Validation of a rapid semi-automated method to assess left atrial longitudinal phasic strains on cine cardiovascular magnetic resonance imaging.
Validation of a rapid semi-automated method to assess left atrial longitudinal phasic strains on cine cardiovascular magnetic resonance imaging.
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DOI：
10.1186/s12968-018-0496-1
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发表时间：
2018-11-05
期刊：
影响因子：
--
通讯作者：
Zhong L
中科院分区：
文献类型：
--
作者：
Leng S;Tan RS;Zhao X;Allen JC;Koh AS;Zhong L
左心房（LA）功能异常是心功能不全和不良心血管结局的标志，但难以评估，因此无法常规量化。我们的目的是确定一种快速方法的可行性和有效性，以测量长轴LA应变和应变率（SR）与标准心血管磁共振（CMR）相比，传统的特征跟踪（FT）衍生的纵向应变。我们研究了50名正常对照、30名肥厚型心肌病患者和100名心力衰竭（HF）患者，其中包括40名射血分数降低（HFrEF）、30名射血分数中等（HFmrEF）和30名射血分数保留（HFpEF）患者。通过在标准电影CMR二腔和四腔视图上跟踪左房室交界处与左心房壁中后壁处用户定义点之间的距离，推导出左心房纵向应变和SR参数。在三个不同的心动时相分析LA性能：储库功能（储库应变εs和应变率SRs）、管道功能（管道应变εe和应变率SRe）和增压泵功能（增压应变εa和应变率SRa）。使用快速和传统FT-CMR方法评估的LA纵向应变和SR之间具有良好的一致性（r = 0.89至0.99，p < 0.001）。与FT-CMR相比，快速应变和SR显示出更好的观察者内和观察者间重现性，并且评估时间缩短了55%（85 ± 10 vs. 190 ± 12 s，p < 0.001）。正常对照组的快速LA测量值分别为：εs 35.3 ± 5.2%，εe 18.1 ± 4.3%，εa 17.2 ± 3.5%，相应相位SR为1.8 ± 0.4，− 2.0 ± 0.5，− 2.3 ± 0.6 s− 1。与正常对照组相比，在所有患者组中观察到LA菌株和SR显著减少。HFpEF和HFmrEF患者的εs、SRs、εe和SRe显著小于肥厚型心肌病患者，HFmrEF患者的左心房储血器和助推器功能显著受损。快速LA菌株和SR在区分患者与对照方面与FT-CMR相似（曲线下面积（AUC）= 0.79 - 0.96 vs. 0.76 - 0.93，p = NS）。新的定量LA应变和SR来自传统的电影CMR图像是快速评估参数LA相位功能分析。本文的在线版本（10.1186/s12968-018-0496-1）包含补充材料，可供授权用户使用。
Abnormal left atrial (LA) function is a marker of cardiac dysfunction and adverse cardiovascular outcome, but is difficult to assess, and hence not, routinely quantified. We aimed to determine the feasibility and effectiveness of a fast method to measure long-axis LA strain and strain rate (SR) with standard cardiovascular magnetic resonance (CMR) compared to conventional feature tracking (FT) derived longitudinal strain. We studied 50 normal controls, 30 patients with hypertrophic cardiomyopathy, and 100 heart failure (HF) patients, including 40 with reduced ejection fraction (HFrEF), 30 mid-range ejection fraction (HFmrEF) and 30 preserved ejection fraction (HFpEF). LA longitudinal strain and SR parameters were derived by tracking the distance between the left atrioventricular junction and a user-defined point at the mid posterior LA wall on standard cine CMR two- and four-chamber views. LA performance was analyzed at three distinct cardiac phases: reservoir function (reservoir strain εs and strain rate SRs), conduit function (conduit strain εe and strain rate SRe) and booster pump function (booster strain εa and strain rate SRa). There was good agreement between LA longitudinal strain and SR assessed using the fast and conventional FT-CMR approaches (r = 0.89 to 0.99, p < 0.001). The fast strain and SRs showed a better intra- and inter-observer reproducibility and a 55% reduction in evaluation time (85 ± 10 vs. 190 ± 12 s, p < 0.001) compared to FT-CMR. Fast LA measurements in normal controls were 35.3 ± 5.2% for εs, 18.1 ± 4.3% for εe, 17.2 ± 3.5% for εa, and 1.8 ± 0.4, − 2.0 ± 0.5, − 2.3 ± 0.6 s− 1 for the respective phasic SRs. Significantly reduced LA strains and SRs were observed in all patient groups compared to normal controls. Patients with HFpEF and HFmrEF had significantly smaller εs, SRs, εe and SRe than hypertrophic cardiomyopathy, and HFmrEF had significantly impaired LA reservoir and booster function compared to HFpEF. The fast LA strains and SRs were similar to FT-CMR for discriminating patients from controls (area under the curve (AUC) = 0.79 to 0.96 vs. 0.76 to 0.93, p = NS). Novel quantitative LA strain and SR derived from conventional cine CMR images are fast assessable parameters for LA phasic function analysis. The online version of this article (10.1186/s12968-018-0496-1) contains supplementary material, which is available to authorized users.
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DOI：
10.1016/j.jchf.2017.06.013
发表时间：
2017-11
期刊：
JACC. Heart failure
影响因子：
--
作者：
Hsu JJ;Ziaeian B;Fonarow GC
通讯作者：
Fonarow GC
DOI：
10.1111/j.1540-8175.2010.01329.x
发表时间：
2011-03-01
影响因子：
1.5
作者：
Cameli, Matteo;Lisi, Matteo;Mondillo, Sergio
通讯作者：
Mondillo, Sergio
影响因子：
37.8
作者：
Barbier, P;Solomon, SB;Glantz, SA
通讯作者：
Glantz, SA
影响因子：
1.9
作者：
Cameli, Matteo;Lisi, Matteo;Maccherini, Massimo
通讯作者：
Maccherini, Massimo
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe