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Werner O, Martins D, Bertini F, Bennati E, Collia D, Olivotto I, Spaziani G, Baruteau AE, Pedrizzetti G, Raimondi F. Comparative analysis of left ventricle function and deformation imaging in short and long axis plane in cardiac magnetic resonance imaging. Front Cardiovasc Med 2024; 11:1388171. [PMID: 38756751 PMCID: PMC11097778 DOI: 10.3389/fcvm.2024.1388171] [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: 02/19/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Background Advancements in cardiac imaging have revolutionized our understanding of ventricular contraction. While ejection fraction (EF) is still the gold standard parameter to assess left ventricle (LV) function, strain imaging (SI) has provided valuable insights into ventricular mechanics. The lack of an integrative method including SI parameters in a single, validated formula may limit its use. Our aim was to compare different methods for evaluating global circumferential strain (GCS) and their relationship with global longitudinal strain (GLS) and EF in CMR and how the different evaluations fit in the theoretical relationship between EF and global strain. Methods Retrospective monocenter study. Inclusion of every patient who underwent a CMR during a 15 months period with various clinical indication (congenital heart defect, myocarditis, cardiomyopathy). A minimum of three LV long-axis planes and a stack of short-axis slices covering the LV using classical steady-state free precession cine sequences. A single assessment of GLS on long axis (LAX) slices and a double assessment of GCS and EF with both short axis (SAX) and LAX slices were made by a single experienced CMR investigator. Results GCS-SAX and GCS-LAX were correlated (r = 0.77, P < 0.001) without being interchangeable with a high reproducibility for GCS, GLS and EF. EF calculated from LAX images showed an overestimation compared to EF derived from SAX images of 7%. The correlation between calculated EF and theoretical EF derived from SI was high (r = 0.88 with EF-SAX, 0.95 with EF-LAX). Data conclusion This study highlights the need to integrate strain imaging techniques into clinical by incorporating strain parameters into EF calculations, because it gives a deeper understanding of cardiac mechanics.
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Affiliation(s)
- Oscar Werner
- Pediatric Cardiology Unit, University Hospital Meyer, Florence, Italy
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
| | - Duarte Martins
- Pediatric and Adult Congenital Cardiology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Federico Bertini
- Pediatric Radiology Department, University Hospital Meyer, Florence, Italy
| | - Elena Bennati
- Pediatric Cardiology Unit, University Hospital Meyer, Florence, Italy
| | - Dario Collia
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Iacopo Olivotto
- Pediatric Cardiology Unit, University Hospital Meyer, Florence, Italy
| | - Gaia Spaziani
- Pediatric Cardiology Unit, University Hospital Meyer, Florence, Italy
| | - Alban-Elouen Baruteau
- Department of Pediatric Cardiology and Pediatric Cardiac Surgery, FHU PRECICARE, Nantes Université, CHU Nantes, Nantes, France
| | - Gianni Pedrizzetti
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Francesca Raimondi
- Pediatric Cardiology Unit, University Hospital Meyer, Florence, Italy
- Pediatric and Adult Congenital Cardiology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
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Hegeman RRMJJ, McManus S, Tóth A, Ladeiras-Lopes R, Kitslaar P, Bui V, Dukker K, Harb SC, Swaans MJ, Ben-Yehuda O, Klein P, Puri R. Reference Values for Inward Displacement in the Normal Left Ventricle: A Novel Method of Regional Left Ventricular Function Assessment. J Cardiovasc Dev Dis 2023; 10:474. [PMID: 38132642 PMCID: PMC10744219 DOI: 10.3390/jcdd10120474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/11/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Regional functional left ventricular (LV) assessment using current imaging techniques remains limited. Inward displacement (InD) has been developed as a novel technique to assess regional LV function via measurement of the regional displacement of the LV endocardial border across each of the 17 LV segments. Currently, normal ranges for InD are not available for clinical use. The aim of this study was to validate the normal reference limits of InD in healthy adults across all LV segments. METHODS InD was analyzed in 120 healthy subjects with a normal LV ejection fraction, using the three standard long-axis views obtained during cardiac MRI that quantified the degree of inward endocardial wall motion towards the true LV center of contraction. For all LV segments, InD was measured in mm and expressed as a percentage of the theoretical degree of maximal segment contraction towards the true LV centerline. The arithmetic average InD was obtained for each of the 17 segments. The LV was divided into three regions, obtaining average InD at the LV base (segments 1-6), mid-cavity (segments 7-12) and apex (segments 13-17). RESULTS Average InD was 33.4 ± 4.3%. InD was higher in basal and mid-cavity LV segments (32.8 ± 4.1% and 38.1 ± 5.8%) compared to apical LV segments (28.6 ± 7.7%). Interobserver variability correlations for InD were strong (R = 0.80, p < 0.0001). CONCLUSIONS We provide clinically meaningful reference ranges for InD in subjects with normal LV function, which will emerge as an important screening and assessment imaging tool for a range of HFrEF therapies.
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Affiliation(s)
- Romy R. M. J. J. Hegeman
- Department of Cardiothoracic Surgery, Sint Antonius Hospital, 3435 CM Nieuwegein, The Netherlands
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
| | | | - Attila Tóth
- Department of Radiology, Gottsegen György Hungarian Institute of Cardiology & Semmelweis University, 1096 Budapest, Hungary
| | - Ricardo Ladeiras-Lopes
- Department of Cardiology, Gaia/Espinho Hospital Centre, Rua Conceicao Fernandes, 4434-502 Vila Nova de Gaia, Portugal
| | - Pieter Kitslaar
- Medis Medical Imaging Systems, 2316 XG Leiden, The Netherlands
| | - Viet Bui
- Medis Medical Imaging Systems, 2316 XG Leiden, The Netherlands
| | - Kayleigh Dukker
- Medis Medical Imaging Systems, 2316 XG Leiden, The Netherlands
| | - Serge C. Harb
- Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA (R.P.)
| | - Martin J. Swaans
- Department of Cardiology, Sint Antonius Hospital, 3435 CM Nieuwegein, The Netherlands
| | - Ori Ben-Yehuda
- Bioventrix Inc., Mansfield, MA 02048, USA
- Sulpizio Cardiovascular Center, University of California San Diego, La Jolla, CA 92037, USA
| | - Patrick Klein
- Department of Cardiothoracic Surgery, Sint Antonius Hospital, 3435 CM Nieuwegein, The Netherlands
- Department of Cardiothoracic Surgery, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
| | - Rishi Puri
- Department of Cardiovascular Medicine, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA (R.P.)
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Aurora L, Basir MB, Cowger JA. Left Ventricular Restoration for Heart Failure: Putting Together the Discoveries of Prior Procedures. J Card Fail 2023; 29:1056-1058. [PMID: 37263387 DOI: 10.1016/j.cardfail.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Affiliation(s)
- Lindsey Aurora
- Henry Ford Heart and Vascular Institute, Henry Ford Health, Detroit, Michigan
| | - Mir B Basir
- Henry Ford Heart and Vascular Institute, Henry Ford Health, Detroit, Michigan
| | - Jennifer A Cowger
- Henry Ford Heart and Vascular Institute, Henry Ford Health, Detroit, Michigan
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