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Updated: Aug 26, 2026
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Comparative Performance of Speckle-Tracking Echocardiography and Cardiac Magnetic Resonance Feature Tracking for
Lang Gao1, Yukun Cao2, Nianguo Dong3
1Department of Ultrasound Medicine, Tongji Medical College, Union Hospital, Huazhong University of Science and Technology, Wuhan, China; Clinical Research Center for Medical Imaging in Hubei Province, Wuhan, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China.
Background:
Right ventricular free-wall longitudinal strain (RVFWLS) assessed by 3-dimensional (3D) speckle-tracking echocardiography (STE), 2-dimensional (2D) STE, and cardiac magnetic resonance (CMR) feature tracking (FT) has been reported to correlate with the degree of right ventricular myocardial fibrosis (RVMF), but the value of 3D STE in evaluating RVMF compared with CMR FT has not been investigated in patients with advanced heart failure.
Aims:
This study aimed to determine which RVFWLS measurement obtained by 2D STE, 3D STE, and CMR FT is the most robust noninvasive imaging marker for evaluating RVMF in patients with advanced heart failure using histopathological RVMF as the gold standard.
Methods:
One hundred fifty-one patients (118 male; mean age, 40 ± 18 years) with advanced heart failure who underwent CMR and 2D and 3D echocardiographic examinations before heart transplantation were recruited into this study. Right ventricular free-wall longitudinal strain was obtained from 2D STE, 3D STE, and CMR FT. The degree of RVMF was evaluated using late gadolinium enhancement (LGE) of CMR and Masson's staining in right ventricular myocardial samples, and patients were divided into 3 groups according to tertiles of histopathological RVMF.
Results:
Patients with severe RVMF had lower 3D RVFWLS, 2D RVFWLS, and CMR-derived RVFWLS and higher CMR LGE compared with those with mild and moderate RVMF. Right ventricular myocardial fibrosis was strongly correlated with CMR-derived RVFWLS (r = 0.73, P < .001), 3D RVFWLS (r = 0.72, P < .001), and CMR LGE (r = 0.71, P < .001) and moderately correlated with 2D RVFWLS (r = 0.56, P < .001). The correlations of CMR-derived RVFWLS and 3D RVFWLS with RVMF were not different from correlation of CMR LGE with RVMF (P > .05). Cardiac magnetic resonance LGE, CMR-derived RVFWLS, and 3D RVFWLS had similar performance in identifying severe RVMF (area under the curve = 0.90 vs 0.87 vs 0.85, all P > .05). The model with CMR-derived RVFWLS (R2 = 0.515, P < .001) had a similar ability to assess RVMF as the model with 3D RVFWLS (R2 = 0.499, P < .001) but a better ability than the model with 2D RVFWLS (R2 = 0.340, P < .001).
Conclusions:
Three-dimensional RVFWLS and CMR-derived RVFWLS are strongly correlated with RVMF in patients with advanced heart failure. Three-dimensional STE may be a promising technique that correlates with RVMF, providing a similar accuracy as CMR FT in assessing RVMF.
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