Robin J Taylor1, Fraz Umar1, William E Moody1, Chitra Meyyappan2, Berthold Stegemann3, John N Townend1, Kan N Hor4, Tomasz Miszalski-Jamka5, Wojciech Mazur6, Richard P Steeds1, Francisco Leyva7. 1. Department of Cardiology, The Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, United Kingdom; Centre for Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom. 2. Centre for Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom. 3. Bakken Research Center, Medtronic Inc., Maastricht, Netherlands. 4. Department of Cardiology, Nationwide Children's Hospital, Columbus, OH, USA. 5. Department of Clinical Radiology and Imaging Diagnostics, 4th Military Hospital, Wrocław, Center for Diagnosis, Prevention and Telemedicine, John Paul II Hospital, Krakow, Poland. 6. The Christ Hospital Heart and Vascular Center, Cincinnati, OH, USA. 7. Department of Cardiology, The Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, United Kingdom; Centre for Cardiovascular Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom. Electronic address: cardiologists@hotmail.com.
Abstract
BACKGROUND: Myocardial tagging using cardiovascular magnetic resonance (CMR) is the gold-standard for the assessment of myocardial mechanics. Feature-tracking cardiovascular magnetic resonance (FT-CMR) has been validated against myocardial tagging. We explore the potential of FT-CMR in the assessment of mechanical dyssynchrony, with reference to patients with cardiomyopathy and healthy controls. METHODS: Healthy controls (n=55, age: 42.9 ± 13 yrs, LVEF: 70 ± 5%, QRS: 88 ± 9 ms) and patients with cardiomyopathy (n=108, age: 64.7 ± 12 yrs, LVEF: 29 ± 6%, QRS: 147 ± 29 ms) underwent FT-CMR for the assessment of the circumferential (CURE) and radial (RURE) uniformity ratio estimate based on myocardial strain (both CURE and RURE: 0 to 1; 1=perfect synchrony) RESULTS: CURE (0.79 ± 0.14 vs. 0.97 ± 0.02) and RURE (0.71 ± 0.14 vs. 0.91 ± 0.04) were lower in patients with cardiomyopathy than in healthy controls (both p<0.0001). CURE (area under the receiver-operator characteristic curve [AUC]: 0.96), RURE (AUC: 0.96) and an average of these (CURE:RUREAVG, AUC: 0.98) had an excellent ability to discriminate between patients with cardiomyopathy and controls (sensitivity 90%; specificity 98% at a cut-off of 0.89). The time taken for semi-automatically tracking myocardial borders was 5.9 ± 1.4 min. CONCLUSION: Dyssynchrony measures derived from FT-CMR, such as CURE and RURE, provide almost absolute discrimination between patients with cardiomyopathy and healthy controls. The rapid acquisition of these measures, which does not require specialized CMR sequences, has potential for the assessment of mechanical dyssynchrony in clinical practice.
BACKGROUND: Myocardial tagging using cardiovascular magnetic resonance (CMR) is the gold-standard for the assessment of myocardial mechanics. Feature-tracking cardiovascular magnetic resonance (FT-CMR) has been validated against myocardial tagging. We explore the potential of FT-CMR in the assessment of mechanical dyssynchrony, with reference to patients with cardiomyopathy and healthy controls. METHODS: Healthy controls (n=55, age: 42.9 ± 13 yrs, LVEF: 70 ± 5%, QRS: 88 ± 9 ms) and patients with cardiomyopathy (n=108, age: 64.7 ± 12 yrs, LVEF: 29 ± 6%, QRS: 147 ± 29 ms) underwent FT-CMR for the assessment of the circumferential (CURE) and radial (RURE) uniformity ratio estimate based on myocardial strain (both CURE and RURE: 0 to 1; 1=perfect synchrony) RESULTS: CURE (0.79 ± 0.14 vs. 0.97 ± 0.02) and RURE (0.71 ± 0.14 vs. 0.91 ± 0.04) were lower in patients with cardiomyopathy than in healthy controls (both p<0.0001). CURE (area under the receiver-operator characteristic curve [AUC]: 0.96), RURE (AUC: 0.96) and an average of these (CURE:RUREAVG, AUC: 0.98) had an excellent ability to discriminate between patients with cardiomyopathy and controls (sensitivity 90%; specificity 98% at a cut-off of 0.89). The time taken for semi-automatically tracking myocardial borders was 5.9 ± 1.4 min. CONCLUSION: Dyssynchrony measures derived from FT-CMR, such as CURE and RURE, provide almost absolute discrimination between patients with cardiomyopathy and healthy controls. The rapid acquisition of these measures, which does not require specialized CMR sequences, has potential for the assessment of mechanical dyssynchrony in clinical practice.
Authors: Kai Lin; Jeremy D Collins; Varun Chowdhary; Michael Markl; James C Carr Journal: Int J Cardiovasc Imaging Date: 2016-04-13 Impact factor: 2.357
Authors: Michael Steinmetz; Simon Usenbenz; Johannes Tammo Kowallick; Olga Hösch; Wieland Staab; Torben Lange; Shelby Kutty; Joachim Lotz; Gerd Hasenfuß; Thomas Paul; Andreas Schuster Journal: J Cardiovasc Magn Reson Date: 2017-12-14 Impact factor: 5.364
Authors: Sören J Backhaus; Thomas Stiermaier; Torben Lange; Amedeo Chiribiri; Pablo Lamata; Johannes Uhlig; Johannes T Kowallick; Uwe Raaz; Adriana Villa; Joachim Lotz; Gerd Hasenfuß; Holger Thiele; Ingo Eitel; Andreas Schuster Journal: Int J Cardiol Date: 2018-04-22 Impact factor: 4.164
Authors: Johannes T Kowallick; Geraint Morton; Pablo Lamata; Roy Jogiya; Shelby Kutty; Gerd Hasenfuß; Joachim Lotz; Amedeo Chiribiri; Eike Nagel; Andreas Schuster Journal: JRSM Cardiovasc Dis Date: 2017-05-15