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Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Quantitative mechanical dyssynchrony in dilated cardiomyopathy measured by deformable registration algorithm.

Yuanwei Xu1, Shuai He2, Weihao Li1

  • 1Department of Cardiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, Sichuan, People's Republic of China.

European Radiology
|January 19, 2020
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Summary

Deformable registration algorithm (DRA)-derived parameters effectively detect mechanical dyssynchrony in dilated cardiomyopathy (DCM) patients. The uniformity ratio estimate (URE) indices offer superior reproducibility and diagnostic value compared to time-to-peak (T2Psd) parameters.

Keywords:
AlgorithmsDilated cardiomyopathyMagnetic resonance imagingMyocardiumVentricular dysfunction, left

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
  • Mechanical dyssynchrony is a key feature of DCM, impacting cardiac function.
  • Accurate assessment of mechanical dyssynchrony is crucial for patient management.

Purpose of the Study:

  • To evaluate the diagnostic utility of deformable registration algorithm (DRA)-derived mechanical dyssynchrony parameters in DCM.
  • To compare the reproducibility of different DRA-derived parameters, including uniformity ratio estimate (URE) and standard deviation of time-to-peak (T2Psd).
  • To assess the correlation between these parameters and QRS duration in differentiating DCM subtypes.

Main Methods:

  • 80 DCM patients (40 with normal QRS duration, 40 with left bundle branch block) and 20 healthy controls were included.
  • Balanced steady-state free-precession (bSSFP) cine images were acquired using a 3.0T scanner.
  • DRA-derived segmental strain parameters (URE and T2Psd) were calculated in circumferential, radial, and longitudinal orientations.

Main Results:

  • DCM patients exhibited significant mechanical dyssynchrony compared to controls.
  • Left bundle branch block DCM (LBBB-DCM) patients showed significantly reduced circumferential URE (CURE) and radial URE (RURE), and increased T2Psd in eccentric (Ecc) and radial (Err) orientations compared to normal QRS duration DCM (NQRS-DCM) patients.
  • CURE demonstrated a strong inverse correlation with QRS duration (r = -0.54, p < 0.001) and the highest area under the curve (AUC = 0.791) for differentiating LBBB-DCM from NQRS-DCM.
  • URE indices exhibited superior intra- and inter-observer reproducibility (CoV: 1.20-3.17%) compared to T2Psd parameters (CoV: 15.28-41.18%).

Conclusions:

  • DRA-based CURE is a valuable parameter for assessing mechanical dyssynchrony in DCM, showing strong correlation with QRS duration and high discriminatory power between DCM subtypes.
  • URE indices provide more reproducible measurements of myocardial dyssynchrony than T2Psd parameters in DCM patients.
  • These findings support the use of DRA-derived URE for improved diagnosis and management of DCM.