Related Experiment Video
Updated: Apr 28, 2026
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Quantification of left ventricular dyssynchrony in patients with systolic dysfunction: a comparison of
Soraya El Ghannudi1, Philippe Germain, Mi-Young Jeung
1Department of Radiology, University Hospital, Strasbourg, France; Department of Nuclear Medicine, University Hospital, Strasbourg, France.
Insights
Standard deviation of time-to-peak (SD_TTP) and circumferential uniformity ratio estimate (CURE) best identify systolic dysfunction. Uniformity indices like CURE and uniformity of strain TTP (US_TTP) are preferred due to lower variability.
Area of Science:
- Cardiovascular Imaging
- Cardiac Mechanics
- Magnetic Resonance Imaging
Background:
- Left ventricular dyssynchrony is a key indicator of systolic dysfunction.
- Accurate identification of dyssynchrony is crucial for patient management, particularly for cardiac resynchronization therapy (CRT).
- Magnetic Resonance (MR) tagging provides detailed assessment of myocardial strain and dyssynchrony.
Purpose of the Study:
- To determine which MR-tagging derived circumferential strain dyssynchrony metrics are most effective in differentiating patients with systolic dysfunction from healthy controls.
- To compare the diagnostic performance and reliability of various dyssynchrony indices.
Main Methods:
- Studied 150 subjects: controls (EF > 55%), patients with EF ≤ 55% (non-CRT eligible), and CRT-eligible patients.
- Utilized MR-tagging cine sequences to extract circumferential filtered strain curves.
- Analyzed six dyssynchrony indices: SD_Ecc_ES, SD_TTP, LIM, RVV, CURE, and US_TTP.
Main Results:
- All six dyssynchrony metrics showed significant differences across the three groups and correlated with ejection fraction (EF).
- Receiver operating characteristic (ROC) curve analysis revealed superior discrimination between normal and reduced EF for SD_TTP (AUC 0.998) and CURE (AUC 0.995).
- CURE and US_TTP demonstrated the lowest interobserver variability (1.2% and 0.8%, respectively).
Conclusions:
- SD_TTP and CURE are the most potent metrics for identifying systolic dysfunction based on left ventricular dyssynchrony.
- Considering measurement variability, uniformity indices such as CURE and US_TTP are recommended for clinical application.
Purpose:
To define which circumferential strain MR-tagging metrics of left intraventricular dyssynchrony better identifies patients with systolic dysfunction against control subjects.
Materials And Methods:
One hundred fifty subjects were studied: (i) controls with ejection fraction (EF) > 55% (n = 84), (ii) patients with EF ≤ 55% not eligible for cardiac resynchronization therapy (CRT) (n = 52), and (iii) patients eligible for CRT according to the ESC guidelines (n = 14). Tagging cine MR-based circumferential filtered strain curves were extracted. Six dyssynchrony indices were studied: standard deviation (SD) of peak strain (SD_Ecc_ES), SD of time-to-peak (SD_TTP), strain delay index (LIM), regional variance vector (RVV), circumferential uniformity ratio estimate (CURE), and uniformity of strain TTP (US_TTP).
Results:
All metrics show significant differences between the three groups (ANOVA, P < 10(-4) ) and are correlated with EF. Significantly higher AUC values of ROC curves between patients with normal vs. decreased EF were obtained with SD_TTP (0.998) and CURE (0.995). Agreement among different methods was fair to good (kappa 0.32 to 0.89). Interobserver variability was best for CURE (1.2%) and US_TTP (0.8%) while more than 3-times larger for other metrics.
Conclusion:
SD_TTP and CURE are the most discriminant dyssynchrony metrics for systolic dysfunction. However, taking into account the method's variability argues in favor of indices of uniformity of the strain, ie, CURE and US_TTP.
More Related Videos
11:50High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
Published on: July 9, 2010
09:05Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
