Cardiovascular magnetic resonance myocardial feature tracking for quantitative viability assessment in ischemic cardiomyopathy

Andreas Schuster, Matthias Paul, Nuno Bettencourt, Geraint Morton, Amedeo Chiribiri, Masaki Ishida, Shazia Hussain, Roy Jogiya, Shelby Kutty, Boris Bigalke, Divaka Perera, Eike Nagel

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Abstract

Background: Low dose dobutamine stress magnetic resonance imaging is valuable to assess viability in patients with ischemic cardiomyopathy. Analysis is usually qualitative with considerable operator dependency. The aim of the current study was to investigate the feasibility of cine images derived quantitative cardiac magnetic resonance (CMR) myocardial feature tracking (FT) strain parameters to assess viability in patients with ischemic cardiomyopathy. Methods: 15 consecutive patients with ischemic cardiomyopathy referred for viability assessment were studied at 3 T at rest and during low dose dobutamine stress (5 and 10 μg/kg/min of dobutamine). Subendocardial and subepicardial circumferential (Eccendo and Eccepi) and radial (Err) strains were assessed using steady state free precession (SSFP) cine images orientated in 3 short axis slices covering 16 myocardial segments. Results: Dysfunctional segments without scar (n = 75) improved in all three strain parameters: Eccendo (Rest: - 10.5 ± 6.9; 5 μg: - 12.1 ± 6.9; 10 μg: - 14.1 ± 9.2; p < 0.05), Eccepi (Rest: - 7 ± 4.8; 5 μg: - 8.2 ± 5.5; 10 μg: - 9.1 ± 5.9; p < 0.05) and Err (Rest: 11.7 ± 8.3; 5 μg: 16 ± 10.9; 10 μg: 16.5 ± 12.8; p < 0.05). There was no response to dobutamine in dysfunctional segments with scar transmurality above 75% (n = 6): Ecc endo (Rest: - 4.7 ± 3.0; 5 μg: - 2.9 ± 2.5; 10 μg: - 6.6 ± 3.3; p = ns), Eccepi (Rest: - 2.9 ± 2.9; 5 μg: - 5.4 ± 3.9; 10 μg: - 4.5 ± 4.2; p = ns) and Err (Rest:9.5 ± 5; 5 μg:5.4 ± 6.2; 10 μg:4.9 ± 3.3; p = ns). Circumferential strain (Eccendo, Eccepi) improved in all segments up to a transmurality of 75% (n = 60; p < 0.05). Err improved in segments < 50% transmurality (n = 45; p < 0.05) and remained unchanged above 50% transmurality (n = 21; p = ns). Conclusions: CMR-FT is a novel technique, which detects quantitative wall motion derived from SSFP cine imaging at rest and with low dose dobutamine stress. CMR-FT holds promise of quantitative assessment of viability in patients with ischemic cardiomyopathy.

Original languageEnglish (US)
Pages (from-to)413-420
Number of pages8
JournalInternational Journal of Cardiology
Volume166
Issue number2
DOIs
StatePublished - Jun 20 2013

Keywords

  • Cardiovascular magnetic resonance imaging
  • Hibernating myocardium
  • Myocardial feature tracking
  • Quantification
  • Viability

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Schuster, A., Paul, M., Bettencourt, N., Morton, G., Chiribiri, A., Ishida, M., Hussain, S., Jogiya, R., Kutty, S., Bigalke, B., Perera, D., & Nagel, E. (2013). Cardiovascular magnetic resonance myocardial feature tracking for quantitative viability assessment in ischemic cardiomyopathy. International Journal of Cardiology, 166(2), 413-420. https://doi.org/10.1016/j.ijcard.2011.10.137