Feature tracking measurement of dyssynchrony from cardiovascular magnetic resonance cine acquisitions: comparison with echocardiographic speckle tracking.
Feature tracking measurement of dyssynchrony from cardiovascular magnetic resonance cine acquisitions: comparison with echocardiographic speckle tracking.
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DOI：
10.1186/1532-429x-15-95
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发表时间：
2013-10-17
期刊：
影响因子：
--
通讯作者：
Gorcsan J 3rd
中科院分区：
文献类型：
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作者：
Onishi T;Saha SK;Ludwig DR;Onishi T;Marek JJ;Cavalcante JL;Schelbert EB;Schwartzman D;Gorcsan J 3rd
对左心室(LV)机械不同步的分析，除了QRS宽度之外，还可以提供心脏再同步治疗(CRT)反应的增量预后信息。我们的目标是使用常规心血管磁共振(CMR)电影采集(FT-CMR)的特征跟踪后处理(FT-CMR)来量化LV不同步，并与斑点跟踪超声心动图进行比较。我们研究了72名连续的患者，他们都有稳态自由进动CMR和超声心动图。应用FT-CMR软件对中短轴CMR图像进行分析，并与超声心动图斑点追踪径向不同步(前后壁峰值应变时间差)进行比较。FT-CMR可分析所有患者的径向不同步，67例(93%)可通过超声心动图分析。FT-CMR和散斑跟踪的不同步显示应变延迟的一致限度为±84毫秒。与同步程度较高的患者测量的较小的平均延迟相比，这些延迟较大(高达100%或更多)，但在平均延迟为>；200毫秒的患者中可以接受(主要为25%)。在FT-CMR(径向应变延迟230 ± 94比77 ± 92*ms)和散斑跟踪(径向应变延迟242 ± 101比75 ± 88*ms，均为*p <； 0.001)方面，宽QRS患者的径向不同步性显著大于窄QRS患者。FT-CMR提供了CMR电影采集的径向不同步测量，至少对于有更明显不同步的患者，这与斑点跟踪超声心动图的结果显示出合理的一致性。例如，该方法在预测CRT患者预后方面的临床实用性仍有待调查。
Analysis of left ventricular (LV) mechanical dyssynchrony may provide incremental prognostic information regarding cardiac resynchronization therapy (CRT) response in addition to QRS width alone. Our objective was to quantify LV dyssynchrony using feature tracking post processing of routine cardiovascular magnetic resonance (CMR) cine acquisitions (FT-CMR) in comparison to speckle tracking echocardiography. We studied 72 consecutive patients who had both steady-state free precession CMR and echocardiography. Mid-LV short axis CMR cines were analyzed using FT-CMR software and compared with echocardiographic speckle tracking radial dyssynchrony (time difference between the anteroseptal and posterior wall peak strain). Radial dyssynchrony analysis was possible by FT-CMR in all patients, and in 67 (93%) by echocardiography. Dyssynchrony by FT-CMR and speckle tracking showed limits of agreement of strain delays of ± 84 ms. These were large (up to 100% or more) relative to the small mean delays measured in more synchronous patients, but acceptable (mainly <25%) in those with mean delays of >200 ms. Radial dyssynchrony was significantly greater in wide QRS patients than narrow QRS patients by both FT-CMR (radial strain delay 230 ± 94 vs. 77 ± 92* ms) and speckle tracking (radial strain delay 242 ± 101 vs. 75 ± 88* ms, all *p < 0.001). FT-CMR delivered measurements of radial dyssynchrony from CMR cine acquisitions which, at least for the patients with more marked dyssynchrony, showed reasonable agreement with those from speckle tracking echocardiography. The clinical usefulness of the method, for example in predicting prognosis in CRT patients, remains to be investigated.