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Journal of Cardiovascular Magnetic Resonance

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Open Access 01-12-2017 | Research

Automated assessments of circumferential strain from cine CMR correlate with LVEF declines in cancer patients early after receipt of cardio-toxic chemotherapy

Authors: Marie-Pierre Jolly, Jennifer H. Jordan, Giselle C. Meléndez, Gary R. McNeal, Ralph B. D’Agostino Jr, W. Gregory Hundley

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2017

Abstract

Background

In patients with cancer receiving potentially cardio-toxic chemotherapy, measurements of left ventricular (LV) circumferential or longitudinal strain are often used clinically to identify myocardial dysfunction. Using a new software algorithm, we sought to determine in individuals receiving treatment for cancer the association between automated assessments of LV mean mid-wall circumferential strain and conventional measures of LV ejection fraction (EF) both obtained from cardiovascular magnetic resonance (CMR) cine balanced steady-state free-precession (bSSFP) white-blood acquisitions.

Methods

Before and 3 months after initiating treatment with potentially cardio-toxic chemotherapy, 72 individuals (aged 54 ± 14 years with breast cancer [39%], lymphoma [49%], or sarcoma [12%]) underwent serial CMR cine bSSFP assessments of LV volumes and EF, and mean mid-wall circumferential strain determined from these same cine images as well as from additional tagged CMR images. On the cine images, assessments of strain were obtained using the newly developed deformation-based segmentation algorithm. Assessments of LV volumes/EF from the cine images and strain from tagged CMR were accomplished using commercially available software. All measures were analyzed in a blinded fashion independent of one another.

Results

Acceptable measures for the automated assessments of mean mid-wall circumferential strain from the cine images were obtained in 142 of 144 visits (98.6%) with an overall analysis time averaging 6:47 ± 1:06 min. The results from these automated measures averaged −18.8 ± 2.9 at baseline and −17.6 ± 3.1 at 3 months (p = 0.001). Left ventricular EF declined slightly from 65 ± 7% at baseline to 62 ± 7% at 3 months (p = 0.0002). The correlation between strain from cine imaging and LVEF was r = −0.61 (p < 0.0001). In addition, the 3-month changes in LV strain and LVEF were correlated (r = −0.49; p < 0.0001). The correlation between cine and tagged derived assessments of strain was r = 0.23; p = 0.01.

Conclusions

Automated measures of LV mean mid-wall circumferential strain can be obtained in 6¾ minutes from cine bSSFP LV short-axis images (used concurrently to assess LV volumes and EF) in 98.6% of patients receiving treatment for cancer with potentially cardio-toxic chemotherapy. These cine derived measures of circumferential strain correlate with early subclinical declines in LVEF.

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Title: Automated assessments of circumferential strain from cine CMR correlate with LVEF declines in cancer patients early after receipt of cardio-toxic chemotherapy
Authors: Marie-Pierre Jolly
Jennifer H. Jordan
Giselle C. Meléndez
Gary R. McNeal
Ralph B. D’Agostino Jr
W. Gregory Hundley
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2017
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/s12968-017-0373-3

At a glance: The STEP trials

Springer Medicine

Automated assessments of circumferential strain from cine CMR correlate with LVEF declines in cancer patients early after receipt of cardio-toxic chemotherapy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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