Quantification of left atrial strain and strain rate using Cardiovascular Magnetic Resonance myocardial feature tracking: a feasibility study.
Quantification of left atrial strain and strain rate using Cardiovascular Magnetic Resonance myocardial feature tracking: a feasibility study.
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DOI：
10.1186/s12968-014-0060-6
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发表时间：
2014-08-12
期刊：
影响因子：
--
通讯作者：
Schuster A
中科院分区：
文献类型：
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作者：
Kowallick JT;Kutty S;Edelmann F;Chiribiri A;Villa A;Steinmetz M;Sohns JM;Staab W;Bettencourt N;Unterberg-Buchwald C;Hasenfuß G;Lotz J;Schuster A
心血管磁共振心肌特征跟踪（CMR-FT）是一种定量技术，用于跟踪标准稳态自由进动（SSFP）电影图像上的组织体素运动，以评估心室心肌变形。左心房（LA）变形评估的重要性日益得到认可，并可通过超声心动图斑点追踪进行评估。然而，心房变形量化以前从未被证明与CMR。我们试图确定CMR-FT定量推导LA应变和应变率（SR）心肌力学的可行性和重现性。10例健康志愿者、10例肥厚型心肌病（HCM）患者和10例心力衰竭和射血分数保留（HFpEF）患者在1.5特斯拉下进行了研究。使用专用CMR-FT软件（2D CPA MR，TomTec，德国）从SSFP电影图像中推导出LA纵向应变和SR参数。使用4腔和2腔视图分析LA性能，包括LA储血功能（总应变[？s]，峰值正SR [SRs]），LA导管功能（被动应变[？e]、峰值早期负SR [SRe]）和LA增压泵功能（活动应变[？晚峰负SR [SRa]）。在所有受试者中，LA应变和SR参数可以从SSFP图像中导出。HCM和HFpEF患者左房储血功能受损（？s [%]：HCM 22.1？±？5.5，HFpEF 16.3？±？5.8，对照组29.1？±？5.3，p？<? 0.01; SR [s？1]：HCM 0.9？±？0.2，HFpEF 0.8？±？0.3，对照品1.1？±？0.2，p？<? 0.05）和受损的左心房导管功能相比，健康对照组（？e [%]：HCM 10.4？±？3.9，HFpEF 11.9？±？4.0，对照组21.3？±？5.1，p？<? 0.001; SRe [s？1]：HCM？0.5？±？0.2，HFpEF？0.6？±？0.1，对照组？一点零？±？0.3，p？<? 0.01）。左心房增压泵功能在肥厚型心肌病时增强，而在高频率射血分数时减弱（？a [%]：HCM 11.7？±？4.0，HFpEF 4.5？±？2.9，对照组7.8？±？2.5，p？<? 0.01; SRa [s？1]：HCM？一点二？±？0.4，HFpEF？0.5？±？0.2，对照组？0.9？±？0.3，p？<? 0.01）。通过Bland-Altman、变异系数和组内相关系数分析确定，在观察者内和观察者间水平上，所有应变和SR参数的观察者变异性均极佳。基于CMR-FT的心房性能分析可靠地量化了标准SSFP电影图像中的LA纵向应变和SR，并区分了左心室舒张受损患者和健康对照者。CMR-FT衍生的心房变形量化似乎是研究健康和疾病状态下心房性能和生理学的一种有前途的新方法。
Cardiovascular Magnetic Resonance myocardial feature tracking (CMR-FT) is a quantitative technique tracking tissue voxel motion on standard steady-state free precession (SSFP) cine images to assess ventricular myocardial deformation. The importance of left atrial (LA) deformation assessment is increasingly recognized and can be assessed with echocardiographic speckle tracking. However atrial deformation quantification has never previously been demonstrated with CMR. We sought to determine the feasibility and reproducibility of CMR-FT for quantitative derivation of LA strain and strain rate (SR) myocardial mechanics. 10 healthy volunteers, 10 patients with hypertrophic cardiomyopathy (HCM) and 10 patients with heart failure and preserved ejection fraction (HFpEF) were studied at 1.5 Tesla. LA longitudinal strain and SR parameters were derived from SSFP cine images using dedicated CMR-FT software (2D CPA MR, TomTec, Germany). LA performance was analyzed using 4- and 2-chamber views including LA reservoir function (total strain [?s], peak positive SR [SRs]), LA conduit function (passive strain [?e], peak early negative SR [SRe]) and LA booster pump function (active strain [?a], late peak negative SR [SRa]). In all subjects LA strain and SR parameters could be derived from SSFP images. There was impaired LA reservoir function in HCM and HFpEF (?s [%]: HCM 22.1?±?5.5, HFpEF 16.3?±?5.8, Controls 29.1?±?5.3, p?<?0.01; SRs [s?1]: HCM 0.9?±?0.2, HFpEF 0.8?±?0.3, Controls 1.1?±?0.2, p?<?0.05) and impaired LA conduit function as compared to healthy controls (?e [%]: HCM 10.4?±?3.9, HFpEF 11.9?±?4.0, Controls 21.3?±?5.1, p?<?0.001; SRe [s?1]: HCM ?0.5?±?0.2, HFpEF ?0.6?±?0.1, Controls ?1.0?±?0.3, p?<?0.01). LA booster pump function was increased in HCM while decreased in HFpEF (?a [%]: HCM 11.7?±?4.0, HFpEF 4.5?±?2.9, Controls 7.8?±?2.5, p?<?0.01; SRa [s?1]: HCM ?1.2?±?0.4, HFpEF ?0.5?±?0.2, Controls ?0.9?±?0.3, p?<?0.01). Observer variability was excellent for all strain and SR parameters on an intra- and inter-observer level as determined by Bland-Altman, coefficient of variation and intraclass correlation coefficient analyses. CMR-FT based atrial performance analysis reliably quantifies LA longitudinal strain and SR from standard SSFP cine images and discriminates between patients with impaired left ventricular relaxation and healthy controls. CMR-FT derived atrial deformation quantification seems a promising novel approach for the study of atrial performance and physiology in health and disease states.