Quantitative analysis of left ventricular strain using cardiac computed tomography.

Area of Science:

• Cardiology
• Medical Imaging
• Cardiac Physiology

Background:

• Echocardiography is standard for cardiac strain assessment but limited by poor echogenic windows.
• Reduced myocardial strain correlates with poor prognosis in cardiomyopathies.
• Tomographic imaging may offer an alternative for deformation analysis.

Purpose of the Study:

• To compare cardiac computed tomography (CCT) with echocardiography for assessing left ventricular (LV) myocardial deformation.
• To evaluate CCT's feasibility in patients with congestive heart failure.

Main Methods:

• 27 heart failure patients underwent ECG-gated contrast-enhanced CCT and echocardiography.
• LV radial, circumferential, and longitudinal strain/strain rates were analyzed using feature tracking software.
• Analysis time and diagnostic segment rates were compared between modalities.

Main Results:

• CCT showed strong correlations with echocardiography for global and regional LV strain (r=0.84-0.94).
• CCT yielded significantly fewer non-diagnostic segments (1.9% vs. 9.6%) compared to echocardiography.
• Quantitative strain analysis was significantly faster with CCT (877s vs. 1105s).

Conclusions:

• CCT enables quantitative assessment of LV myocardial deformation.
• CCT is a viable alternative to echocardiography for myocardial deformation analysis, particularly in patients with poor acoustic windows or MRI contraindications.