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Quantification of Mouse Heart Left Ventricular Function, Myocardial Strain, and Hemodynamic Forces by Cardiovascular Magnetic Resonance Imaging
Published on: May 24, 2021
Value of Cardiac Magnetic Resonance Fractal Analysis Combined With Myocardial Strain in Discriminating Isolated Left
Tian Zheng1, Xiaohai Ma2, Shuhao Li1
1Department of Radiology, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
Insights
Fractal analysis quantitatively measures left ventricular trabeculation, aiding differentiation between left ventricular noncompaction (LVNC) and dilated cardiomyopathy (DCM). Combining fractal dimension with myocardial strain offers a novel biomarker for distinguishing these conditions.
Area of Science:
- Cardiovascular Imaging
- Biomedical Engineering
- Quantitative Analysis
Background:
- Distinguishing isolated left ventricular noncompaction (LVNC) from dilated cardiomyopathy (DCM) can be challenging due to excessive trabeculation in both conditions.
- Fractal dimension (FD) offers a quantitative method to assess myocardial trabeculation extent.
Purpose of the Study:
- To compare trabeculae features and myocardial strain using cardiac MRI between LVNC and DCM patients.
- To evaluate the diagnostic utility of fractal analysis and myocardial strain in differentiating LVNC from DCM.
Main Methods:
- Cardiac MRI with steady-state free precession cine imaging was performed on 35 LVNC patients, 30 DCM patients, and 20 healthy controls.
- Left ventricular trabeculation was assessed using a semiautomatic fractal analysis tool.
- Myocardial deformation was quantified using feature tracking to derive global peak longitudinal strain (GPLS).
Main Results:
- Max apical FD and mean global FD were significantly higher in the LVNC group compared to the DCM group (P < 0.001).
- FD values demonstrated good diagnostic accuracy for LVNC, with AUCs of 0.881 for max apical FD and 0.895 for mean global FD.
- The combination of fractal analysis (FD) and GPLS achieved the highest diagnostic accuracy (AUC = 0.93) for differentiating LVNC from DCM.
Conclusions:
- Fractal analysis provides a robust quantitative measure of myocardial trabeculation.
- The integration of fractal analysis with myocardial strain parameters presents a promising novel biomarker for distinguishing LVNC from DCM.
Background:
Excessive trabeculation is present in isolated left ventricular noncompaction (LVNC) and dilated cardiomyopathy (DCM), which sometimes makes the differentiation between these two difficult. Fractal dimension (FD) is a unitless measure value of how completely the object fills space, which can assess the extent of myocardial trabeculae quantitatively.
Purpose:
To compare the trabeculae features and myocardial strain derived from cardiac MR between LVNC and DCM.
Study Type:
Respective case-control series.
Population:
In all, 35 LVNC patients and 30 DCM patients were enrolled, and 20 healthy volunteers were selected as a control group.
Field Strength/Sequence:
5 T with 8-channel phased-array cardiac receiver coil including steady-state free precession cine imaging.
Assessment:
The degree of left ventricular trabeculation was evaluated by a semiautomatic tool based on fractal analysis. Myocardial deformation was assessed by feature tracking.
Statistical Tests:
Independent samples Student's t-test, Mann-Whitney U-test, receiver operating characteristics (ROC) curves, and Spearman's rank coefficient were conducted.
Results:
Max apical FD and mean global FD were higher in the LVNC group than in the DCM group (1.433 ± 0.074 vs. 1.341 ± 0.062, P < 0.001; 1.323 ± 0.036 vs. 1.267 ± 0.041, P < 0.001, respectively). For diagnosing LVNC, max apical FD was 1.392 (area under the curve [AUC] = 0.881, 95% confidence interval [CI]: 0.804-0.957), and the cutoff value of mean global FD was 1.283 (AUC = 0.895, 95% CI: 0.828-0.961). The global peak longitudinal strain value of the left ventricle (GPLS) showed significant differences between the LVNC group and DCM group [-6.49 (-11.41, -4.90) vs. -4.61 (-5.87, -3.61), P = 0.006]. The diagnostic accuracy for LVNC is highest when using FDs in coordination with GPLS (AUC = 0.93, 95% CI: 0.86-0.98, P < 0.001).
Data Conclusion:
Fractal analysis provides a quantitative measurement of myocardial trabeculation. The combination of fractal analysis with myocardial strain provides a novel biomarker in distinguishing LVNC from DCM.
Level Of Evidence:
3 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:153-163.
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