Yuanwei Xu1, Shuai He2, Weihao Li1, Ke Wan3, Jie Wang1, David Mui4, Fuyao Yang1, Hong Liu1, Wei Cheng2, Xiaoyue Zhou5, Jens Wetzl6, Jiayu Sun7, Yucheng Chen8. 1. Department of Cardiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China. 2. Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China. 3. Department of Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China. 4. Department of Medicine, Cardiovascular Division, University of Pennsylvania, Philadelphia, USA. 5. Siemens Healthcare Ltd., Shanghai, People's Republic of China. 6. Siemens Healthcare, Erlangen, Germany. 7. Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China. sjy080512@163.com. 8. Department of Cardiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China. chenyucheng2003@126.com.
Abstract
OBJECTIVES: To investigate the diagnostic value and reproducibility of deformable registration algorithm (DRA)-derived mechanical dyssynchrony parameters in dilated cardiomyopathy (DCM) patients. METHODS: The present study included 80 DCM patients (40 with normal QRS duration (NQRS-DCM); 40 with left bundle branch block (LBBB-DCM)) and 20 healthy volunteers. The balanced steady-state free-precession (bSSFP) cine images were acquired using a 3.0T scanner. Mechanical dyssynchrony parameters were calculated based on DRA-derived segmental strain, including uniformity ratio estimate (URE) and standard derivation of time-to-peak (T2Psd) parameters in circumferential, radial, and longitudinal orientations. RESULTS: DCM patients showed significant mechanical dyssynchrony reflected by both URE and T2Psd parameters compared with controls. Among DCM patients, LBBB-DCM showed decreased CURE (0.78 ± 0.21 vs. 0.93 ± 0.05, p < 0.001) and RURE (0.69 ± 0.14 vs. 0.83 ± 0.15, p = 0.001), and increased T2Psd-Ecc (median with interquartile range, 94.1 (54.4-123.2) ms vs. 63.7 (44.9-80.4) ms, p = 0.003) and T2Psd-Err (91.1 (61.1-103.2) ms vs. 62.3 (46.3-104.5) ms, p = 0.041) compared with NQRS-DCM patients. CURE showed a strong correlation with QRS duration (r = - 0.54, p < 0.001), with maximum AUC (0.791) to differentiate LBBB-DCM from NQRS-DCM patients. Improved intra- and inter-observer reproducibility was found using URE indices (coefficient of variation (CoV), 1.20-3.17%) than T2Psd parameters (CoV, 15.28-41.18%). CONCLUSIONS: The DRA-based CURE showed significant correlation with QRS duration and the highest discriminatory value between LBBB-DCM and NQRS-DCM patients. URE indices showed greater reproducibility compared with T2Psd parameters for assessing myocardial dyssynchrony in DCM patients. KEY POINTS: • The strain analyses based on DRA suggested that DCM patients have varying degrees of mechanical dyssynchrony and there is a significant difference from normal controls. • CURE showed the strongest correlation with QRS duration and was the best parameter for differentiating DCM patients with normal QRS duration from patients with LBBB, and with normal controls. • URE indices showed improved reproducibility compared with T2Psd parameters in all three orientations (circumferential, radial, and longitudinal).
OBJECTIVES: To investigate the diagnostic value and reproducibility of deformable registration algorithm (DRA)-derived mechanical dyssynchrony parameters in dilated cardiomyopathy (DCM) patients. METHODS: The present study included 80 DCMpatients (40 with normal QRS duration (NQRS-DCM); 40 with left bundle branch block (LBBB-DCM)) and 20 healthy volunteers. The balanced steady-state free-precession (bSSFP) cine images were acquired using a 3.0T scanner. Mechanical dyssynchrony parameters were calculated based on DRA-derived segmental strain, including uniformity ratio estimate (URE) and standard derivation of time-to-peak (T2Psd) parameters in circumferential, radial, and longitudinal orientations. RESULTS:DCMpatients showed significant mechanical dyssynchrony reflected by both URE and T2Psd parameters compared with controls. Among DCMpatients, LBBB-DCM showed decreased CURE (0.78 ± 0.21 vs. 0.93 ± 0.05, p < 0.001) and RURE (0.69 ± 0.14 vs. 0.83 ± 0.15, p = 0.001), and increased T2Psd-Ecc (median with interquartile range, 94.1 (54.4-123.2) ms vs. 63.7 (44.9-80.4) ms, p = 0.003) and T2Psd-Err (91.1 (61.1-103.2) ms vs. 62.3 (46.3-104.5) ms, p = 0.041) compared with NQRS-DCMpatients. CURE showed a strong correlation with QRS duration (r = - 0.54, p < 0.001), with maximum AUC (0.791) to differentiate LBBB-DCM from NQRS-DCMpatients. Improved intra- and inter-observer reproducibility was found using URE indices (coefficient of variation (CoV), 1.20-3.17%) than T2Psd parameters (CoV, 15.28-41.18%). CONCLUSIONS: The DRA-based CURE showed significant correlation with QRS duration and the highest discriminatory value between LBBB-DCM and NQRS-DCMpatients. URE indices showed greater reproducibility compared with T2Psd parameters for assessing myocardial dyssynchrony in DCMpatients. KEY POINTS: • The strain analyses based on DRA suggested that DCMpatients have varying degrees of mechanical dyssynchrony and there is a significant difference from normal controls. • CURE showed the strongest correlation with QRS duration and was the best parameter for differentiating DCMpatients with normal QRS duration from patients with LBBB, and with normal controls. • URE indices showed improved reproducibility compared with T2Psd parameters in all three orientations (circumferential, radial, and longitudinal).
Entities:
Keywords:
Algorithms; Dilated cardiomyopathy; Magnetic resonance imaging; Myocardium; Ventricular dysfunction, left
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