PMID- 32084516 OWN - NLM STAT- MEDLINE DCOM- 20201130 LR - 20201130 IS - 1873-5894 (Electronic) IS - 0730-725X (Linking) VI - 68 DP - 2020 May TI - Regional myocardial strain by cardiac magnetic resonance feature tracking for detection of scar in ischemic heart disease. PG - 190-196 LID - S0730-725X(19)30591-0 [pii] LID - 10.1016/j.mri.2020.02.009 [doi] AB - BACKGROUND: Although cardiac magnetic resonance (CMR) can accurately quantify global left ventricular strain using feature tracking (FT), it has been suggested that FT cannot reliably quantify regional strain. We aimed to determine whether abnormalities in regional strain measured using FT can be detected within areas of myocardial scar and to determine the extent to which the regional strain measurement is impacted by LV ejection fraction (EF). METHODS: We retrospectively studied 96 patients (46 with LVEF 40%) with coronary artery disease and a late gadolinium enhancement (LGE) pattern consistent with myocardial infarction, who underwent CMR imaging (1.5T). Regional peak systolic longitudinal and circumferential strains (RLS, RCS) were measured within LGE and non-LGE areas. Linear regression analysis was performed for strain in both areas against LVEF to determine whether the relationship between strain and LGE holds across the LV function spectrum. Receiver-operating curve (ROC) analysis was performed in 33 patients (derivation cohort) to optimize strain cutoff, which was tested in the remaining 63 patients (validation cohort) for its ability to differentiate LGE from non-LGE areas. RESULTS: Both RLS and RCS magnitudes were reduced in LGE areas: RLS = -10.4 +/- 6.2% versus -21.0 +/- 8.5% (p < 0.001); RCS = -10.4 +/- 6.0% versus -18.9 +/- 8.6%, respectively (p < 0.001), but there was considerable overlap between LGE and non-LGE areas. Linear regression revealed that it was partially driven by the natural dependence between strain and EF, suggesting that EF-corrected strain cutoff is needed to detect LGE. ROC analysis showed the ability of both RLS and RCS to differentiate LGE from non-LGE areas: area under curve 0.95 and 0.89, respectively. In the validation cohort, optimal cutoffs of RLS/EF = 0.36 and RCS/EF = 0.37 yielded sensitivity, specificity and accuracy 0.74-0.78. CONCLUSION: Abnormalities in RLS and RCS within areas of myocardial scar can be detected using CMR-FT; however, LVEF must be accounted for. CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Stathogiannis, Konstantinos AU - Stathogiannis K AD - Department of Medicine, University of Chicago Medicine, Chicago, IL, USA; First Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece. FAU - Mor-Avi, Victor AU - Mor-Avi V AD - Department of Medicine, University of Chicago Medicine, Chicago, IL, USA. Electronic address: vmoravi@bsd.uchicago.edu. FAU - Rashedi, Nina AU - Rashedi N AD - Department of Medicine, University of Chicago Medicine, Chicago, IL, USA. Electronic address: nina.rashedi@uchospitals.edu. FAU - Lang, Roberto M AU - Lang RM AD - Department of Medicine, University of Chicago Medicine, Chicago, IL, USA. Electronic address: rlang@bsd.uchicago.edu. FAU - Patel, Amit R AU - Patel AR AD - Department of Medicine, University of Chicago Medicine, Chicago, IL, USA. Electronic address: amitpatel@uchicago.edu. LA - eng PT - Journal Article DEP - 20200219 PL - Netherlands TA - Magn Reson Imaging JT - Magnetic resonance imaging JID - 8214883 RN - 0 (Contrast Media) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Aged MH - Cicatrix/*diagnostic imaging MH - Cohort Studies MH - Contrast Media MH - Female MH - Gadolinium DTPA MH - Heart/*diagnostic imaging MH - Heart Ventricles/diagnostic imaging MH - Humans MH - Linear Models MH - *Magnetic Resonance Imaging, Cine MH - Magnetic Resonance Spectroscopy MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnostic imaging MH - Myocardial Ischemia/*diagnostic imaging MH - Myocardium/pathology MH - ROC Curve MH - Retrospective Studies MH - Sensitivity and Specificity MH - Systole MH - Ventricular Function, Left OTO - NOTNLM OT - Late gadolinium enhancement OT - Left ventricular function OT - Myocardial deformation EDAT- 2020/02/23 06:00 MHDA- 2020/12/01 06:00 CRDT- 2020/02/22 06:00 PHST- 2019/10/01 00:00 [received] PHST- 2019/12/23 00:00 [revised] PHST- 2020/02/18 00:00 [accepted] PHST- 2020/02/23 06:00 [pubmed] PHST- 2020/12/01 06:00 [medline] PHST- 2020/02/22 06:00 [entrez] AID - S0730-725X(19)30591-0 [pii] AID - 10.1016/j.mri.2020.02.009 [doi] PST - ppublish SO - Magn Reson Imaging. 2020 May;68:190-196. doi: 10.1016/j.mri.2020.02.009. Epub 2020 Feb 19.