Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography

The International Journal of Cardiovascular Imaging, Oct 2017

Parameters using myocardial strain analysis may predict response to cardiac resynchronization therapy (CRT). As the agreement between currently available strain imaging modalities is unknown, three different modalities were compared. Twenty-seven CRT-candidates, prospectively included in the MARC study, underwent cardiac magnetic resonance (CMR) imaging and echocardiographic examination. Left ventricular (LV) circumferential strain was analysed with CMR tagging (CMR-TAG), CMR feature tracking (CMR-FT), and speckle tracking echocardiography (STE). Basic strain values and parameters of dyssynchrony and discoordination obtained with CMR-FT and STE were compared to CMR-TAG. Agreement of CMR-FT and CMR-TAG was overall fair, while agreement between STE and CMR-TAG was often poor. For both comparisons, agreement on discoordination parameters was highest, followed by dyssynchrony and basic strain parameters. For discoordination parameters, agreement on systolic stretch index was highest, with fair intra-class correlation coefficients (ICC) (CMR-FT: 0.58, STE: 0.55). ICC of septal systolic rebound stretch (SRSsept) was poor (CMR-FT: 0.41, STE: 0.30). Internal stretch factor of septal and lateral wall (ISFsep–lat) showed fair ICC values (CMR-FT: 0.53, STE: 0.46), while the ICC of the total LV (ISFLV) was fair for CMR-FT (0.55) and poor for STE (ICC: 0.32). The CURE index had a fair ICC for both comparisons (CMR-FT: 0.49, STE 0.41). Although comparison of STE to CMR-TAG was limited by methodological differences, agreement between CMR-FT and CMR-TAG was overall higher compared to STE and CMR-TAG. CMR-FT is a potential clinical alternative for CMR-TAG and STE, especially in the detection of discoordination in CRT-candidates.

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Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography

Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography Wouter M. van Everdingen 0 1 2 3 4 5 6 7 Alwin Zweerink 0 1 2 3 4 5 6 7 Robin Nijveldt 0 1 2 3 4 5 6 7 Odette A. E. Salden 0 1 2 3 4 5 6 7 Mathias Meine 0 1 2 3 4 5 6 7 Alexander H. Maass 0 1 2 3 4 5 6 7 Kevin Vernooy 0 1 2 3 4 5 6 7 Frederik J. De Lange 0 1 2 3 4 5 6 7 Albert C. van Rossum 0 1 2 3 4 5 6 7 Pierre Croisille 0 1 2 3 4 5 6 7 Patrick Clarysse 0 1 2 3 4 5 6 7 Bastiaan Geelhoed 0 1 2 3 4 5 6 7 Michiel Rienstra 0 1 2 3 4 5 6 7 Isabelle C. Van Gelder 0 1 2 3 4 5 6 7 Marc A. Vos 0 1 2 3 4 5 6 7 Cornelis P. Allaart 0 1 2 3 4 5 6 7 Maarten J. Cramer 0 1 2 3 4 5 6 7 0 Odette A. E. Salden 1 Wouter M. van Everdingen 2 Wouter M. van Everdingen , Alwin Zweerink, Cornelis P. manuscript 3 Michiel Rienstra 4 Patrick Clarysse 5 Albert C. van Rossum 6 Department of Cardiology, University Medical Centre Utrecht , Utrecht , The Netherlands 7 Maarten J. Cramer Parameters using myocardial strain analysis may predict response to cardiac resynchronization therapy (CRT). As the agreement between currently available strain imaging modalities is unknown, three different modalities were compared. Twenty-seven CRT-candidates, prospectively included in the MARC study, underwent cardiac magnetic resonance (CMR) imaging and echocardiographic examination. Left ventricular (LV) circumferential strain was analysed with CMR tagging (CMR-TAG), CMR feature tracking (CMR-FT), and speckle tracking echocardiography (STE). Basic strain values and parameters of dyssynchrony Vol.:(011233456789) - and discoordination obtained with CMR-FT and STE were compared to CMR-TAG. Agreement of CMR-FT and CMRTAG was overall fair, while agreement between STE and CMR-TAG was often poor. For both comparisons, agreement on discoordination parameters was highest, followed by dyssynchrony and basic strain parameters. For discoordination parameters, agreement on systolic stretch index was highest, with fair intra-class correlation coefficients (ICC) (CMR-FT: 0.58, STE: 0.55). ICC of septal systolic rebound stretch (SRSsept) was poor (CMR-FT: 0.41, STE: 0.30). Internal stretch factor of septal and lateral wall (ISFsep–lat) showed fair ICC values (CMR-FT: 0.53, STE: 0.46), while the ICC of the total LV (ISFLV) was fair for CMR-FT (0.55) and poor for STE (ICC: 0.32). The CURE index had a fair ICC for both comparisons (CMR-FT: 0.49, STE 0.41). Although comparison of STE to CMR-TAG was limited by methodological differences, agreement between CMR-FT and CMRTAG was overall higher compared to STE and CMR-TAG. R RVEF SRSsept SSFP SSI STE TE TR TTPmax TTPSD CMR-FT is a potential clinical alternative for CMR-TAG and STE, especially in the detection of discoordination in CRT-candidates. Onset-delay Peak-delay Abbreviations AVC strain AVC CMR CMR-FT CMR-TAG CRT CSPAMM CURE ICC ISFLV ISFsep–lat LBBB LV LVEDV LVEF LVESV MARC NYHA Strain value at aortic valve closure Aortic valve closure Cardiac magnetic resonance imaging Cardiac magnetic resonance feature tracking Cardiac magnetic resonance myocardial tagging Cardiac resynchronization therapy Complementary spatial modulation of magnetization Circumferential uniformity ratio estimates. Intra-class correlation coefficient Internal stretch factor of all left ventricular segments Internal stretch factor of septum and lateral wall Left bundle branch block Left ventricle Left ventricular end-diastolic volume Left ventricular ejection fraction Left ventricular end-systolic volume Markers of response to cardiac resynchronization therapy New York Heart Association 1 2 3 4 5 6 7 Department of Cardiology, and Institute for Cardiovascular Research (ICaR-VU), VU University Medical Centre, Amsterdam, The Netherlands Department of Cardiology, Thoraxcenter, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands Université Lyon, UJM-Saint-Etienne, INSA, CNRS UMR 5520, INSERM U1206, CREATIS, 42023 Saint-Etienne, France Department of Medical Physiology, University of Utrecht, Utrecht, The Netherlands Time delay between onset of shortening of septal and lateral wall Septal to lateral wall delay of time to maximal peak shortening Correlation coefficient Right ventricular ejection fraction. Septal systolic rebound stretch Steady-state free-precession Systolic stretch index Speckle tracking echocardiography Echo time Repetition time Time to maximal peak shortening Standard deviation if time to peak max of all segments Introduction Cardiac resynchronization therapy (CRT) is an established treatment for patients with heart failure, reduced left ventricular (LV) ejection fraction, and a prolonged QRS caused by a left bundle branch block (LBBB) or nonspecific intraventricular conduction delay [ (...truncated)


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Wouter M. van Everdingen, Alwin Zweerink, Robin Nijveldt, Odette A. E. Salden, Mathias Meine, Alexander H. Maass, Kevin Vernooy, Frederik J. De Lange, Albert C. van Rossum, Pierre Croisille, Patrick Clarysse, Bastiaan Geelhoed, Michiel Rienstra, Isabelle C. Van Gelder, Marc A. Vos, Cornelis P. Allaart, Maarten J. Cramer. Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography, The International Journal of Cardiovascular Imaging, 2017, pp. 1-14, DOI: 10.1007/s10554-017-1253-5