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Related Experiment Video

Updated: Jul 15, 2026

Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

Published on: February 12, 2011

Cardiac dyssynchrony analysis using circumferential versus longitudinal strain: implications for assessing cardiac

Robert H Helm¹, Christophe Leclercq, Owen P Faris

¹Division of Cardiology, Department of Medicine, Johns Hopkins Medical Institutions, 720 Rutland Ave, Baltimore, MD 21205, USA.

|May 25, 2005

Summary

Circumferential strain analysis better predicts cardiac resynchronization therapy (CRT) response in heart failure than longitudinal strain. This highlights limitations of longitudinal measures and supports developing circumferential-based methods for improved patient selection.

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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation

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Published on: October 20, 2016

Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging

Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging

Published on: May 24, 2021

Area of Science:

Cardiology
Biomedical Engineering
Medical Imaging

Background:

QRS duration is a standard but imperfect predictor of cardiac resynchronization therapy (CRT) response in heart failure.
Current echocardiography methods often rely on longitudinal strain (epsilonll), but its effectiveness compared to circumferential strain (epsiloncc) is unclear.

Purpose of the Study:

To compare the ability of longitudinal (epsilonll) and circumferential (epsiloncc) strain analyses to assess mechanical dyssynchrony and predict CRT response.
To evaluate the impact of different pacing modes (biventricular vs. left ventricular) on resynchronization metrics.

Main Methods:

3D MR-tagged imaging was used to calculate left ventricular epsilonll and epsiloncc in dogs with heart failure and conduction delay.
Dyssynchrony was assessed using temporal and regional strain variance analysis.
CRT was implemented via biventricular (BiV) or left ventricular (LV) pacing.

Main Results:

Both epsilonll and epsiloncc improved with CRT, but epsiloncc-based metrics correlated better with global functional improvement.
Longitudinal analysis showed resynchronization with BiV pacing but not LV pacing, and had poor correlation with functional benefit.
Epsilonll-based indexes showed limited resynchronization during systole and had higher variance compared to epsiloncc.

Conclusions:

Circumferential strain analysis is more sensitive to dyssynchrony and better predicts CRT response than longitudinal strain analysis.
Longitudinal strain measures have limitations, including different temporal profiles and lower dynamic range, potentially affecting CRT outcome prediction.
Developing noninvasive synchrony measures based on circumferential deformation is recommended for improved patient selection for CRT.