Feature-tracking cardiovascular magnetic resonance as a novel technique for the assessment of mechanical dyssynchrony

被引:26
|
作者
Taylor, Robin J. [1 ,2 ]
Umar, Fraz [1 ,2 ]
Moody, William E. [1 ,2 ]
Meyyappan, Chitra [2 ]
Stegemann, Berthold [3 ]
Townend, John N. [1 ,2 ]
Hor, Kan N. [4 ]
Miszalski-Jamka, Tomasz [5 ,6 ]
Mazur, Wojciech [7 ,8 ]
Steeds, Richard P. [1 ,2 ]
Leyva, Francisco [1 ,2 ]
机构
[1] Queen Elizabeth Hosp, Dept Cardiol, Birmingham B15 2WB, W Midlands, England
[2] Univ Birmingham, Ctr Cardiovascular Sci, Birmingham B15 2TT, W Midlands, England
[3] Medtronic Inc, Bakken Res Ctr, Maastricht, Netherlands
[4] Nationwide Childrens Hosp, Dept Cardiol, Columbus, OH USA
[5] 4th Mil Hosp, Dept Clin Radiol & Imaging Diagnost, Wroclaw, Poland
[6] John Paul 2 Hosp, Ctr Diag Prevent & Telemedicine, Krakow, Poland
[7] Christ Hosp Heart, Cincinnati, OH USA
[8] Vasc Ctr, Cincinnati, OH USA
关键词
Feature-tracking; Heart failure; Dyssynchrony; CURE; RURE; Cardiovascular magnetic resonance; CARDIAC-RESYNCHRONIZATION THERAPY; HEART-FAILURE PATIENTS; NARROW QRS COMPLEXES; ASYNCHRONY; STRAIN; ECHOCARDIOGRAPHY; CARDIOMYOPATHY; CONTRACTION; IMPROVEMENT; PREVALENCE;
D O I
10.1016/j.ijcard.2014.04.268
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2014 Elsevier Ireland Ltd. All rights reserved
引用
收藏
页码:120 / 125
页数:6
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