Elliot R McVeigh1, Amir Pourmorteza2, Michael Guttman3, Veit Sandfort4, Francisco Contijoch5, Suhas Budhiraja5, Zhennong Chen5, David A Bluemke6, Marcus Y Chen7. 1. Department of Bioengineering, UC San Diego, La Jolla, CA, USA; Department of Cardiology, UC San Diego, La Jolla, CA, USA; Department of Radiology, UC San Diego, La Jolla, CA, USA. Electronic address: emcveigh@ucsd.edu. 2. Winship Cancer Institute, Department of Radiology and Imaging Sciences, Emory University, Atlanta, GA, USA. 3. Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. Department of Cardiology, UC San Diego, La Jolla, CA, USA. 5. Department of Bioengineering, UC San Diego, La Jolla, CA, USA; Department of Cardiology, UC San Diego, La Jolla, CA, USA; Department of Radiology, UC San Diego, La Jolla, CA, USA. 6. University of Wisconsin-Madison, School of Medicine and Public Health, USA. 7. Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA.
Abstract
BACKGROUND: CT SQUEEZ is a new automated technique to evaluate regional endocardial strain by tracking features on the endocardium from 4D cine CT data. The objective of this study was to measure the range of endocardial regional strain (RSCT) values obtained with CT SQUEEZ in the normal human left ventricle (LV) from standard clinical 4D coronary CTA exams. METHODS: RSCT was measured over the heart cycle in 25 humans with normal LV function using cine CT from three vendors. Mean and standard deviation of RSCT values were computed in 16 AHA LV segments to estimate the range of values expected in the normal LV. RESULTS: Curves describing RSCT vs. time were consistent between subjects. There was a slight gradient of decreasing minimum RSCT value (increased shortening) from the base to the apex of the heart. Mean RSCT values at end-systole were: base = -32% ± 1%, mid = -33% ± 1%, apex = -36% ± 1%. The standard deviation of the minimum systolic RSCT in each segment over all subjects was 5%. The average time to reach maximum shortening was 34% of the RR interval. CONCLUSIONS: Regional strain (RSCT) can be rapidly obtained from standard gated coronary CCTA protocols using 4DCT SQUEEZ processing. We estimate that 95% of normal LV end-systolic RSCT values will fall between -23% and -43%; therefore, we hypothesize that an RSCT value higher than -23% will indicate a hypokinetic segment in the human heart.
BACKGROUND: CT SQUEEZ is a new automated technique to evaluate regional endocardial strain by tracking features on the endocardium from 4D cine CT data. The objective of this study was to measure the range of endocardial regional strain (RSCT) values obtained with CT SQUEEZ in the normal human left ventricle (LV) from standard clinical 4D coronary CTA exams. METHODS:RSCT was measured over the heart cycle in 25 humans with normal LV function using cine CT from three vendors. Mean and standard deviation of RSCT values were computed in 16 AHA LV segments to estimate the range of values expected in the normal LV. RESULTS: Curves describing RSCT vs. time were consistent between subjects. There was a slight gradient of decreasing minimum RSCT value (increased shortening) from the base to the apex of the heart. Mean RSCT values at end-systole were: base = -32% ± 1%, mid = -33% ± 1%, apex = -36% ± 1%. The standard deviation of the minimum systolic RSCT in each segment over all subjects was 5%. The average time to reach maximum shortening was 34% of the RR interval. CONCLUSIONS: Regional strain (RSCT) can be rapidly obtained from standard gated coronary CCTA protocols using 4DCT SQUEEZ processing. We estimate that 95% of normal LV end-systolic RSCT values will fall between -23% and -43%; therefore, we hypothesize that an RSCT value higher than -23% will indicate a hypokinetic segment in the human heart.
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