2 (14.5; 39.2) at BL to 37.0% (25.2; 44.1, P = 0.0018) at FU in the entire study population. Median LA-GLS also increased from 36.7 (26.5; 42.3) at BL to 41.3% (34.5; 44.8, P = 0.0262) at FU in the ILM subgroup and from 11.3 (6.4; 21.1) at BL to 21.4% (14.2; 30.7, P = 0.0186) at FU in the CLM subgroup. Median RA-GLS significantly increased from BL with 30.8 (22.5; 37.0) to FU with 33.7% (26.8; 45.4, P = 0.0027) in the entire study population. Median RA-GLS also significantly increased from 32.7 (25.8; 41.0) at BL to 35.8% (27.7; 48.0, P = 0.0495) at FU in the ILM subgroup and from 22.8 (13.1; 33.9) at BL to 31.0% (26.0; 40.8, P = 0.0266) at FU in the CLM subgroup. Our findings demonstrate recovery of LA and RA function by CMR-FT strain analyses in patients after acute myocarditis independent from clinical presentation. Monitoring of atrial strain could be an important tool for an individual assessment of healing after acute myocarditis.
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Affiliation(s)
- J N Schneider
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany.
| | - C Jahnke
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - E Cavus
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - C Chevalier
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - S Bohnen
- Department of Cardiology, Asklepios Clinic St. Georg, Hamburg, Germany
| | - U K Radunski
- Department of Cardiology, Regio Clinics Pinneberg and Elmshorn, Hamburg, Germany
| | - K A Riedl
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
| | - E Tahir
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Kirchhof
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - S Blankenberg
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - G K Lund
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Müllerleile
- Department of Cardiology, University Heart and Vascular Center Hamburg, Martinistrasse 52, 20246, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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16
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Yu ZX, Yang W, Yin WS, Peng KX, Pan YL, Chen WW, Du BB, He YQ, Yang P. Clinical utility of left atrial strain in predicting atrial fibrillation recurrence after catheter ablation: An up-to-date review. World J Clin Cases 2022; 10:8063-8075. [PMID: 36159552 PMCID: PMC9403688 DOI: 10.12998/wjcc.v10.i23.8063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/03/2022] [Accepted: 07/17/2022] [Indexed: 02/06/2023] Open
Abstract
Rhythm control is the core part of the integrated management of atrial fibrillation (AF), especially in the early stages. Despite advances in catheter ablation (CA), the recurrence rate of AF after CA remains high. As a result, stratification and early management of AF recurrence after CA are critical. Currently, predictors of recurrence of AF after CA are mostly based on dysfunction caused by structural remodeling, apart from traditional risk factors. Atrial strain is a recently developed important parameter for detecting the deformability of atrial myocardium during the cardiac cycle prior to atrial remodeling. Although there is only preliminary evidence, atrial strain is still a promising parameter in predicting the recurrence of AF after CA at an early stage. This review focuses on the evaluation of atrial strain, the current applications of atrial strain in assessing atrial function, and predicting the recurrence of AF after CA. We summarize the contents related as follows: (1) CA for rhythm control in AF; (2) Evaluation methods of atrial strain; (3) Atrial strain in the remodeling and reverse remodeling of AF; and (4) Clinical applications of atrial strain in predicting the recurrence of AF after CA. Although there is accumulating evidence on the role of decreased atrial strain in the early prediction of AF recurrence, atrial strain is limited in clinical practice for lacking exact cut-off values and difficulty in distinguishing specific function phases of the atrium. More research is needed in the future to add strength to the early prediction value of atrial strain in AF recurrences.
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Affiliation(s)
- Zhi-Xi Yu
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Wen Yang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Wei-Si Yin
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Ke-Xin Peng
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Yi-Lin Pan
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Wei-Wei Chen
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Bei-Bei Du
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Yu-Quan He
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
| | - Ping Yang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
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17
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Zhang Y, Li XM, Shen MT, Huang S, Li Y, Yang ZG. Atrioventricular coupling and left atrial abnormality in type 2 diabetes mellitus with functional mitral regurgitation patients verified by cardiac magnetic resonance imaging. Cardiovasc Diabetol 2022; 21:100. [PMID: 35681217 PMCID: PMC9185866 DOI: 10.1186/s12933-022-01536-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 05/30/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Functional mitral regurgitation (FMR) in type 2 diabetes mellitus (T2DM) patients induced by left ventricular (LV) enlargement and mitral valve abnormality may aggravated the impairment in left atrial (LA) compliance. Thus, this study aimed to depict how FMR and LV dysfunction affect LA compliance in T2DM patients with FMR. MATERIALS AND METHODS A total of 148 patients with T2DM and 49 age- and sex-matched normal controls underwent cardiac magnetic resonance examination. LA longitudinal strain and LA and LV functional indices were compared among controls and different T2DM patients. The multivariate analysis was used to identify the independent indicators of LA longitudinal strain. RESULTS T2DM Patients without FMR had a lower total LA empty fraction (LAEF) compared with the controls (all P < 0.05). T2DM patients with mild and moderate FMR showed increased LA volume (LAV) and LV volume while decreased LAEF, LA strain, and LV ejection fraction (P < 0.05). T2DM patients with severe FMR showed markedly increased LAV and LV volume while decreased LAEF, LA strain, and LVEF (P < 0.05). In T2DM patients with FMR, reservoir strain (εs) was independently correlated with LV end-diastolic volume (LVEDV) (β = - 0.334) and regurgitation degree (β = - 0.256). The passive strain (εe) was independently correlated with regurgitation degree (β = - 0.297), whereas the active strain (εa) was independently correlated with LVESV (β = - 0.352) and glycated haemoglobin (β = - 0.279). CONCLUSION FMR may aggravate LA and LV dysfunction in T2DM patients. Regurgitation degree was an independent determinant of the εs and the εe, LVEDV was an independent determinant of the εs, and LVESV was an independent determinant of the εa in T2DM patients with FMR.
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Affiliation(s)
- Yi Zhang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.,Department of Radiology, School of Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, 55# Lan 4 RenMing Road (South), Chengdu, 610041, Sichuan, China
| | - Xue-Ming Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.,Department of Radiology, School of Medicine, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, 55# Lan 4 RenMing Road (South), Chengdu, 610041, Sichuan, China
| | - Meng-Ting Shen
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Shan Huang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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18
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Hou J, Sun Y, Zhang L, Wang W, You H, Zhang R, Yang B, Wang H. Assessing left atrial function in patients with atrial fibrillation and valvular heart disease using cardiovascular magnetic resonance imaging. Clin Cardiol 2022; 45:527-535. [PMID: 35289415 PMCID: PMC9045075 DOI: 10.1002/clc.23811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 12/11/2022] Open
Abstract
Background Atrial fibrillation (AF) is common arrhythmia in valvular heart disease (VHD) and is associated with adverse outcomes. Hypothesis To evaluate the left atrial (LA) function in patients with AF‐VHD by cardiovascular magnetic resonance imaging feature tracking (CMR‐FT) using LA strain (εs/εe/εa) and their corresponding strain rate (SRs/SRe/SRa). Methods This was a retrospective cross‐sectional inter‐reader and intra‐reader reproducibility conducted from July 1, 2020, to January 31, 2021. A total of 39 patients with AF‐VHD (rheumatic heart valvular disease [RHVD] [n = 22], degenerative heart valvular disease [DHVD] [n = 17]) underwent MRI scans performed with drug‐controlled heart rate before correcting the rhythm and valves through maze procedure. Fifteen participants with normal cardiac MRI were included as healthy control. εs/SRs, εe/SRe, and εa/SRa, corresponding to LA reservoir, conduit, and booster‐pump function, were assessed using Feature Tracking software (CVI42 v5.12.1). Results Compared with healthy controls, LA global strain parameters (εs/εe/εa/SRs/SRe/SRa) were significantly decreased (all p < 0.001), while LA size and volume were increased in AF‐VHD group (all p < 0.001). In the subgroup, RHVD group showed lower LA total ejection fraction (LATEF) and strain data than DHVD group (12.6% ± 3.3% vs. 19.4 ± 8.6, p = 0.001). Decreased LATEF was significantly related to altered LA strain and strain rate, especially in εs, εe, and SRs (Pearson/Spearman r/ρ = 0.856/0.837/0.562, respectively; all p < 0.001). Interstudy and intrastudy reproducibility were consistent for LA volumetry and strain parameters (intraclass correlation coefficient: 0.88–0.99). Conclusions CMR‐FT can be used to assess the LA strain parameters, and identify LA dysfunction and deformation noninvasively, which could be a helpful functional imaging biomarker in the clinical treatment of AF‐VHD.
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Affiliation(s)
- Jie Hou
- College of Medical and Biological Informatics Engineering, Northeastern University, Shenyang, China.,Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.,Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China
| | - Yu Sun
- College of Medical and Biological Informatics Engineering, Northeastern University, Shenyang, China.,Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.,Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China
| | - Libo Zhang
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.,Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China
| | - Wei Wang
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.,Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China
| | - Hongrui You
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.,Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China
| | - Rongrong Zhang
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.,Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China
| | - Benqiang Yang
- Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.,Key Laboratory of Cardiovascular Imaging and Research of Liaoning Province, Shenyang, China
| | - Huishan Wang
- Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China
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19
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Zhou D, Yang W, Yang Y, Yin G, Li S, Zhuang B, Xu J, He J, Wu W, Jiang Y, Sun X, Wang Y, Sirajuddin A, Zhao S, Lu M. Left atrial dysfunction may precede left atrial enlargement and abnormal left ventricular longitudinal function: a cardiac MR feature tracking study. BMC Cardiovasc Disord 2022; 22:99. [PMID: 35282817 PMCID: PMC8919633 DOI: 10.1186/s12872-022-02532-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 02/28/2022] [Indexed: 01/22/2023] Open
Abstract
Abstract
Background
The role of the dysfunction of left atrium in the occurrence and development of cardiovascular disease has been gradually recognized. We aim to compare the impact on left atrial (LA) function between patients with hypertrophic cardiomyopathy (HCM) and hypertension (HTN) without LA enlargement using cardiovascular magnetic resonance feature tracking (CMR-FT), and if possible, explore the capability of LA function for providing clinical implication and predicting clinical adverse events in the early stage of cardiovascular disease.
Methods
Consecutive 60 HCM patients and 60 HTN patients with normal LA size among 1413 patients who underwent CMR were retrospectively analyzed as well as 60 controls. Left atrial and ventricular functions were quantified by volumetric and CMR-FT derived strain analysis from long and short left ventricular view cines. The primary endpoint was a composite of all-cause death, stroke, new-onset or worsening heart failure to hospitalization, and paroxysmal or persistent atrial fibrillation.
Results
Compared to the controls, both HTN and HCM participants had impaired LA reservoir function (εs) and conduit function (εe) with the different stage of LA booster pump dysfunction (εa). LA strain was more sensitive than LV longitudinal strain (GLS) for evaluate primary endpoint (εs: 33.9% ± 7.5 vs. 41.2% ± 14.3, p = 0.02; εe: 13.6% ± 6.2 vs. 17.4% ± 10.4, p = 0.03; εa: 20.2% ± 6.0 vs. 23.7% ± 8.8, p = 0.07; GLS: -19.4% ± 6.4 vs. -20.0% ± 6.8, p = 0.70, respectively). After a mean follow-up of 6.8 years, 23 patients reached primary endpoint. Cox regression analyses indicated impaired LA reservoir and booster pump strain were associated with clinical outcomes in patients at the early stage of HTN and HCM (p < 0.05).
Conclusions
CMR-FT-derived strain is a potential and robust tool in demonstrating impaired LA mechanics, quantifying LA dynamics and underlining the impacts on LA-LV coupling in patients with HTN and HCM without LA enlargement. The corresponding LA dysfunction is a promising metric to assess clinical implication and predict prognosis at the early stage, superior to GLS.
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20
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Xu J, Yang W, Zhao S, Lu M. State-of-the-art myocardial strain by CMR feature tracking: clinical applications and future perspectives. Eur Radiol 2022; 32:5424-5435. [PMID: 35201410 DOI: 10.1007/s00330-022-08629-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 01/13/2023]
Abstract
Based on conventional cine sequences of cardiac magnetic resonance (CMR), feature tracking (FT) is an emerging tissue tracking technique that evaluates myocardial motion and deformation quantitatively by strain, strain rate, torsion, and dyssynchrony. It has been widely accepted in modern literature that strain analysis can offer incremental information in addition to classic global and segmental functional analysis. Furthermore, CMR-FT facilitates measurement of all cardiac chambers, including the relatively thin-walled atria and the right ventricle, which has been a difficult measurement to obtain with the reference standard technique of myocardial tagging. CMR-FT objectively quantifies cardiovascular impairment and characterizes myocardial function in a novel way through direct assessment of myocardial fiber deformation. The purpose of this review is to discuss the current status of clinical applications of myocardial strain by CMR-FT in a variety of cardiovascular diseases. KEY POINTS: • CMR-FT is of great value for differential diagnosis and provides incremental value for evaluating the progression and severity of diseases. • CMR-FT guides the early diagnosis of various cardiovascular diseases and provides the possibility for the early detection of myocardial impairment and additional information regarding subclinical cardiac abnormalities. • Direct assessment of myocardial fiber deformation using CMR-FT has the potential to provide prognostic information incremental to common clinical and CMR risk factors.
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Affiliation(s)
- Jing Xu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, 100037, China.,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Wenjing Yang
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, 100037, China.,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Shihua Zhao
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, 100037, China.,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Minjie Lu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Beijing, 100037, China. .,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China. .,Key Laboratory of Cardiovascular Imaging (Cultivation), Chinese Academy of Medical Sciences, Beijing, 100037, China.
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21
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Peters DC, Lamy J, Sinusas AJ, Baldassarre LA. Left atrial evaluation by cardiovascular magnetic resonance: sensitive and unique biomarkers. Eur Heart J Cardiovasc Imaging 2021; 23:14-30. [PMID: 34718484 DOI: 10.1093/ehjci/jeab221] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/12/2021] [Indexed: 12/12/2022] Open
Abstract
Left atrial (LA) imaging is still not routinely used for diagnosis and risk stratification, although recent studies have emphasized its importance as an imaging biomarker. Cardiovascular magnetic resonance is able to evaluate LA structure and function, metrics that serve as early indicators of disease, and provide prognostic information, e.g. regarding diastolic dysfunction, and atrial fibrillation (AF). MR angiography defines atrial anatomy, useful for planning ablation procedures, and also for characterizing atrial shapes and sizes that might predict cardiovascular events, e.g. stroke. Long-axis cine images can be evaluated to define minimum, maximum, and pre-atrial contraction LA volumes, and ejection fractions (EFs). More modern feature tracking of these cine images provides longitudinal LA strain through the cardiac cycle, and strain rates. Strain may be a more sensitive marker than EF and can predict post-operative AF, AF recurrence after ablation, outcomes in hypertrophic cardiomyopathy, stratification of diastolic dysfunction, and strain correlates with atrial fibrosis. Using high-resolution late gadolinium enhancement (LGE), the extent of fibrosis in the LA can be estimated and post-ablation scar can be evaluated. The LA LGE method is widely available, its reproducibility is good, and validations with voltage-mapping exist, although further scan-rescan studies are needed, and consensus regarding atrial segmentation is lacking. Using LGE, scar patterns after ablation in AF subjects can be reproducibly defined. Evaluation of 'pre-existent' atrial fibrosis may have roles in predicting AF recurrence after ablation, predicting new-onset AF and diastolic dysfunction in patients without AF. LA imaging biomarkers are ready to enter into diagnostic clinical practice.
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Affiliation(s)
- Dana C Peters
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Jérôme Lamy
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Albert J Sinusas
- Department of Cardiology, Yale School of Medicine, New Haven, CT, USA
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22
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Shi R, Shi K, Huang S, Li X, Xia CC, Li Y, He S, Li ZL, He Y, Guo YK, Yang ZG. Association Between Heart Failure With Preserved Left Ventricular Ejection Fraction and Impaired Left Atrial Phasic Function in Hypertrophic Cardiomyopathy: Evaluation by Cardiac MRI Feature Tracking. J Magn Reson Imaging 2021; 56:248-259. [PMID: 34799953 DOI: 10.1002/jmri.28000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The majority of heart failure (HF) in hypertrophic cardiomyopathy (HCM) manifests as a phenotype with preserved left ventricular (LV) ejection fraction; however, the exact contribution of left atrial (LA) phasic function to HF with preserved ejection fraction (HFpEF) in HCM remains unresolved. PURPOSE To define the association between LA function and HFpEF in HCM patients using cardiac magnetic resonance imaging (MRI) feature tracking. STUDY TYPE Retrospective. POPULATION One hundred and fifty-four HCM patients (HFpEF vs. non-HF: 55 [34 females] vs. 99 [43 females]). FIELD STRENGTH/SEQUENCE 3.0 T/balanced steady-state free precession. ASSESSMENT LA reservoir function (reservoir strain [εs ], total ejection fraction [EF]), conduit function (conduit strain [εe ], passive EF), booster-pump function (booster strain [εa ] and active EF), LA volume index, and LV global longitudinal strain (LV GLS) were evaluated in HCM patients. STATISTICAL TESTS Chi-square test, Student's t-test, Mann-Whitney U test, multivariate linear regression, logistic regression, and net reclassification analysis were used. Two-sided P < 0.05 was considered statistically significant. RESULTS No significant difference was found in LV GLS between the non-HF and HFpEF group (-10.67 ± 3.14% vs. -10.14 ± 4.01%, P = 0.397), whereas the HFpEF group had more severely impaired LA phasic strain (εs : 27.40 [22.60, 35.80] vs. 18.15 [11.98, 25.90]; εe : 13.80 [9.20, 18.90] vs. 7.95 [4.30, 14.35]; εa : 13.50 [9.90, 17.10] vs. 7.90 [5.40, 14.15]). LA total EF (37.91 [29.54, 47.94] vs. 47.49 [39.18, 55.01]), passive EF (14.70 [7.41, 21.49] vs. 18.07 [9.32, 24.78]), and active EF (27.19 [17.79, 36.60] vs. 36.64 [26.63, 42.71]) were all significantly decreased in HFpEF patients compared with non-HF patients. LA reservoir (β = 0.90 [0.85, 0.96]), conduit (β = 0.93 [0.87, 0.99]), and booster (β = 0.86 [0.78, 0.95]) strain were independently associated with HFpEF in HCM patients. The model including reservoir strain (Net Reclassification Index [NRI]: 0.260) or booster strain (NRI: 0.325) improved the reclassification of HFpEF based on LV GLS and minimum left atrial volume index (LAVImin ). DATA CONCLUSION LA phasic function was severely impaired in HCM patients with HFpEF, whereas LV function was not further impaired compared with non-HF patients. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Rui Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ke Shi
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Shan Huang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Chun-Chao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Sen He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhen-Lin Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Yong He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Ying-Kun Guo
- Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Zhi-Gang Yang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
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23
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Truong VT, Palmer C, Wolking S, Sheets B, Young M, Ngo TNM, Taylor M, Nagueh SF, Zareba KM, Raman S, Mazur W. Normal left atrial strain and strain rate using cardiac magnetic resonance feature tracking in healthy volunteers. Eur Heart J Cardiovasc Imaging 2021; 21:446-453. [PMID: 31504357 DOI: 10.1093/ehjci/jez157] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS The aim of our study was to establish normal ranges for left atrial (LA) strain and strain rate using cardiac magnetic resonance feature tracking (CMR-FT), LA sphericity index, and to compare LA strain using CMR-FT with 2D-speckle tracking echocardiography (STE) in a healthy population. METHODS AND RESULTS A total of 112 volunteers (45 male, 67 female) had adequate tracking for analysis on CMR-FT (Circle Cardiovascular Imaging, Calgary, Canada). The median age was 42 years (range 19-79 years, interquartile range 30-53 years). LA reservoir, conduit, booster strain, strain rate using CMR-FT, and sphericity index were evaluated. Of the 112 volunteers, 91 patients had adequate tracking on 2D-STE using three commonly applied zero-baseline time reference methods: R-R gating, P-P gating, and volume gating (defining end-systole at the LA maximum and end-diastole at the LA minimum). The LA strain, strain rate using CMR-FT, and sphericity index were reported and comparable between both genders (P > 0.05 for all). The LA booster function including strain and strain rate increased significantly with age (P < 0.001 for all), while the LA conduit function gradually decreased. In comparison with STE, the LA reservoir strain was comparable between CMR and volume-gating methods (38.48 ± 9.31 vs. 36.77 ± 6.46; P = 0.13) but not with R-R and P-P gating methods (P < 0.001 for all). LA strain, strain rate, and sphericity index using CMR-FT had good intraobserver and interobserver reproducibility. CONCLUSION LA strain, strain rate using CMR-FT, and sphericity index can be quickly assessed with good intraobserver and interobserver reproducibility.
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Affiliation(s)
- Vien T Truong
- Cardiology Department, The Christ Hospital Health Network, 2139 Auburn Ave, Cincinnati, OH, 45219, USA.,Cardiology Department, The Sue and Bill Butler Research Fellow, The Linder Research Center, 2139 Auburn Ave, Cincinnati, OH, USA
| | - Cassady Palmer
- Cardiology Department, The Christ Hospital Health Network, 2139 Auburn Ave, Cincinnati, OH, 45219, USA
| | - Sarah Wolking
- Cardiology Department, The Christ Hospital Health Network, 2139 Auburn Ave, Cincinnati, OH, 45219, USA
| | - Brandy Sheets
- Cardiology Department, The Christ Hospital Health Network, 2139 Auburn Ave, Cincinnati, OH, 45219, USA
| | - Michael Young
- Cardiology Department, The Christ Hospital Health Network, 2139 Auburn Ave, Cincinnati, OH, 45219, USA
| | - Tam N M Ngo
- Cardiology Department, The Christ Hospital Health Network, 2139 Auburn Ave, Cincinnati, OH, 45219, USA
| | - Michael Taylor
- Cardiology Department, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Sherif F Nagueh
- Cardiology Department, Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, 6565 Fannin St, Houston, TX, 77030, USA
| | - Karolina M Zareba
- Cardiology Department, Ohio State University Wexner Medical Center, 410W 10th Ave, Columbus, OH, 43210, USA
| | - Subha Raman
- Cardiology Department, Ohio State University Wexner Medical Center, 410W 10th Ave, Columbus, OH, 43210, USA
| | - Wojciech Mazur
- Cardiology Department, The Christ Hospital Health Network, 2139 Auburn Ave, Cincinnati, OH, 45219, USA
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24
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Alfuhied A, Kanagala P, McCann GP, Singh A. Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease. Int J Cardiovasc Imaging 2021; 37:3355-3369. [PMID: 34169399 PMCID: PMC8557157 DOI: 10.1007/s10554-021-02316-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 06/14/2021] [Indexed: 01/20/2023]
Abstract
The left atrium (LA) plays a vital role in maintaining normal cardiac function. LA volume and function have been utilised as important imaging biomarkers, with their prognostic value demonstrated in multiple cardiac conditions. More recently, there has been a sharp increase in the number of publications utilising LA strain by echocardiography and cardiac magnetic resonance (CMR) imaging. However, little is known about its prognostic value or reproducibility as a technique. In this review, we aim to highlight the conventional and novel imaging techniques available for LA assessment, using echocardiography and CMR, their role as an imaging biomarker in cardiovascular disease, the reproducibility of the techniques and the current limitations to their clinical application. We identify a need for further standardisation of techniques, with establishment of ‘normal’ cut-offs before routine clinical application can be made.
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Affiliation(s)
- Aseel Alfuhied
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.,King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Prathap Kanagala
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.,Aintree University Hospital, Liverpool, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
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25
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Gonzales RA, Seemann F, Lamy J, Arvidsson PM, Heiberg E, Murray V, Peters DC. Automated left atrial time-resolved segmentation in MRI long-axis cine images using active contours. BMC Med Imaging 2021; 21:101. [PMID: 34147081 PMCID: PMC8214286 DOI: 10.1186/s12880-021-00630-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/10/2021] [Indexed: 12/28/2022] Open
Abstract
Background Segmentation of the left atrium (LA) is required to evaluate atrial size and function, which are important imaging biomarkers for a wide range of cardiovascular conditions, such as atrial fibrillation, stroke, and diastolic dysfunction. LA segmentations are currently being performed manually, which is time-consuming and observer-dependent. Methods This study presents an automated image processing algorithm for time-resolved LA segmentation in cardiac magnetic resonance imaging (MRI) long-axis cine images of the 2-chamber (2ch) and 4-chamber (4ch) views using active contours. The proposed algorithm combines mitral valve tracking, automated threshold calculation, edge detection on a radially resampled image, edge tracking based on Dijkstra’s algorithm, and post-processing involving smoothing and interpolation. The algorithm was evaluated in 37 patients diagnosed mainly with paroxysmal atrial fibrillation. Segmentation accuracy was assessed using the Dice similarity coefficient (DSC) and Hausdorff distance (HD), with manual segmentations in all time frames as the reference standard. For inter-observer variability analysis, a second observer performed manual segmentations at end-diastole and end-systole on all subjects. Results The proposed automated method achieved high performance in segmenting the LA in long-axis cine sequences, with a DSC of 0.96 for 2ch and 0.95 for 4ch, and an HD of 5.5 mm for 2ch and 6.4 mm for 4ch. The manual inter-observer variability analysis had an average DSC of 0.95 and an average HD of 4.9 mm. Conclusion The proposed automated method achieved performance on par with human experts analyzing MRI images for evaluation of atrial size and function. Video Abstract
Supplementary Information The online version contains supplementary material available at 10.1186/s12880-021-00630-3.
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Affiliation(s)
- Ricardo A Gonzales
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.,Department of Electrical Engineering, Universidad de Ingeniería y Tecnología, Lima, Peru.,Department of Clinical Physiology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Felicia Seemann
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.,Department of Clinical Physiology, Lund University, Skåne University Hospital, Lund, Sweden.,Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Jérôme Lamy
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Per M Arvidsson
- Department of Clinical Physiology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Einar Heiberg
- Department of Clinical Physiology, Lund University, Skåne University Hospital, Lund, Sweden.,Department of Biomedical Engineering, Lund University, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Victor Murray
- Department of Electrical Engineering, Universidad de Ingeniería y Tecnología, Lima, Peru.,John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts, United States of America.,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, New Mexico, United States of America
| | - Dana C Peters
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Yale University, New Haven, Connecticut, United States of America.
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26
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Comprehensive assessment of left atrial and ventricular remodeling in paroxysmal atrial fibrillation by the cardiovascular magnetic resonance myocardial extracellular volume fraction and feature tracking strain. Sci Rep 2021; 11:10941. [PMID: 34035345 PMCID: PMC8149643 DOI: 10.1038/s41598-021-90117-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/28/2021] [Indexed: 01/18/2023] Open
Abstract
Atrial fibrillation (AF) is a progressive disease that starts with structural or functional changes in the left atrium and left ventricle, and evolves from paroxysmal toward sustained forms. Early detection of structural or functional changes in the left atrium and left ventricle in the paroxysmal stage could be useful for identifying a higher risk of progression to persistent AF and future cardio-cerebrovascular events. The aim of this study was to test the hypothesis that the feature tracking (FT) left atrial (LA) strain and left ventricular (LV) extracellular volume fraction (ECV) derived from cardiovascular magnetic resonance (CMR) could detect early changes in remodeling of the left atrium and ventricle in the paroxysmal AF (PAF) stage. The participants were comprised of 106 PAF patients (age, 66.1 ± 10.7 years; 66% male) who underwent clinical CMR before pulmonary vein isolation and 20 control subjects (age, 68.3 ± 8.6 years; 55% male). The CMR-FT LA strain/phasic function and LV-ECV were compared between the PAF and control groups. The total and passive LA empty fraction (LAEF) and LA strain (corresponding to LA reservoir and conduit function) were decreased in the PAF group as compared to the control group. However, active LAEF (corresponding to the LA booster pump function) did not differ significantly between the PAF group (33.9 ± 10.9%) and control group (37.9 ± 13.3%, p = 0.15), while the active LA strain (corresponding to the LA booster pump function) was significantly decreased in the PAF group (11.4 ± 4.3 vs. 15.2 ± 5.6%, p = 0.002). The LV-ECV was significantly greater in the PAF group (28.7 ± 2.8%) than control group (26.6 ± 2.0%, p = 0.002). In the PAF group, the LV-ECV correlated significantly with the E/e′ and LA volume index. Regarding the LA strain, correlations were seen between the LV-ECV and both the reservoir function and conduit function. CMR-FT LA strain in combination with the LV-ECV in a single clinical study offers a potential imaging marker that identifies LA/LV remodeling including subtle LA booster pump dysfunction undetectable by the conventional booster pump LAEF in the PAF stage.
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Alfuhied A, Marrow BA, Elfawal S, Gulsin GS, Graham-Brown MP, Steadman CD, Kanagala P, McCann GP, Singh A. Reproducibility of left atrial function using cardiac magnetic resonance imaging. Eur Radiol 2020; 31:2788-2797. [PMID: 33128187 PMCID: PMC8043954 DOI: 10.1007/s00330-020-07399-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/23/2020] [Accepted: 10/08/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the test-retest reproducibility and observer variability of CMR-derived LA function, using (i) LA strain (LAS) and strain rate (LASR), and (ii) LA volumes (LAV) and emptying fraction (LAEF). METHODS Sixty participants with and without cardiovascular disease (aortic stenosis (AS) (n = 16), type 2 diabetes (T2D) (n = 28), end-stage renal disease on haemodialysis (n = 10) and healthy volunteers (n = 6)) underwent two separate CMR scans 7-14 days apart. LAS and LASR, corresponding to LA reservoir, conduit and contractile booster-pump function, were assessed using Feature Tracking software (QStrain v2.0). LAEF was calculated using the biplane area length method (QMass v8.1). Both were assessed using 4- and 2-chamber long-axis standard steady-state free precession cine images, and average values were calculated. Intra- and inter-observer variabilities were assessed in 10 randomly selected participants. RESULTS The test-retest reproducibility was moderate to poor for all strain and strain rate parameters. Overall, strain and strain rate corresponding to reservoir phase (LAS_r, LASR_r) were the most reproducible, yielding the smallest coefficient of variance (CoV) (29.9% for LAS_r, 28.9% for LASR_r). The test-retest reproducibility for LAVs and LAEF was good: LAVmax CoV = 19.6% ICC = 0.89, LAVmin CoV = 27.0% ICC = 0.89 and total LAEF CoV = 15.6% ICC = 0.78. The inter- and intra-observer variabilities were good for all parameters except for conduit function. CONCLUSION The test-retest reproducibility of LA strain and strain rate assessment by CMR utilising Feature Tracking is moderate to poor across disease states, whereas LA volume and emptying fraction are more reproducible on CMR. Further improvements in LA strain quantification are needed before widespread clinical application. KEY POINTS • LA strain and strain rate assessment using Feature Tracking on CMR has moderate to poor test-retest reproducibility across disease states. • The test-retest reproducibility for the biplane method of assessing LA function is better than strain assessment, with lower coefficient of variances and narrower limits of agreement on Bland-Altman plots. • Biplane LA volumetric measurement also has better intra- and inter-observer variability compared to strain assessment.
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Affiliation(s)
- Aseel Alfuhied
- Department of Cardiovascular Sciences, Cardiovascular Theme National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester, Groby Road, Leicester, LE3 9QP, UK.,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Benjamin A Marrow
- Department of Cardiovascular Sciences, Cardiovascular Theme National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester, Groby Road, Leicester, LE3 9QP, UK
| | - Sara Elfawal
- Department of Radiology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Gaurav S Gulsin
- Department of Cardiovascular Sciences, Cardiovascular Theme National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester, Groby Road, Leicester, LE3 9QP, UK
| | | | | | - Prathap Kanagala
- Department of Cardiovascular Sciences, Cardiovascular Theme National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester, Groby Road, Leicester, LE3 9QP, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, Cardiovascular Theme National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester, Groby Road, Leicester, LE3 9QP, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, Cardiovascular Theme National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester, Groby Road, Leicester, LE3 9QP, UK.
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28
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He J, Xu J, Chen L, Ji K, Fan X, Zhao S, Lu M. Clinical features and cardiovascular magnetic resonance characteristics in Danon disease. Clin Radiol 2020; 75:712.e1-712.e11. [PMID: 32499120 DOI: 10.1016/j.crad.2020.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 04/23/2020] [Indexed: 12/12/2022]
Abstract
AIMS To investigate the clinical spectrum, cardiovascular magnetic resonance imaging (cMRI) characteristics, including T1 and extracellular volume fraction, and outcomes of Danon disease to facilitate further understanding of the phenotype of patients with Danon disease. MATERIALS AND METHODS The study comprised six male patients 8-23 years old recruited to the study between 2014-2019. The clinical presentation, laboratory examinations, pathology/genetic analysis, electrocardiography (ECG), echocardiography, and cCMRI characteristics were summarised. RESULTS Five out of six patients suffered from hypertrophic cardiomyopathy (HCM) phenotype of Danon disease, while one patient had dilated cardiomyopathy (DCM) phenotype. Left ventricular (LV) and left atrial (LA) function were impaired at strain measurement. Diffuse and focal late gadolinium enhancement (LGE) were observed separately in the LV walls of three patients and right ventricular (RV) insertion points of the remaining three patients. Furthermore, values for the native T1 (mean 1313.3 ms) and extracellular volume fraction (ECV; mean 39.17%) of three patients were increased. CONCLUSIONS Both dilated and hypertrophic cardiomyopathy may be the phenotypes of Danon disease. Comprehensive cCMRI played a unique role in the diagnosis and grading severity and risk factors of Danon disease in vivo, especially by using robust quantitative strain analysis, T1 mapping, and further ECV calculation.
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Affiliation(s)
- J He
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - J Xu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - L Chen
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - K Ji
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - X Fan
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - S Zhao
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - M Lu
- Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Imaging (Cultivation), Chinese Academy of Medical Sciences, Beijing 100037, China.
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29
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Truong VT, Palmer C, Young M, Wolking S, Ngo TNM, Sheets B, Hausfeld C, Ornella A, Taylor MD, Zareba KM, Raman SV, Mazur W. Right Atrial Deformation Using Cardiovascular Magnetic Resonance Myocardial Feature Tracking Compared with Two-Dimensional Speckle Tracking Echocardiography in Healthy Volunteers. Sci Rep 2020; 10:5237. [PMID: 32251322 PMCID: PMC7089993 DOI: 10.1038/s41598-020-62105-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/03/2020] [Indexed: 11/08/2022] Open
Abstract
Speckle tracking echocardiography (STE), and more recently, cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) provides insight into all phases of atrial function. The aim of our study was to compare all phases of RA strain using CMR-FT and STE and also assess the relationship between RA and LA strain. A total of 61 healthy volunteers with mean age of 45 ± 13 years had adequate tracking for analysis on CMR-FT and 2D-STE. Females had larger RA reservoir strain (39 ± 15% vs. 32 ± 13%, p = 0.046) and conduit strain (26 ± 12% vs. 20 ± 9%, p = 0.03) when compared to males, but was not the case with booster strain (14 ± 7% vs. 12 ± 6%, p = 0.45). In comparison with STE derived strain, the RA reservoir and conduit strain were not significantly different between CMR-FT and the three echocardiography gating methods (p > 0.05 for all). Noticeably, there were no significant differences in strain and strain rate between RA and LA function using CMR-FT (p > 0.05 for all). RA strain and strain rate using CMR-FT had fair and good intra- and inter-observer reproducibility and had superior reproducibility compared to STE derived strain.
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Affiliation(s)
- Vien T Truong
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
- The Sue and Bill Butler Research Fellow, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Cassady Palmer
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Michael Young
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Sarah Wolking
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Tam N M Ngo
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Brandy Sheets
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Chelsey Hausfeld
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Allison Ornella
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA
| | - Michael D Taylor
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | | | - Subha V Raman
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Wojciech Mazur
- The Christ Hospital Health Network, The Lindner Research Center, Cincinnati, Ohio, USA.
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Schuster A, Backhaus SJ, Stiermaier T, Navarra JL, Uhlig J, Rommel KP, Koschalka A, Kowallick JT, Bigalke B, Kutty S, Gutberlet M, Hasenfuß G, Thiele H, Eitel I. Impact of Right Atrial Physiology on Heart Failure and Adverse Events after Myocardial Infarction. J Clin Med 2020; 9:jcm9010210. [PMID: 31940959 PMCID: PMC7019524 DOI: 10.3390/jcm9010210] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Right ventricular (RV) function is a known predictor of adverse events in heart failure and following acute myocardial infarction (AMI). While right atrial (RA) involvement is well characterized in pulmonary arterial hypertension, its relative contributions to adverse events following AMI especially in patients with heart failure and congestion need further evaluation. Methods: In this cardiovascular magnetic resonance (CMR)-substudy of AIDA STEMI and TATORT NSTEMI, 1235 AMI patients underwent CMR after primary percutaneous coronary intervention (PCI) in 15 centers across Germany (n = 795 with ST-elevation myocardial infarction and 440 with non-ST-elevation MI). Right atrial (RA) performance was evaluated using CMR myocardial feature tracking (CMR-FT) for the assessment of RA reservoir (total strain εs), conduit (passive strain εe), booster pump function (active strain εa), and associated strain rates (SR) in a blinded core-laboratory. The primary endpoint was the occurrence of major adverse cardiac events (MACE) 12 months post AMI. Results: RA reservoir (εsp = 0.061, SRs p = 0.049) and conduit functions (εep = 0.006, SRe p = 0.030) were impaired in patients with MACE as opposed to RA booster pump (εap = 0.579, SRa p = 0.118) and RA volume index (p = 0.866). RA conduit function was associated with the clinical onset of heart failure and MACE independently of RV systolic function and atrial fibrillation (AF) (multivariable analysis hazard ratio 0.95, 95% confidence interval 0.92 to 0.99, p = 0.009), while RV systolic function and AF were not independent prognosticators. Furthermore, RA conduit strain identified low- and high-risk groups within patients with reduced RV systolic function (p = 0.019 on log rank testing). Conclusions: RA impairment is a distinct feature and independent risk factor in patients following AMI and can be easily assessed using CMR-FT-derived quantification of RA strain.
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Affiliation(s)
- Andreas Schuster
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, German Center for Cardiovascular Research (DZHK), 37075 Göttingen, Germany; (S.J.B.); (J.-L.N.); (A.K.); (G.H.)
- Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney 2065, Australia
- Correspondence: ; Tel.: +49-551-39-20870; Fax: +49-551-39-22026
| | - Sören J. Backhaus
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, German Center for Cardiovascular Research (DZHK), 37075 Göttingen, Germany; (S.J.B.); (J.-L.N.); (A.K.); (G.H.)
| | - Thomas Stiermaier
- University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, German Center for Cardiovascular Research (DZHK), 23538 Lübeck, Germany; (T.S.); (I.E.)
| | - Jenny-Lou Navarra
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, German Center for Cardiovascular Research (DZHK), 37075 Göttingen, Germany; (S.J.B.); (J.-L.N.); (A.K.); (G.H.)
| | - Johannes Uhlig
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Georg-August University, German Center for Cardiovascular Research (DZHK), 37075 Göttingen, Germany; (J.U.); (J.T.K.)
| | - Karl-Philipp Rommel
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig Heart Institute, 04289 Leipzig, Germany; (K.-P.R.); (H.T.)
| | - Alexander Koschalka
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, German Center for Cardiovascular Research (DZHK), 37075 Göttingen, Germany; (S.J.B.); (J.-L.N.); (A.K.); (G.H.)
| | - Johannes T. Kowallick
- University Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Georg-August University, German Center for Cardiovascular Research (DZHK), 37075 Göttingen, Germany; (J.U.); (J.T.K.)
| | - Boris Bigalke
- Department of Cardiology and Pneumology, Charité Campus Benjamin Franklin, University Medical Center Berlin, 12203 Berlin, Germany;
| | - Shelby Kutty
- Taussig Heart Center, Johns Hopkins Hospital, Baltimore, MD 21287, USA;
| | - Matthias Gutberlet
- Department of Radiology, Heart Center Leipzig, University of Leipzig, 04289 Leipzig, Germany;
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Georg-August University, German Center for Cardiovascular Research (DZHK), 37075 Göttingen, Germany; (S.J.B.); (J.-L.N.); (A.K.); (G.H.)
| | - Holger Thiele
- Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig Heart Institute, 04289 Leipzig, Germany; (K.-P.R.); (H.T.)
| | - Ingo Eitel
- University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, German Center for Cardiovascular Research (DZHK), 23538 Lübeck, Germany; (T.S.); (I.E.)
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Cardiac magnetic resonance-derived right atrial functional analysis in patients with atrial fibrillation and typical atrial flutter. J Interv Card Electrophysiol 2019; 59:381-391. [PMID: 31807985 DOI: 10.1007/s10840-019-00636-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Typical atrial flutter (AFL) often occurs in patients with atrial fibrillation (AF). Decision-making tools for application of prophylactic cavo-tricuspid isthmus (CTI) ablation at the time of AF ablation may improve outcomes. In this study, we sought to define the right atrial (RA) functional characteristics of AF patients with documented typical AFL. METHODS Consecutive patients that underwent cardiac magnetic resonance (CMR) prior to initial AF ablation in the Johns Hopkins Hospital were enrolled. The AF database was reviewed to identify prevalent and incident documented typical AFL. Feature tracking CMR analysis during sinus rhythm was utilized to quantify RA longitudinal strain and strain rate, as well as RA passive and active emptying fractions derived from phasic RA volumes. RESULTS A total of 115 patients were analyzed (mean age 59.1 ± 11.4 years, 78.3% male, 74.8% paroxysmal AF). Of all patients, 30 (26.1%) had typical AFL. Clinical characteristics and AF type did not differ among groups defined by the absence or presence of typical AFL. In contrast, RA longitudinal strain (41.6 ± 16.8% vs. 55.8 ± 17.1%, p ≤ 0.001), systolic strain rate (1.71 ± 0.85 s-1 vs. 2.33 ± 0.93 s-1, p = 0.002), and late diastolic strain rate (1.78 ± 1.02 s-1 vs. 2.50 ± 0.91 s-1 p ≤ 0.001) were significantly lower in patients with typical AFL. Although RA passive emptying fraction was similar among groups (18.9 ± 8.1 vs. 19.5 ± 8.0, p = 0.75), RA active emptying fraction was lower in patients with typical AFL (34.8 ± 12.3 vs. 40.8 ± 12.1, p = 0.02). CONCLUSIONS The reservoir and pump function of the RA is significantly reduced in patients with typical AFL. Prophylactic CTI ablation warrants further study as adjunctive therapy to AF catheter ablation in selected patients with RA dysfunction.
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Schuster A, Backhaus SJ, Stiermaier T, Navarra JL, Uhlig J, Rommel KP, Koschalka A, Kowallick JT, Lotz J, Gutberlet M, Bigalke B, Kutty S, Hasenfuss G, Thiele H, Eitel I. Left Atrial Function with MRI Enables Prediction of Cardiovascular Events after Myocardial Infarction: Insights from the AIDA STEMI and TATORT NSTEMI Trials. Radiology 2019; 293:292-302. [PMID: 31526253 DOI: 10.1148/radiol.2019190559] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background The role of left atrial (LA) performance in acute myocardial infarction (AMI) remains controversial. Cardiac MRI myocardial feature tracking (hereafter, MRI-FT) is a method used to quantify myocardial function that enables reliable assessment of atrial function. Purpose To assess the relationship between LA function assessed with MRI-FT and major adverse cardiovascular events (MACE) after AMI. Materials and Methods This secondary analysis of two prospective multicenter cardiac MRI studies (AIDA STEMI [NCT00712101] and TATORT NSTEMI [NCT01612312]) included 1235 study participants with ST-elevation myocardial infarction (n = 795) or non-ST-elevation myocardial infarction (n = 440) between July 2008 and June 2013. All study participants underwent primary percutaneous coronary intervention. MRI-FT analyses were performed in a core laboratory by researchers blinded to clinical status to determine LA performance using LA reservoir function peak systolic strain (εs), LA conduit strain (εe), and LA booster pump function active strain (εa). The relationship of LA performance to a MACE within 12 months after AMI was evaluated by using Cox proportional hazards models and area under the receiver operating characteristic curve (AUC). Results Study participants with MACE had worse LA performance parameters compared with study participants without MACE (εs = 21.2% vs 16.2%, εe = 8.8% vs 6.9%, εa = 11.8% vs 10%; P < .001 for all). All atrial parameters were strongly associated with MACE (hazard ratio [HR], εs = 0.9, εe = 0.88, εa = 0.89; P < .001 for all). For εs, a cutoff of 18.8% was identified as the only independent atrial parameter with which to predict MACE after accounting for confounders and established prognostic markers in adjusted analysis (HR, 0.95; P = .02). The εs yielded incremental prognostic value above left ventricular ejection fraction, global longitudinal strain, microvascular obstruction, and infarct size (AUC comparisons, P < .04 for all). Conclusion Feature tracking of cardiac MRI to derive left atrial peak reservoir strain provided incremental prognostic value for major adverse cardiovascular events prediction versus established cardiac risk factors after acute myocardial infarction. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Almeida in this issue.
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Affiliation(s)
- Andreas Schuster
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Sören J Backhaus
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Thomas Stiermaier
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Jenny-Lou Navarra
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Johannes Uhlig
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Karl-Philipp Rommel
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Alexander Koschalka
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Johannes T Kowallick
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Joachim Lotz
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Matthias Gutberlet
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Boris Bigalke
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Shelby Kutty
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Gerd Hasenfuss
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Holger Thiele
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
| | - Ingo Eitel
- From the Department of Cardiology, 5th Floor, Acute Services Building, Royal North Shore Hospital, Reserve Road, St Leonard's, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, NSW, 2065, Australia (A.S.); Department of Cardiology and Pneumology (A.S., S.J.B., J.L.N., A.K., G.H.) and Institute for Diagnostic and Interventional Radiology (J.U., J.T.K., J.L.), University Medical Center Göttingen, Georg-August University, Göttingen, Germany; German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany (A.S., S.J.B., J.L.N., A.K., G.H., J.U., J.T.K., J.L.) ; University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany (T.S., I.E.); German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany (T.S., I.E.); Departments of Internal Medicine/Cardiology (K.P.R., H.T.) and Radiology (M.G.), Heart Center Leipzig, University of Leipzig, Leipzig, Germany; Charité Campus Benjamin Franklin, Department of Cardiology, University Medical Center Berlin, Berlin, Germany (B.B.); and Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD (S.K.)
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Fonseca AC, Marto JP, Alves PN, Inácio N, Viana-Baptista M, Pinho E Melo T, Ferro JM, Almeida AG. Women Who Have Ischemic Strokes Have a Higher Burden of Left Atrial Fibrosis Than Men. Stroke 2019; 49:2584-2589. [PMID: 30355185 DOI: 10.1161/strokeaha.118.022105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background and Purpose- Women with atrial fibrillation (AF) have a higher risk of stroke than men who have AF. Atrial fibrosis is a marker of atrial disease that precedes the appearance of AF increasing the risk of ischemic stroke. We aimed to determine whether female sex is independently associated with left atrial fibrosis in stroke patients. Methods- We prospectively included a consecutive sample of ischemic stroke patients aged over 50 years of age. Late gadolinium enhancement cardiac magnetic resonance imaging was performed to quantify the severity of left atrial fibrosis and the wall pattern of its distribution. A multivariable linear regression analysis was performed to determine whether female sex was independently associated with left atrial fibrosis after adjusting for potential confounders namely AF and age. Results- One hundred twenty-four patients were deemed eligible; 117 patients were included (7 were excluded because of cardiomyopathy identified by cardiac magnetic resonance imaging). All had usable cardiac magnetic resonance imaging data. Fifty-three patients (45.3%) were women. Women were older and were less frequently treated with angiotensin-converting-enzyme inhibitors. Ninety-one patients had any degree of atrial fibrosis. Women had a higher percentage of atrial fibrosis than men-median (interquartile range)-18% (17) versus 10% (20). In a multivariable linear regression model adjusted for demographics, medications, AF, comorbidities, and cardiac parameters, female sex was found to be independently associated with left atrial fibrosis. Women were found to have more 4.70% of left atrial fibrosis than men (95% CI, 0.70-8.71%; P=0.02) after controlling for confounders. Conclusions- Female sex was found to be independently associated with left atrial fibrosis after controlling for confounders such as AF and age. Further studies are needed to understand if this contributes to the increased stroke risk related to AF in women compared with men.
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Affiliation(s)
- Ana Catarina Fonseca
- From the Department of Neurology, Institute of Molecular Medicine (A.C.F., P.N.A., T.P.M., J.M.F.), University of Lisboa, Portugal
| | - João Pedro Marto
- Department of Neurology, Hospital Egas Moniz, Lisboa, Portugal (J.P.M., M.V.-B.)
| | - Pedro N Alves
- From the Department of Neurology, Institute of Molecular Medicine (A.C.F., P.N.A., T.P.M., J.M.F.), University of Lisboa, Portugal
| | - Nuno Inácio
- Department of Neurology, Hospital Beatriz Ângelo, Loures, Portugal (N.I.)
| | | | - Teresa Pinho E Melo
- From the Department of Neurology, Institute of Molecular Medicine (A.C.F., P.N.A., T.P.M., J.M.F.), University of Lisboa, Portugal
| | - José M Ferro
- From the Department of Neurology, Institute of Molecular Medicine (A.C.F., P.N.A., T.P.M., J.M.F.), University of Lisboa, Portugal
| | - Ana G Almeida
- Department of Cardiology (A.G.A.), Hospital de Santa Maria, University of Lisboa, Portugal
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Almeida AG. The Importance of Left Atrial Function for Prognosis after Acute Myocardial Infarction. Radiology 2019; 293:303-304. [PMID: 31532301 DOI: 10.1148/radiol.2019191933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Ana G Almeida
- From the Department of Cardiology, Faculty of Medicine of Lisbon University, Santa Maria Hospital/CHLN, CAML, CCUL, Av. Professor Egas Moniz, 1649-035 Lisbon, Portugal
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Li L, Chen X, Yin G, Yan W, Cui C, Cheng H, Lu M, Zhao S. Early detection of left atrial dysfunction assessed by CMR feature tracking in hypertensive patients. Eur Radiol 2019; 30:702-711. [PMID: 31515621 DOI: 10.1007/s00330-019-06397-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/22/2019] [Accepted: 07/26/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate whether early left atrial (LA) dysfunction in hypertension (HTN), with or without left ventricular hypertrophy (LVH), can be detected by cardiovascular magnetic resonance feature tracking (CMR-FT). METHODS Seventy-three HTN patients and 29 healthy controls were retrospectively recruited. HTN patients were divided into the LVH (n = 29) and non-LVH group (n = 44). LA performance was analysed using CMR-FT in 2- and 4-chamber cine images, including LA reservoir function (total ejection fraction [EF], total strain [εs], peak positive strain rate [SRs]), conduit function (passive EF, passive strain [εe], peak early negative strain rate [SRe]) and booster pump function (booster EF, active strain [εa], late peak negative strain rate [SRa]). One-way analysis of variance with post hoc LSD tests, Spearman analysis, receiver operating characteristic curve and intra-class correlation coefficient analysis were applied for statistical analyses. RESULTS Compared with healthy controls, LA reservoir (LA total EF, εs, SRs) and conduit function (LA passive EF, εe, SRe) were significantly impaired in HTN patients with or without LVH, and these parameters significantly correlated with mitral E/A < 1 (all p < 0.05). However, LA booster pump function was relatively preserved in non-LVH patients, representing an intermediate stage between the LVH group and controls. Among LA deformation parameters, εe showed the highest diagnostic value for differentiation of HTN patients with healthy controls (AUC, 0.82; sensitivity, 80.82%; specificity, 72.41%). Observer reproducibility was good-excellent (ICC, 0.83-0.97) for all CMR-FT derived parameters. CONCLUSIONS CMR-FT is a promising tool for quantification of LA function. LA reservoir and conduit dysfunction might be detected early by CMR-FT in HTN patients before the presence of LVH. KEY POINTS • CMR-FT is a promising tool in quantifying LA function, including deformation and volumetric parameters. • LA reservoir and conduit dysfunction might be detected early by CMR-FT in HTN patients with or without LVH. • The LA booster pump function was relatively preserved in non-LVH patients.
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Affiliation(s)
- Lu Li
- Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Xiuyu Chen
- Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Gang Yin
- Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Weipeng Yan
- Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Chen Cui
- Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Huaibin Cheng
- Department of Function Test Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Minjie Lu
- Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China
| | - Shihua Zhao
- Department of CMR, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xi Cheng District, Beijing, 100037, China.
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Backhaus SJ, Stiermaier T, Lange T, Chiribiri A, Uhlig J, Freund A, Kowallick JT, Gertz RJ, Bigalke B, Villa A, Lotz J, Hasenfuß G, Thiele H, Eitel I, Schuster A. Atrial mechanics and their prognostic impact in Takotsubo syndrome: a cardiovascular magnetic resonance imaging study. Eur Heart J Cardiovasc Imaging 2019; 20:1059-1069. [DOI: 10.1093/ehjci/jey219] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
AbstractAimsThe exact pathophysiology of Takotsubo syndrome (TTS) remains not fully understood with most studies focussing on ventricular pathology. Since atrial involvement may have a significant role, we assessed the diagnostic and prognostic potential of atrial cardiovascular magnetic resonance feature tracking (CMR-FT) in TTS.Methods and resultsThis multicentre study recruited 152 TTS patients who underwent CMR on average within 3 days after hospitalization. Reservoir [total strain εs and peak positive strain rate (SR) SRs], conduit (passive strain εe and peak early negative SRe), and booster pump function (active strain εa and peak late negative SRa) were assessed in a core laboratory. Results were compared with 21 control patients with normal biventricular function. A total of 20 patients underwent follow-up CMR (median 3.5 months, interquartile range 3–5). All patients were approached for general follow-up. Left atrial (LA) but not right atrial (RA) reservoir and conduit function were impaired during the acute phase (εs: P = 0.043, εe: P < 0.001, SRe: P = 0.047 vs. controls) and recovered until follow-up (εs: P < 0.001, SRs: P = 0.04, εe: P = 0.001, SRe: P = 0.04). LA and RA booster pump function were increased in the acute setting (LA-εa: P = 0.045, SRa: P = 0.002 and RA-εa: P = 0.004, SRa: P = 0.002 vs. controls). LA-εs predicted mortality [hazard ratio 1.10, 95% confidence interval (CI) 1.01–1.20; P = 0.037] irrespectively of established cardiovascular risk factors (P = 0.019, multivariate analysis) including left ventricular ejection fraction (LVEF) (area under the curve 0.71, 95% CI 0.55–0.86, P = 0.048).ConclusionTTS pathophysiology comprises transient impairments in LA reservoir and conduit functions and enhanced bi-atrial active booster pump functions. Atrial CMR-FT may evolve as a superior marker of adverse events over and above established parameters such as LVEF and atrial volume.
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Affiliation(s)
- Sören J Backhaus
- Department of Cardiology and Pneumology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
| | - Thomas Stiermaier
- Department of Cardiology/Angiology/Intensive Care Medicine, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Torben Lange
- Department of Cardiology and Pneumology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
| | - Amedeo Chiribiri
- Division of Imaging Sciences and Biomedical Engineering, Department of Cardiovascular Imaging, King’s College London, St Thomas’ Hospital, Westminster Bridge Road, SW1 7EH London, UK
| | - Johannes Uhlig
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - Anne Freund
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University of Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany
| | - Johannes T Kowallick
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - Roman J Gertz
- Department of Cardiology and Pneumology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
| | - Boris Bigalke
- Department of Cardiology and Pneumology, Charité Campus Benjamin Franklin, University Medical Center Berlin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Adriana Villa
- Division of Imaging Sciences and Biomedical Engineering, Department of Cardiovascular Imaging, King’s College London, St Thomas’ Hospital, Westminster Bridge Road, SW1 7EH London, UK
| | - Joachim Lotz
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
- Institute for Diagnostic and Interventional Radiology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
| | - Holger Thiele
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University of Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany
| | - Ingo Eitel
- Department of Cardiology/Angiology/Intensive Care Medicine, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, Georg-August University, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch-Str. 42a, 37075 Göttingen, Germany
- Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Nothern Clinical School, University of Sydney, 5th Floor, Acute Services Building, Reserve Road, St Leonard’s, Sydney, NSW 2065, Australia
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Culprit vessel-related myocardial mechanics and prognostic implications following acute myocardial infarction. Clin Res Cardiol 2019; 109:339-349. [DOI: 10.1007/s00392-019-01514-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 06/21/2019] [Indexed: 01/04/2023]
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von Roeder M, Kowallick JT, Rommel KP, Blazek S, Besler C, Fengler K, Lotz J, Hasenfuß G, Lücke C, Gutberlet M, Thiele H, Schuster A, Lurz P. Right atrial-right ventricular coupling in heart failure with preserved ejection fraction. Clin Res Cardiol 2019; 109:54-66. [PMID: 31053957 DOI: 10.1007/s00392-019-01484-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/23/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Right ventricular (RV) function is prognostically relevant in heart failure with preserved ejection fraction (HFpEF) but data on profound assessment of RV and right atrial (RA) interaction in HFpEF are lacking. The current study characterizes RV and RA interaction using invasive pressure-volume-loop analysis and cardiac magnetic resonance imaging (CMR) data. METHODS AND RESULTS We performed CMR and myocardial feature-tracking in 24 HFpEF patients and 12 patients without HFpEF. Invasive pressure-volume-loops were obtained to evaluate systolic and diastolic RV properties. RV early filling was determined from CMR RV volume-time curves. RV systolic function was slightly increased in HFpEF (RV EF 68 ± 8 vs. 60 ± 9%, p = 0.01), while no differences in RV stroke volume were found (45 ± 7 vs 42 ± 9 ml/m2, p = 0.32). RV early filling was decreased in HFpEF (21 ± 11 vs. 40 ± 11% of RV filling volume, p < 0.01) and RV early filling was the strongest predictor for VO2max even after inclusion of invasively derived RV stiffness and relaxation constant (Beta 0.63, p < 0.01). RA conduit-function was lower in HFpEF (RA conduit-strain - 11 ± 5 vs. - 16 ± 4%, p < 0.01) while RA booster-pump-function was increased (RA active-strain - 18 ± 6 vs. - 12 ± 6%, p = 0.01) as a compensation. RV filling was associated with RA conduit-function (r = - 0.55, p < 0.01) but not with invasively derived RV relaxation constant. CONCLUSION In compensated HFpEF patients RV early filling was impaired and compensated by increased RA booster pump function, while RV systolic function was preserved. Impaired RV diastology and RA-RV interaction were linked to impaired exercise tolerance and RA-RV-coupling seems to be independent of RV relaxation, suggestive of an independent pathophysiological contribution of RA dysfunction in HFpEF. CLINICAL-TRIAL-REGISTRATION NCT02459626 (www.clinicaltrials.gov).
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Affiliation(s)
- Maximilian von Roeder
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Struempellstrasse 39, 04289, Leipzig, Germany
| | - Johannes Tammo Kowallick
- Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research Partner Site Göttingen), Göttingen, Germany
| | - Karl-Philipp Rommel
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Struempellstrasse 39, 04289, Leipzig, Germany
| | - Stephan Blazek
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Struempellstrasse 39, 04289, Leipzig, Germany
| | - Christian Besler
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Struempellstrasse 39, 04289, Leipzig, Germany
| | - Karl Fengler
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Struempellstrasse 39, 04289, Leipzig, Germany
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research Partner Site Göttingen), Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research Partner Site Göttingen), Göttingen, Germany
| | - Christian Lücke
- Department of Radiology, Heart Center Leipzig, University Hospital, Leipzig, Germany
| | - Matthias Gutberlet
- Department of Radiology, Heart Center Leipzig, University Hospital, Leipzig, Germany
| | - Holger Thiele
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Struempellstrasse 39, 04289, Leipzig, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research Partner Site Göttingen), Göttingen, Germany.,Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, Australia
| | - Philipp Lurz
- Department of Internal Medicine/Cardiology, Heart Center Leipzig, University Hospital, Struempellstrasse 39, 04289, Leipzig, Germany.
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Peng J, Zhao X, Zhao L, Fan Z, Wang Z, Chen H, Leng S, Allen J, Tan RS, Koh AS, Ma X, Lou M, Zhong L. Normal Values of Myocardial Deformation Assessed by Cardiovascular Magnetic Resonance Feature Tracking in a Healthy Chinese Population: A Multicenter Study. Front Physiol 2018; 9:1181. [PMID: 30233388 PMCID: PMC6129778 DOI: 10.3389/fphys.2018.01181] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/06/2018] [Indexed: 01/15/2023] Open
Abstract
Reference values on atrial and ventricular strain from cardiovascular magnetic resonance (CMR) are essential in identifying patients with impaired atrial and ventricular function. However, reference values have not been established for Chinese subjects. One hundred and fifty healthy volunteers (75 Males/75 Females; 18–82 years) were recruited. All underwent CMR scans with images acceptable for further strain analysis. Subjects were stratified by age: Group 1, 18–44 years; Group 2, 45–59 years; Group 3, ≥60 years. Feature tracking of CMR cine imaging was used to obtain left atrial global longitudinal (LA Ell) and circumferential strains (LA Ecc) and respective systolic strain rates, left ventricular longitudinal (LV Ell), circumferential (LV Ecc) and radial strains (LV Err) and their respective strain rates, and right ventricular longitudinal strain (RV Ell) and strain rate. LA Ell and LA Ecc were 32.8 ± 9.2% and 40.3 ± 13.4%, respectively, and RV Ell was −29.3 ± 6.0%. LV Ell, LV Ecc and LV Err were −22.4 ± 2.9%, −24.3 ± 3.1%, and 79.0 ± 19.4%, respectively. LV Ell and LV Ecc were higher in females than males (P < 0.05). LA Ell, LA Ecc, and LV Ecc decreased, while LV Err increased with age (P < 0.05). LV Ell and RV Ell were not shown to be associated with age. Normal ranges for atrial and ventricular strain and strain rates are provided using CMR feature tracking in Chinese subjects.
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Affiliation(s)
- Junping Peng
- Department of Radiology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.,Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.,Post-Doctoral Research Center, Department of Radiology, Longgang Central Hospital, Shenzhen Clinical Medical Institute, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Xiaodan Zhao
- National Heart Centre Singapore, Singapore, Singapore
| | - Lei Zhao
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhanming Fan
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zheng Wang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Hui Chen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Shuang Leng
- National Heart Centre Singapore, Singapore, Singapore
| | - John Allen
- Duke-NUS Medical School, Singapore, Singapore
| | - Ru-San Tan
- National Heart Centre Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Angela S Koh
- National Heart Centre Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Xiaohai Ma
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Mingwu Lou
- Post-Doctoral Research Center, Department of Radiology, Longgang Central Hospital, Shenzhen Clinical Medical Institute, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Liang Zhong
- National Heart Centre Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
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40
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Steinmetz M, Broder M, Hösch O, Lamata P, Kutty S, Kowallick JT, Staab W, Ritter CO, Hasenfuß G, Paul T, Lotz J, Schuster A. Atrio-ventricular deformation and heart failure in Ebstein's Anomaly - A cardiovascular magnetic resonance study. Int J Cardiol 2018; 257:54-61. [PMID: 29402525 PMCID: PMC5856281 DOI: 10.1016/j.ijcard.2017.11.097] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 11/04/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE We aimed to quantify atrial and ventricular myocardial deformation in Ebstein's Anomaly (EA) in a case-control study with cardiovascular magnetic resonance (CMR) feature tracking and to correlate changes in cardiac performance with the severity of disease and clinical heart failure parameters. MATERIALS AND METHODS Atrial and ventricular deformation was measured using CMR feature tracking in 30 EA and 20 healthy control subjects. Atrial performance was characterized using longitudinal strain and strain rate parameters for reservoir function, conduit function and booster pump function. Ventricular performance was characterized using RV and LV global longitudinal strain (εl) and LV circumferential and radial strain (εc and εr). Volumetric measurements for the ventricles including the Total Right/Left-Volume-Index (R/L-Volume-Index) and heart failure markers (BNP, NYHA class) were also quantified. RESULTS EA patients showed significantly impaired right atrial performance, which correlated with heart failure markers (NYHA, BNP, R/L-Volume-Index). LA function in EA patients was also impaired with atrial contractile function correlating with NYHA class. EA patients exhibited impaired RV myocardial deformation, also with a significant correlation with heart failure markers. CONCLUSION CMR feature tracking can be used to quantify ventricular and atrial function in a complex cardiac malformation such as EA. EA is characterized by impaired quantitative right heart atrio-ventricular deformation, which is associated with heart failure severity. While LV function remains preserved, there is also significant impairment of LA function. These quantitative performance parameters may represent early markers of cardiac deterioration of potential value in the clinical management of EA.
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Affiliation(s)
- Michael Steinmetz
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen, Heart Center, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany.
| | - Marike Broder
- Department of Cardiology and Pneumology, University Medical Center, Georg-August-University Göttingen, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Olga Hösch
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen, Heart Center, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Pablo Lamata
- Department of Computer Science, University of Oxford, Oxford, United Kingdom,; Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, St. Thomas' Hospital, King's College London, London, United Kingdom
| | - Shelby Kutty
- University of Nebraska Medical Center/Children's Hospital and Medical Center, Omaha, NE, USA
| | - Johannes T Kowallick
- Inst. for Diag. and Interventional Radiology, University Medical Center, Georg-August-University Göttingen, Heart Center, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Wieland Staab
- Inst. for Diag. and Interventional Radiology, University Medical Center, Georg-August-University Göttingen, Heart Center, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Christian Oliver Ritter
- Inst. for Diag. and Interventional Radiology, University Medical Center, Georg-August-University Göttingen, Heart Center, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, University Medical Center, Georg-August-University Göttingen, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Thomas Paul
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen, Heart Center, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Joachim Lotz
- Inst. for Diag. and Interventional Radiology, University Medical Center, Georg-August-University Göttingen, Heart Center, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, University Medical Center, Georg-August-University Göttingen, Germany; DZHK, German Center for Heart Research, partner site Göttingen, Germany; Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, Australia.
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41
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Gertz RJ, Lange T, Kowallick JT, Backhaus SJ, Steinmetz M, Staab W, Kutty S, Hasenfuß G, Lotz J, Schuster A. Inter-vendor reproducibility of left and right ventricular cardiovascular magnetic resonance myocardial feature-tracking. PLoS One 2018. [PMID: 29538467 PMCID: PMC5851552 DOI: 10.1371/journal.pone.0193746] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
AIM Since cardiovascular magnetic resonance feature-tracking (CMR-FT) has been demonstrated to be of incremental clinical merit we investigated the interchangeability of global left and right ventricular strain parameters between different CMR-FT software solutions. MATERIAL AND METHODS CMR-cine images of 10 patients without significant reduction in LVEF and RVEF and 10 patients with a significantly impaired systolic function were analyzed using two different types of FT-software (TomTec, Germany; QStrain, Netherlands). Global longitudinal strains (LV GLS, RV GLS), global left ventricular circumferential (GCS) and radial strains (GRS) were assessed. Differences in intra- and inter-observer variability within and between software types based on single and up to three repeated and subsequently averaged measurements were evaluated. RESULTS Inter-vendor agreement was highest for GCS followed by LV GLS. GRS and RV GLS showed lower inter-vendor agreement. Variability was consistently higher in healthy volunteers as compared to the patient group. Intra-vendor reproducibility was excellent for GCS, LV GLS and RV GLS, but lower for GRS. The impact of repeated measurements was most pronounced for GRS and RV GLS on an intra-vendor level. CONCLUSION Cardiac pathology has no influence on CMR-FT reproducibility. LV GLS and GCS qualify as the most robust parameters within and between individual software types. Since both parameters can be interchangeably assessed with different software solutions they may enter the clinical arena for optimized diagnostic and prognostic evaluation of cardiovascular morbidity and mortality in various pathologies.
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Affiliation(s)
- Roman Johannes Gertz
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Torben Lange
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Johannes Tammo Kowallick
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany.,Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - Sören Jan Backhaus
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Michael Steinmetz
- Department of Paediatric Cardiology and Intensive Care Medicine, Georg-August-University Göttingen, Göttingen, Germany
| | - Wieland Staab
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany.,Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - Shelby Kutty
- Children's Hospital and Medical Center, University of Nebraska, Omaha, NE, United States of America
| | - Gerd Hasenfuß
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany
| | - Joachim Lotz
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany.,Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - Andreas Schuster
- Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Göttingen, Germany.,Department of Cardiology, Royal North Shore Hospital, The Kolling Institute, Northern Clinical School, University of Sydney, Sydney, Australia
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42
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Huber AT, Lamy J, Rahhal A, Evin M, Atassi F, Defrance C, Lebreton G, Clément K, Berthet M, Isnard R, Leprince P, Cluzel P, Hatem SN, Kachenoura N, Redheuil A. Cardiac MR Strain: A Noninvasive Biomarker of Fibrofatty Remodeling of the Left Atrial Myocardium. Radiology 2018; 286:83-92. [DOI: 10.1148/radiol.2017162787] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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43
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Manning WJ. Review of Journal of Cardiovascular Magnetic Resonance (JCMR) 2015-2016 and transition of the JCMR office to Boston. J Cardiovasc Magn Reson 2017; 19:108. [PMID: 29284487 PMCID: PMC5747150 DOI: 10.1186/s12968-017-0423-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 12/07/2017] [Indexed: 02/06/2023] Open
Abstract
The Journal of Cardiovascular Magnetic Resonance (JCMR) is the official publication of the Society for Cardiovascular Magnetic Resonance (SCMR). In 2016, the JCMR published 93 manuscripts, including 80 research papers, 6 reviews, 5 technical notes, 1 protocol, and 1 case report. The number of manuscripts published was similar to 2015 though with a 12% increase in manuscript submissions to an all-time high of 369. This reflects a decrease in the overall acceptance rate to <25% (excluding solicited reviews). The quality of submissions to JCMR continues to be high. The 2016 JCMR Impact Factor (which is published in June 2016 by Thomson Reuters) was steady at 5.601 (vs. 5.71 for 2015; as published in June 2016), which is the second highest impact factor ever recorded for JCMR. The 2016 impact factor means that the JCMR papers that were published in 2014 and 2015 were on-average cited 5.71 times in 2016.In accordance with Open-Access publishing of Biomed Central, the JCMR articles are published on-line in the order that they are accepted with no collating of the articles into sections or special thematic issues. For this reason, over the years, the Editors have felt that it is useful to annually summarize the publications into broad areas of interest or themes, so that readers can view areas of interest in a single article in relation to each other and other recent JCMR articles. The papers are presented in broad themes with previously published JCMR papers to guide continuity of thought in the journal. In addition, I have elected to open this publication with information for the readership regarding the transition of the JCMR editorial office to the Beth Israel Deaconess Medical Center, Boston and the editorial process.Though there is an author publication charge (APC) associated with open-access to cover the publisher's expenses, this format provides a much wider distribution/availability of the author's work and greater manuscript citation. For SCMR members, there is a substantial discount in the APC. I hope that you will continue to send your high quality manuscripts to JCMR for consideration. Importantly, I also ask that you consider referencing recent JCMR publications in your submissions to the JCMR and elsewhere as these contribute to our impact factor. I also thank our dedicated Associate Editors, Guest Editors, and reviewers for their many efforts to ensure that the review process occurs in a timely and responsible manner and that the JCMR continues to be recognized as the leading publication in our field.
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Affiliation(s)
- Warren J Manning
- From the Journal of Cardiovascular Magnetic Resonance Editorial Office and the Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
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44
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Kutty S, Shang Q, Joseph N, Kowallick JT, Schuster A, Steinmetz M, Danford DA, Beerbaum P, Sarikouch S. Abnormal right atrial performance in repaired tetralogy of Fallot: A CMR feature tracking analysis. Int J Cardiol 2017; 248:136-142. [PMID: 28712562 DOI: 10.1016/j.ijcard.2017.06.121] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/01/2017] [Accepted: 06/22/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND We hypothesized that right atrial (RA) performance is abnormal in repaired tetralogy of Fallot (TOF). METHODS TOF patients were prospectively enrolled for cardiovascular magnetic resonance (CMR), echocardiography and exercise stress following a standardized 14-center protocol. Peak RA longitudinal strain (RALS) and right ventricular longitudinal strain (RVLS) were measured using CMR feature tracking (FT) and correlated to RA and RV end diastolic volumes (EDVi) and ejection fraction (EF). RESULTS The cohort had 311 subjects: 171 TOF (94 male, age 18.2±8years) and 140 healthy controls (69 male, 16.4±11years). RAEDVi, RALS, RVEDVi, RVLS, RAEF, and RVEF in TOF were 60.8±17.1ml/m2, 13.6±5.7%, 120.3±30.3ml/m2, 12.3±4.2%, 32.5±9.9% and 51.2±8.4% and differed from respective indices in controls: 51.7±15.7ml/m2, 27±10.1%, 74±19.0ml/m2, 18.5±5.3%, 54±8% and 62.5±5.5% (p<0.001). RAEDVi and RALS correlated with RVLS (p=0.004, <0.001, r=0.2,0.3). RAEDVi was higher in older TOF, while RALS did not increase with age. RAEDVi but not RALS correlated with RV systolic pressure(r=0.2, 0). Neither RAEDVi nor RALS was associated with tricuspid regurgitation grade or peak oxygen uptake (r=0.1, 0). Positive correlation was observed for RVEDVi with RAEDVi (p=0.035, r=0.2) and a trend toward negative correlation with RALS (p=0.09, r=0.1). CONCLUSION RALS, RAEDVi and RAEF are abnormal in TOF. Reduced RALS indicates decreased RA reservoir function. Because they correlate with other functional RV indices, these abnormalities may represent RA diastolic burden from chronic RV dysfunction in TOF. The young cohort age might explain the absence of RALS correlation to tricuspid regurgitation and peak oxygen uptake.
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Affiliation(s)
- Shelby Kutty
- University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, United States.
| | - Quanliang Shang
- University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, United States; Department of Radiology, Central South University, China
| | - Navya Joseph
- University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, United States
| | - Johannes T Kowallick
- Department of Cardiology, Pneumology, and the Institute for Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - Andreas Schuster
- Department of Cardiology, Pneumology, and the Institute for Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - Michael Steinmetz
- Department of Cardiology, Pneumology, and the Institute for Radiology, Georg-August-University Göttingen, Göttingen, Germany
| | - David A Danford
- University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, United States
| | - Phillip Beerbaum
- Department of Pediatric Cardiology and Intensive Care, Hanover Medical School, Hanover, Germany
| | - Samir Sarikouch
- Department of Cardiothoracic Surgery, Hanover Medical School, Hanover, Germany
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45
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Hewing B, Theres L, Spethmann S, Stangl K, Dreger H, Knebel F. Left atrial strain predicts hemodynamic parameters in cardiovascular patients. Echocardiography 2017; 34:1170-1178. [DOI: 10.1111/echo.13595] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Bernd Hewing
- Department of Cardiology and Angiology, Campus Mitte; Charité-Universitätsmedizin Berlin; Berlin Germany
- Berlin Institute of Health (BIH); Berlin Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin; Berlin Germany
| | - Lena Theres
- Department of Cardiology and Angiology, Campus Mitte; Charité-Universitätsmedizin Berlin; Berlin Germany
| | - Sebastian Spethmann
- Department of Cardiology and Angiology, Campus Mitte; Charité-Universitätsmedizin Berlin; Berlin Germany
- Department of Internal Medicine (Cardiology and Angiology); Bundeswehrkrankenhaus Berlin; Berlin Germany
| | - Karl Stangl
- Department of Cardiology and Angiology, Campus Mitte; Charité-Universitätsmedizin Berlin; Berlin Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin; Berlin Germany
| | - Henryk Dreger
- Department of Cardiology and Angiology, Campus Mitte; Charité-Universitätsmedizin Berlin; Berlin Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin; Berlin Germany
| | - Fabian Knebel
- Department of Cardiology and Angiology, Campus Mitte; Charité-Universitätsmedizin Berlin; Berlin Germany
- Berlin Institute of Health (BIH); Berlin Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Berlin; Berlin Germany
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46
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Tao S, Ciuffo LA, Lima JAC, Wu KC, Ashikaga H. Quantifying left atrial structure and function using single-plane tissue-tracking cardiac magnetic resonance. Magn Reson Imaging 2017. [PMID: 28642098 DOI: 10.1016/j.mri.2017.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Left atrial (LA) structure and function are important markers of adverse cardiovascular outcomes. Tissue-tracking cardiovascular magnetic resonance (CMR) accurately quantifies LA volume, strain, and strain rate based on biplane long-axis imaging. We aimed to assess the accuracy of the LA indices quantification from single-plane tissue-tracking CMR. METHODS We included 388 subjects (mean age 57±13, male 70%) whose cine CMR images in sinus rhythm were available in both four-chamber and two-chamber views: 162 patients from the Prospective Observational Study of Implantable Cardioverter-Defibrillators (PROSE-ICD) Study, 208 patients from atrial fibrillation cohort, and 18 healthy volunteers. The group was divided into the training set (n=291) and the test set (n=97). In the training set, we compared the LA indices derived from biplane imaging and single-plane imaging (a four-chamber view), and developed regression equations. In the test set, we used the regression equations to estimate the LA indices from the single-plane imaging, and quantified the accuracy of the estimation against the LA indices from the biplane. RESULTS In the training set, all the LA indices from the single-plane imaging tended to be systematically underestimated compared with those from the biplane imaging, however, the correlation coefficient was high (r2=0.73-0.90, p<0.001). In the test set, LA volumetric indices showed excellent reproducibility (intra-class correlation coefficient (ICC): 0.91-0.92) with relatively low variability (16.3-22.3%); For LA strain and strain rate indices, reproducibility was excellent (ICC: 0.81-0.93), however, the variability was slightly higher than that of volumetric indices (21.7-25.4%). CONCLUSIONS LA volumetric indices measured from single-plane tissue-tracking CMR are highly accurate and reproducible with reference to those derived from the standard biplane imaging. The reproducibility of LA strain and strain rate indices from single-plane tissue-tracking CMR is excellent but the variability is higher than that of the volumetric indices.
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Affiliation(s)
- Susumu Tao
- Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Luisa A Ciuffo
- Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Joao A C Lima
- Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Katherine C Wu
- Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
| | - Hiroshi Ashikaga
- Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA.
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47
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Wandelt LK, Kowallick JT, Schuster A, Wachter R, Stümpfig T, Unterberg-Buchwald C, Steinmetz M, Ritter CO, Lotz J, Staab W. Quantification of left atrial volume and phasic function using cardiovascular magnetic resonance imaging-comparison of biplane area-length method and Simpson's method. Int J Cardiovasc Imaging 2017; 33:1761-1769. [PMID: 28523471 DOI: 10.1007/s10554-017-1160-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 05/06/2017] [Indexed: 11/26/2022]
Abstract
Left atrial (LA) enlargement and dysfunction are markers of chronic diastolic dysfunction and an important predictor of adverse cardiovascular and cerebrovascular outcomes. Accordingly, accurate quantification of left atrial volume (LAV) and function is needed. In routine clinical cardiovascular magnetic resonance (CMR) imaging the biplane area-length method (Bi-ALM) is frequently applied due to time-saving image acquisition and analysis. However, given the varying anatomy of the LA we hypothesized that the diagnostic accuracy of the Bi-ALM is not sufficient and that results would be different from a precise volumetric assessment of transversal multi-slice cine images using Simpson's method. Thirty one patients of the FIND-AFRANDOMISED-study with status post acute cerebral ischemia (mean age 70.5 ± 6.2 years) received CMR imaging at 3T. The study protocol included cine SSFP sequences in standard 2- and 4 CV and a stack of contiguous slices in transversal orientation. Total, passive and active LA emptying fractions were calculated from LA maximal volume, minimal volume and volume prior to atrial contraction. Intra- and inter-observer variability was assessed in ten patients. Significant differences were found for LA volume and phasic function. The Bi-ALM significantly underestimated LA volume and overestimated LA function in comparison to Simpson's method (Bi-ALM vs. Simpson's method: LAVmax: 80.18 vs. 98.80 ml; LAVpre-ac: 61.09 vs. 80.41 ml; LAVmin: 36.85 vs. 52.66 ml; LAEFTotal: 55.17 vs. 47.85%; LAEFPassive: 23.96 vs. 19.15%; LAEFBooster: 40.87 vs. 35.64%). LA volumetric and functional parameters were reproducible on an intra- and inter-observer levels for both methods. Intra-observer agreement for LA function was better for Simpson's method (Bi-ALM vs. Simpson's method; ICC LAEFTotal: 0.84 vs. 0.96; ICC LAEFPassive: 0.74 vs. 0.92; ICC LAEFBooster: 0.86 vs. 0.89). The Bi-ALM is based on geometric assumptions that do not reflect the complex individual LA geometry. The assessment of transversal slices covering the left atrium with Simpson's method is feasible and might be more suitable for an accurate quantification of LA volume and phasic function.
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Affiliation(s)
- Laura Kristin Wandelt
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany.
| | - Johannes Tammo Kowallick
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Andreas Schuster
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Rolf Wachter
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Thomas Stümpfig
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- Department of Paediatric Cardiology and Intensive Care Medicine, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Christina Unterberg-Buchwald
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- Department of Cardiology and Pneumology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Michael Steinmetz
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- Department of Paediatric Cardiology and Intensive Care Medicine, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Christian Oliver Ritter
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
| | - Wieland Staab
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Robert-Koch Straße 40, 37075, Göttingen, Germany
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48
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Kowallick JT, Morton G, Lamata P, Jogiya R, Kutty S, Hasenfuß G, Lotz J, Chiribiri A, Nagel E, Schuster A. Quantitative assessment of left ventricular mechanical dyssynchrony using cine cardiovascular magnetic resonance imaging: Inter-study reproducibility. JRSM Cardiovasc Dis 2017; 6:2048004017710142. [PMID: 28567282 PMCID: PMC5438106 DOI: 10.1177/2048004017710142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/13/2017] [Accepted: 04/23/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES To determine the inter-study reproducibility of left ventricular (LV) mechanical dyssynchrony measures based on standard cardiovascular magnetic resonance (CMR) cine images. DESIGN Steady-state free precession (SSFP) LV short-axis stacks and three long-axes were acquired on the same day at three time points. Circumferential strain systolic dyssynchrony indexes (SDI), area-SDI as well as circumferential and radial uniformity ratio estimates (CURE and RURE, respectively) were derived from CMR myocardial feature-tracking (CMR-FT) based on the tracking of three SSFP short-axis planes. Furthermore, 4D-LV-analysis based on SSFP short-axis stacks and longitudinal planes was performed to quantify 4D-volume-SDI. SETTING A single-centre London teaching hospital. PARTICIPANTS 16 healthy volunteers. MAIN OUTCOME MEASURES Inter-study reproducibility between the repeated exams. RESULTS CURE and RURE as well as 4D-volume-SDI showed good inter-study reproducibility (coefficient of variation [CoV] 6.4%-12.9%). Circumferential strain and area-SDI showed higher variability between the repeated measurements (CoV 24.9%-37.5%). Uniformity ratio estimates showed the lowest inter-study variability (CoV 6.4%-8.5%). CONCLUSIONS Derivation of LV mechanical dyssynchrony measures from standard cine images is feasible using CMR-FT and 4D-LV-analysis tools. Uniformity ratio estimates and 4D-volume-SDI showed good inter-study reproducibility. Their clinical value should next be explored in patients who potentially benefit from cardiac resynchronization therapy.
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Affiliation(s)
- Johannes T Kowallick
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St Thomas' Hospital, London, UK.,Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany
| | | | - Pablo Lamata
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St Thomas' Hospital, London, UK
| | - Roy Jogiya
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St Thomas' Hospital, London, UK
| | - Shelby Kutty
- Children's Hospital and Medical Center, University of Nebraska College of Medicine, Omaha, NE, USA
| | - Gerd Hasenfuß
- DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany.,Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, Göttingen, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany
| | - Amedeo Chiribiri
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St Thomas' Hospital, London, UK
| | - Eike Nagel
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St Thomas' Hospital, London, UK.,Division of Cardiovascular Imaging, Goethe University Frankfurt and German Centre for Cardiovascular Research (DZHK, partner site Rhine-Main), Frankfurt, Germany
| | - Andreas Schuster
- Division of Imaging Sciences and Biomedical Engineering, The Rayne Institute, King's College London, St Thomas' Hospital, London, UK.,DZHK (German Centre for Cardiovascular Research), partner site Göttingen, Germany.,Department of Cardiology and Pneumology, Georg-August-University Göttingen, Göttingen, Germany
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Lapinskas T, Bučius P, Urbonaitė L, Stabinskaitė A, Valuckienė Ž, Jankauskaitė L, Benetis R, Žaliūnas R. Left atrial mechanics in patients with acute STEMI and secondary mitral regurgitation: A prospective pilot CMR feature tracking study. MEDICINA-LITHUANIA 2017; 53:11-18. [PMID: 28283244 DOI: 10.1016/j.medici.2017.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/22/2017] [Accepted: 02/11/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVE Left atrium (LA) is an important biomarker of adverse cardiovascular outcomes and cerebrovascular events. This study aimed to evaluate LA myocardial deformation using cardiac magnetic resonance feature tracking (CMR-FT) in patients with acute ST-segment elevation myocardial infarction (STEMI) and secondary mitral regurgitation (MR). Additionally, to assess interobserver and intraobserver variability of the technique. MATERIALS AND METHODS Twenty patients with STEMI underwent CMR with a 1.5Tesla MRI scanner. According to the presence of MR patients were divided into two groups: MR(+) and MR(-). Total LA strain (ɛs), passive LA strain (ɛe), and active LA strain (ɛa) were obtained. Additionally, total, passive and active strain rates (SRs, SRe, and SRa) were calculated. To assess interobserver agreement data analysis was performed by second independent observer. RESULTS LA volumetric and functional parameters were similar in both groups. All LA strain values were significantly higher in patients with MR: ɛs (27.67±10.25 for MR(-) vs. 32.80±6.95 for MR(+); P=0.01), ɛe (15.29±7.30 for MR(-) vs. 19.22±6.04 for MR(+); P=0.01) and ɛa (12.38±4.23 for MR(-) vs. 14.44±5.19 for MR(+); P=0.03). Only SRe significantly increased in patients with MR (-0.57±0.24 for MR(-) vs. -0.70±0.20 for MR(+); P=0.01). All LA deformation parameters demonstrated high interobserver and intraobserver agreement. CONCLUSIONS Conventional volumetric and functional LA parameters do not detect early changes in LA performance in patients with STEMI and secondary MR. In contrast, LA reservoir, passive and active strain are significantly higher in patients with MR. Only peak early negative strain rate substantially increases during secondary MR. LA deformation parameters derived from conventional cine images using CMR-FT technique are highly reproducible.
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Affiliation(s)
- Tomas Lapinskas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
| | - Paulius Bučius
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laura Urbonaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Agnieta Stabinskaitė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Živilė Valuckienė
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Lina Jankauskaitė
- Department of Internal Medicine II, University Clinic Giessen-Marburg, Giessen, Germany
| | - Rimantas Benetis
- Department of Cardiac, Thoracic and Vascular Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Remigijus Žaliūnas
- Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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