Reference ranges for three-dimensional feature tracking cardiac magnetic resonance: comparison with two-dimensional methodology and relevance of age and gender

Boyang Liu, Ahmed M Dardeer, William E Moody, Manvir K Hayer, Shanat Baig, Anna M Price, Francisco Leyva, Nicola C Edwards, Richard P Steeds, Boyang Liu, Ahmed M Dardeer, William E Moody, Manvir K Hayer, Shanat Baig, Anna M Price, Francisco Leyva, Nicola C Edwards, Richard P Steeds

Abstract

Myocardial deformation is a sensitive marker of sub-clinical myocardial dysfunction that carries independent prognostic significance across a broad range of cardiovascular diseases. It is now possible to perform 3D feature tracking of SSFP cines on cardiac magnetic resonance imaging (FT-CMR). This study provides reference ranges for 3D FT-CMR and assesses its reproducibility compared to 2D FT-CMR. One hundred healthy individuals with 10 men and women in each of 5 age deciles from 20 to 70 years, underwent 2D and 3D FT-CMR of left ventricular myocardial strain and strain rate using SSFP cines. Good health was defined by the absence of hypertension, diabetes, obesity, dyslipidaemia, or any cardiovascular, renal, hepatic, haematological and systemic inflammatory disease. Normal values for myocardial strain assessed by 3D FT-CMR were consistently lower compared with 2D FT-CMR measures [global circumferential strain (GCS) 3D - 17.6 ± 2.6% vs. 2D - 20.9 ± 3.7%, P < 0.005]. Validity of 3D FT-CMR was confirmed against other markers of systolic function. The 3D algorithm improved reproducibility compared to 2D, with GCS having the best inter-observer agreement [intra-class correlation (ICC) 0.88], followed by global radial strain (GRS; ICC 0.79) and global longitudinal strain (GLS, ICC 0.74). On linear regression analyses, increasing age was weakly associated with increased GCS (R2 = 0.15, R = 0.38), peak systolic strain rate, peak late diastolic strain rate, and lower peak early systolic strain rate. 3D FT-CMR offers superior reproducibility compared to 2D FT-CMR, with circumferential strain and strain rates offering excellent intra- and inter-observer variability. Normal range values for myocardial strain measurements using 3D FT-CMR are provided.

Keywords: Cardiac magnetic resonance; Strain imaging; Three-dimensional feature tracking.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Steps taken for 3D FT-CMR. a Define endocardial and epicardial borders. b 3D construct of endocardial and epicardial borders are used to generate a 3D model of the myocardium in diastole which is tracked through to systole. c Ensure good quality tracking. d Results for global and/or segmental strain and strain rates
Fig. 1
Fig. 1
Steps taken for 3D FT-CMR. a Define endocardial and epicardial borders. b 3D construct of endocardial and epicardial borders are used to generate a 3D model of the myocardium in diastole which is tracked through to systole. c Ensure good quality tracking. d Results for global and/or segmental strain and strain rates
Fig. 2
Fig. 2
a Bland–Altman plots for intra-observer bias for 3D peak GCS, GRS, and GLS. b Bland–Altman plots for inter-observer bias for 3D peak GCS, GRS, and GLS
Fig. 2
Fig. 2
a Bland–Altman plots for intra-observer bias for 3D peak GCS, GRS, and GLS. b Bland–Altman plots for inter-observer bias for 3D peak GCS, GRS, and GLS
Fig. 3
Fig. 3
16 segment model illustrating peak GCS ± SD with mean intra-observer absolute bias ± SD and ICC
Fig. 4
Fig. 4
Correlation of 3D GCS against Ecc and LVEF

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Source: PubMed

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