Dynamic mapping of ventricular function from cardiovascular magnetic resonance imaging

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Imaging

Background:

• Heart failure significantly impacts mortality and morbidity, particularly in older adults.
• Cardiac resynchronization therapy (CRT) is crucial for heart failure management, but optimal left ventricular (LV) pacing site selection remains challenging.
• Current methods for identifying the optimal LV pacing site involve complex 3D mapping of scar and activation data, which is time-consuming.

Purpose of the Study:

• To develop and validate a novel method for improving CRT patient planning.
• To map mechanical activation propagation from cardiac magnetic resonance (CMR) onto a 3D+t model.
• To assist cardiologists in determining the optimal LV pacing site for enhanced CRT outcomes.

Main Methods:

• Automatic motion analysis of patient-specific LV anatomical models segmented from cine MR data.
• Extraction of regional volume change curves and intraventricular dyssynchrony indices.
• Mapping regional volume changes onto 3D+t CMR data to create a mechanical activation map throughout the cardiac cycle.

Main Results:

• A 3D+t mechanical activation map was successfully generated for each subject.
• The workflow was tested on 7 heart failure patients and 3 healthy volunteers.
• Demonstrated feasibility of mapping regional LV volume changes during ventricular pacing.

Conclusions:

• The developed 3D+t mechanical activation mapping facilitates optimal LV pacing site selection during CRT planning.
• This approach has the potential to decrease the number of patients who inadequately respond to CRT.
• Improved planning may lead to more effective CRT interventions for heart failure patients.