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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

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3D-wall motion tracking: a new tool for myocardial contractility analysis.

Leopoldo Perez de Isla¹, Cesar Montes, Tania Monzón

¹Hospital Clínico San Carlos, Madrid, Spain.

Journal of Cardiovascular Medicine (Hagerstown, Md.)

|December 8, 2010

Summary

New 3D-wall motion tracking echocardiography (3D-WMT) parameters for left ventricular (LV) systolic function show less dependence on loading conditions compared to the traditional left-ventricular ejection fraction (LVEF). These novel parameters may offer a more direct assessment of myocardial contractility.

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Area of Science:

Cardiology
Medical Imaging
Biomedical Engineering

Background:

Left-ventricular ejection fraction (LVEF) is a standard measure of left ventricular (LV) systolic function.
LVEF is influenced by loading conditions (preload and afterload), potentially confounding assessments of intrinsic myocardial contractility.
Three-dimensional wall motion tracking echocardiography (3D-WMT) offers novel parameters for LV systolic function assessment.

Purpose of the Study:

To evaluate if 3D-WMT-derived LV systolic function parameters are less susceptible to variations in loading conditions than LVEF.
To investigate the potential of 3D-WMT parameters for a more direct assessment of myocardial contractility.

Main Methods:

A cohort of chronic hemodialysis patients was studied to induce significant changes in loading conditions.
Echocardiographic studies, including 3D-WMT analysis, were performed immediately before and after hemodialysis sessions.
Changes in preload and afterload were assessed using parameters like E/È ratio and systolic blood pressure.

Main Results:

Hemodialysis significantly altered preload, afterload, LV end-diastolic volume, and LVEF.
In contrast, 3D-WMT-derived LV systolic function parameters remained stable and showed no significant changes before and after dialysis.
This indicates a lower load dependency for 3D-WMT parameters compared to LVEF.

Conclusions:

LV systolic function parameters derived from 3D-WMT exhibit reduced dependence on loading conditions compared to LVEF.
These novel parameters may provide a more direct and reliable measure of myocardial contractility.
3D-WMT parameters hold potential for early detection of subtle contractility impairments and optimizing patient management in cardiology.