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The International Journal of Cardiovascular Imaging

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Open Access 01-03-2018 | Original Paper

Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography

Published in: The International Journal of Cardiovascular Imaging | Issue 3/2018

Abstract

Parameters using myocardial strain analysis may predict response to cardiac resynchronization therapy (CRT). As the agreement between currently available strain imaging modalities is unknown, three different modalities were compared. Twenty-seven CRT-candidates, prospectively included in the MARC study, underwent cardiac magnetic resonance (CMR) imaging and echocardiographic examination. Left ventricular (LV) circumferential strain was analysed with CMR tagging (CMR-TAG), CMR feature tracking (CMR-FT), and speckle tracking echocardiography (STE). Basic strain values and parameters of dyssynchrony and discoordination obtained with CMR-FT and STE were compared to CMR-TAG. Agreement of CMR-FT and CMR-TAG was overall fair, while agreement between STE and CMR-TAG was often poor. For both comparisons, agreement on discoordination parameters was highest, followed by dyssynchrony and basic strain parameters. For discoordination parameters, agreement on systolic stretch index was highest, with fair intra-class correlation coefficients (ICC) (CMR-FT: 0.58, STE: 0.55). ICC of septal systolic rebound stretch (SRS_sept) was poor (CMR-FT: 0.41, STE: 0.30). Internal stretch factor of septal and lateral wall (ISF_sep–lat) showed fair ICC values (CMR-FT: 0.53, STE: 0.46), while the ICC of the total LV (ISF_LV) was fair for CMR-FT (0.55) and poor for STE (ICC: 0.32). The CURE index had a fair ICC for both comparisons (CMR-FT: 0.49, STE 0.41). Although comparison of STE to CMR-TAG was limited by methodological differences, agreement between CMR-FT and CMR-TAG was overall higher compared to STE and CMR-TAG. CMR-FT is a potential clinical alternative for CMR-TAG and STE, especially in the detection of discoordination in CRT-candidates.

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Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA et al (2013) 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J 34(29):2281–2329CrossRefPubMed

Sweeney MO, Prinzen FW (2008) Ventricular pump function and pacing: physiological and clinical integration. Circ Arrhythm Electrophysiol 1(2):127–139CrossRefPubMed

Daubert JC, Saxon L, Adamson PB, Auricchio A, Berger RD, Beshai JF et al (2012) 2012 EHRA/HRS expert consensus statement on cardiac resynchronization therapy in heart failure: implant and follow-up recommendations and management. Europace 14(9):1236–1286CrossRefPubMed

Auricchio A, Prinzen FW (2011) Non-responders to cardiac resynchronization therapy: the magnitude of the problem and the issues. Circ J 75(3):521–527CrossRefPubMed

van Everdingen WM, Schipper JC, van ‘t Sant J, Ramdat Misier K, Meine M, Cramer MJ (2016) Echocardiography and cardiac resynchronisation therapy, friends or foes? Netherlands Heart J 24(1):25–38CrossRef

Risum N, Tayal B, Hansen TF, Bruun NE, Jensen MT, Lauridsen TK et al (2015) Identification of typical left bundle branch block contraction by strain echocardiography is additive to electrocardiography in prediction of long-term outcome after cardiac resynchronization therapy. J Am Coll Cardiol 66(6):631–641CrossRefPubMed

Wang CL, Wu CT, Yeh YH, Wu LS, Chan YH, Kuo CT et al (2017) Left bundle-branch block contraction patterns identified from radial-strain analysis predicts outcomes following cardiac resynchronization therapy. Int J Cardiovasc Imaging 33(6):869–877CrossRefPubMed

Leenders GE, Cramer MJ, Bogaard MD, Meine M, Doevendans PA, De Boeck BW (2011) Echocardiographic prediction of outcome after cardiac resynchronization therapy: conventional methods and recent developments. Heart Fail Rev 16(3):235–250CrossRefPubMed

Chung ES, Leon AR, Tavazzi L, Sun JP, Nihoyannopoulos P, Merlino J et al (2008) Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation 117(20):2608–2616CrossRefPubMed

10.

Leenders GE, De Boeck BW, Teske AJ, Meine M, Bogaard MD, Prinzen FW et al (2012) Septal rebound stretch is a strong predictor of outcome after cardiac resynchronization therapy. J Card Fail 18(5):404–412CrossRefPubMed

11.

Lumens J, Tayal B, Walmsley J, Delgado-Montero A, Huntjens PR, Schwartzman D et al (2015) Differentiating electromechanical from non-electrical substrates of mechanical discoordination to identify responders to cardiac resynchronization therapy. Circ Cardiovasc Imaging 8(9):e003744CrossRefPubMed

12.

Leenders GE, Lumens J, Cramer MJ, De Boeck BW, Doevendans PA, Delhaas T et al (2012) Septal deformation patterns delineate mechanical dyssynchrony and regional differences in contractility: analysis of patient data using a computer model. Circ Heart Fail 5(1):87–96CrossRefPubMed

13.

Revah G, Wu V, Huntjens PR, Piekarski E, Chyou JY, Axel L (2016) Cardiovascular magnetic resonance features of mechanical dyssynchrony in patients with left bundle branch block. Int J Cardiovasc Imaging 32(9):1427–1438CrossRefPubMed

14.

Pedrizzetti G, Claus P, Kilner PJ, Nagel E (2016) Principles of cardiovascular magnetic resonance feature tracking and echocardiographic speckle tracking for informed clinical use. J Cardiovasc Magn Reson 18(1):51CrossRefPubMedPubMedCentral

15.

Harrild DM, Han Y, Geva T, Zhou J, Marcus E, Powell AJ (2012) Comparison of cardiac MRI tissue tracking and myocardial tagging for assessment of regional ventricular strain. Int J Cardiovasc Imaging 28(8):2009–2018CrossRefPubMed

16.

Zwanenburg JJ, Gotte MJ, Kuijer JP, Heethaar RM, van Rossum AC, Marcus JT (2004) Timing of cardiac contraction in humans mapped by high-temporal-resolution MRI tagging: early onset and late peak of shortening in lateral wall. Am J Physiol Heart Circ Physiol 286(5):H1872–H1880CrossRefPubMed

17.

Maass AH, Vernooy K, Wijers SC, van ‘t Sant J, Cramer MJ, Meine M et al. (2017) Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study. Europace. doi:10.1093/europace/euw445 PubMed

18.

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16(3):233–270CrossRefPubMed

19.

Miller CA, Borg A, Clark D, Steadman CD, McCann GP, Clarysse P et al (2013) Comparison of local sine wave modeling with harmonic phase analysis for the assessment of myocardial strain. J Magn Reson Imaging 38(2):320–328CrossRefPubMed

20.

Kirn B, Jansen A, Bracke F, van Gelder B, Arts T, Prinzen FW (2008) Mechanical discoordination rather than dyssynchrony predicts reverse remodeling upon cardiac resynchronization. Am J Physiol Heart Circ Physiol 295(2):H640–H646CrossRefPubMed

21.

Helm RH, Leclercq C, Faris OP, Ozturk C, McVeigh E, Lardo AC et al (2005) Cardiac dyssynchrony analysis using circumferential versus longitudinal strain: implications for assessing cardiac resynchronization. Circulation 111(21):2760–2767CrossRefPubMedPubMedCentral

22.

Shrout PE, Fleiss JL (1979) Intraclass correlations: uses in assessing rater reliability. Psychol Bull 86(2):420–428CrossRefPubMed

23.

Castillo E, Osman NF, Rosen BD, El-Shehaby I, Pan L, Jerosch-Herold M et al (2005) Quantitative assessment of regional myocardial function with MR-tagging in a multi-center study: interobserver and intraobserver agreement of fast strain analysis with Harmonic Phase (HARP) MRI. J Cardiovasc Magn Reson 7(5):783–791CrossRefPubMed

24.

van Everdingen WM, Paiman ML, van Deursen CJ, Cramer MJ, Vernooy K, Delhaas T et al (2015) Comparison of septal strain patterns in dyssynchronous heart failure between speckle tracking echocardiography vendor systems. J Electrocardiol 48(4):609–616CrossRefPubMed

25.

Wu L, Germans T, Guclu A, Heymans MW, Allaart CP, van Rossum AC (2014) Feature tracking compared with tissue tagging measurements of segmental strain by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 16:10CrossRefPubMedPubMedCentral

26.

Onishi T, Saha SK, Ludwig DR, Marek JJ, Cavalcante JL, Schelbert EB et al (2013) Feature tracking measurement of dyssynchrony from cardiovascular magnetic resonance cine acquisitions: comparison with echocardiographic speckle tracking. J Cardiovasc Magn Reson 15:95CrossRefPubMedPubMedCentral

27.

Moody WE, Taylor RJ, Edwards NC, Chue CD, Umar F, Taylor TJ et al (2015) Comparison of magnetic resonance feature tracking for systolic and diastolic strain and strain rate calculation with spatial modulation of magnetization imaging analysis. J Magn Reson Imaging 41(4):1000–1012CrossRefPubMed

28.

Singh A, Steadman CD, Khan JN, Horsfield MA, Bekele S, Nazir SA et al (2015) Intertechnique agreement and interstudy reproducibility of strain and diastolic strain rate at 1.5 and 3 T: a comparison of feature-tracking and tagging in patients with aortic stenosis. J Magn Reson Imaging 41(4):1129–1137CrossRefPubMed

29.

Rosner A, Barbosa D, Aarsaether E, Kjonas D, Schirmer H, D’Hooge J (2015) The influence of frame rate on two-dimensional speckle-tracking strain measurements: a study on silico-simulated models and images recorded in patients. Eur Heart J Cardiovasc Imaging 16(10):1137–1147CrossRefPubMed

30.

D’Hooge J, Barbosa D, Gao H, Claus P, Prater D, Hamilton J et al (2016) Two-dimensional speckle tracking echocardiography: standardization efforts based on synthetic ultrasound data. Eur Heart J Cardiovasc Imaging 17(6):693–701CrossRefPubMed

31.

Bilchick KC, Dimaano V, Wu KC, Helm RH, Weiss RG, Lima JA et al (2008) Cardiac magnetic resonance assessment of dyssynchrony and myocardial scar predicts function class improvement following cardiac resynchronization therapy. J Am Coll Cardiol Img 1(5):561–568CrossRef

32.

Marechaux S, Guiot A, Castel AL, Guyomar Y, Semichon M, Delelis F et al (2014) Relationship between two-dimensional speckle-tracking septal strain and response to cardiac resynchronization therapy in patients with left ventricular dysfunction and left bundle branch block: a prospective pilot study. J Am Soc Echocardiogr 27(5):501–511CrossRefPubMed

33.

De Boeck BW, Teske AJ, Meine M, Leenders GE, Cramer MJ, Prinzen FW et al (2009) Septal rebound stretch reflects the functional substrate to cardiac resynchronization therapy and predicts volumetric and neurohormonal response. Eur J Heart Fail 11(9):863–871CrossRefPubMed

34.

Farsalinos KE, Daraban AM, Unlu S, Thomas JD, Badano LP, Voigt JU (2015) Head-to-head comparison of global longitudinal strain measurements among nine different vendors: the EACVI/ASE Inter-Vendor Comparison Study. J Am Soc Echocardiogr 28(10):1171–1181, e1172CrossRefPubMed

35.

de Simone G, Ganau A, Roman MJ, Devereux RB (1997) Relation of left ventricular longitudinal and circumferential shortening to ejection fraction in the presence or in the absence of mild hypertension. J Hypertens 15(9):1011–1017CrossRefPubMed

36.

Leitman M, Lysiansky M, Lysyansky P, Friedman Z, Tyomkin V, Fuchs T et al (2010) Circumferential and longitudinal strain in 3 myocardial layers in normal subjects and in patients with regional left ventricular dysfunction. J Am Soc Echocardiogr 23(1):64–70CrossRefPubMed

Title: Comparison of strain imaging techniques in CRT candidates: CMR tagging, CMR feature tracking and speckle tracking echocardiography
Publication date: 01-03-2018
Published in: The International Journal of Cardiovascular Imaging / Issue 3/2018
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-017-1253-5

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