Top

Published in:

01-01-2022 | Computed Tomography | Original Article

Left ventricular longitudinal strain is a major determinant of CT-derived three-dimensional maximum principal strain: comparison with two-dimensional speckle tracking echocardiography

Authors: Masaki Kinoshita, Yuki Tanabe, Kazuki Yoshida, Akira Kurata, Yusuke Kobayashi, Teruyoshi Uetani, Katsuji Inoue, Kazuhisa Nishimura, Shuntaro Ikeda, Teruhito Mochizuki, Teruhito Kido, Osamu Yamaguchi

Published in: Heart and Vessels | Issue 1/2022

Abstract

Computed tomography (CT)-derived three-dimensional maximum principal strain (MP-strain) can provide incremental value to coronary CT angiography for cardiac dysfunction assessment with high diagnostic performance in patients with myocardial infarction. Global longitudinal strain (GLS) measured using two-dimensional speckle tracking echocardiography (2D-STE) is more sensitive than left ventricular ejection fraction (LVEF) for detecting early myocardial dysfunction. We aimed to compare CT-derived MP-strain with each of 2D-STE-derived strains (i.e., longitudinal, circumferential, and radial strains), and identify the major determinants of CT-derived MP-strain among 2D-STE-derived strains. We studied 51 patients who underwent cardiac CT and echocardiography. CT images were reconstructed at every 5% (0–95%) of the RR interval. A dedicated workstation was used to analyze CT-derived MP-strain on the 16-segment model. We calculated CT-derived global MP-strain with all the 16 segments on a per patient basis. Pearson’s test was used to assess correlations between CT-derived MP-strain and STE-strain at global and segmental levels. The intra-class correlation coefficient for interobserver agreement for CT-derived global MP-strain was 0.98 (95% confidence interval 0.96–0.99). The low-CT-derived global MP-strain group (≤ 0.43) had more patients with LV dysfunction than the high-CT-derived global MP-strain group (> 0.43). CT-derived global MP-strain was associated with STE-GLS (r = 0.738, P < 0.001), global circumferential strain (r = 0.646, P < 0.001), and global radial strain (r = 0.432, P = 0.001). In multivariate analysis, STE-GLS had the strongest association to CT-derived global MP-strain among three directional STE-strains and LVEF by echocardiography (standardized coefficient = − 0.527, P < 0.001). STE-GLS is a major determinant of CT-derived global MP-strain. CT-derived MP-strain may enhance the value of coronary CT angiography by adding functional information to CT-derived LVEF.

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, González-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P, ESC Scientific Document Group (2016) 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the task force for the diagnosis and treatment of acute and chronic heart failure of the European society of cardiology ESC developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37:2129–2200CrossRef

Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013) 2013 ACCF/AHA guideline for the management of heart failure a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 62:e147–e239CrossRef

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (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 16:233–270CrossRef

Smiseth OA, Torp H, Opdahl A, Haugaa KH, Urheim S (2016) Myocardial strain imaging: how useful is it in clinical decision making? Eur Heart J 37:1196–1207CrossRef

Amzulescu MS, De Craene M, Langet H, Pasquet A, Vancraeynest D, Pouleur AC, Vanoverschelde JL, Gerber BL (2019) Myocardial strain imaging: review of general principles, validation, and sources of discrepancies. Eur Heart J Cardiovasc Imaging 20:605–619CrossRef

Motoki H, Borowski AG, Shrestha K, Troughton RW, Tang WH, Thomas JD, Klein AL (2012) Incremental prognostic value of assessing left ventricular myocardial mechanics in patients with chronic systolic heart failure. J Am Coll Cardiol 60:2074–2081CrossRef

Vach M, Vogelhuber J, Weber M, Sprinkart AM, Pieper CC, Block W, Kuetting D, Attenberger UI, Luetkens JA (2021) Feasibility of CT-derived myocardial strain measurement in patients with advanced cardiac valve disease. Sci Rep 11:8793CrossRef

Tavakoli V, Sahba N (2014) Cardiac motion and strain detection using 4D CT images: comparison with tagged MRI, and echocardiography. Int J Cardiovasc Imaging 30:175–184CrossRef

Pilla JJ, Koomalsingh KJ, McGarvey JR, Witschey WRT, Dougherty L, Gorman JH, Gorman RC (2015) Regional myocardial three-dimensional principal strains during postinfarction remodeling. Ann Thorac Surg 99:770–778CrossRef

10.

Tanabe Y, Kido T, Kurata A, Sawada S, Suekuni H, Kido T, Yokoi T, Uetani T, Inoue K, Miyagawa M, Mochizuki T (2017) Three-dimensional maximum principal strain using cardiac computed tomography for identification of myocardial infarction. Eur Radiol 27:1667–1675CrossRef

11.

Kawaguchi N, Kurata A, Kido T, Nishiyama Y, Kido T, Miyagawa M, Ogimoto A, Mochizuki T (2014) Optimization of coronary attenuation in coronary computed tomography angiography using diluted contrast material. Circ J 78:662–670CrossRef

12.

Shrimpton PC, Hillier MC, Lewis MA, Dunn M (2006) National survey of doses from CT in the UK: 2003. Br J Radiol 79:968–980CrossRef

13.

Yoshida K, Tanabe Y, Kido T, Kurata A, Uraoka D, Kinoshita M, Uetani T, Nishimura K, Inoue K, Ikeda S, Yamaguchi O, Mochizuki T (2020) Characteristics of the left ventricular three-dimensional maximum principal strain using cardiac computed tomography: reference values from subjects with normal cardiac function. Eur Radiol 30:6109–6117CrossRef

14.

Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS (2002) American heart association writing group on myocardial segmentation and registration for cardiac imaging. standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. a statement for healthcare professionals from the cardiac imaging committee of the council on clinical cardiology of the American heart association. Circulation 105:539–542CrossRef

15.

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (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. J Am Soc Echocardiogr 28:1–39CrossRef

16.

Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R, Pedri S, Ito Y, Abe Y, Metz S, Song JH, Hamilton J, Sengupta PP, Kolias TJ, d’Hooge J, Aurigemma GP, Thomas JD, Badano LP (2015) Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. J Am Soc Echocardiogr 28:183–193CrossRef

17.

Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 48:452–458CrossRef

18.

Tsuji K, Sakata Y, Nochioka K, Miura M, Yamauchi T, Onose T, Abe R, Oikawa T, Kasahara S, Sato M, Shiroto T, Takahashi J, Miyata S, Shimokawa H (2017) Characterization of heart failure patients with mid-range left ventricular ejection fraction—A report from the CHART-2 Study. Eur J Heart Fail 19:1258–1269CrossRef

19.

Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) (2012) The survival of patients with heart failure with preserved or reduced left ventricular ejection fraction: an individual patient data meta-analysis. Eur Heart J 33:1750–1757CrossRef

20.

Kovács A, Oláh A, Lux Á, Mátyás C, Németh BT, Kellermayer D, Ruppert M, Török M, Szabó L, Meltzer A, Assabiny A, Birtalan E, Merkely B, Radovits T (2015) Strain and strain rate by speckle tracking echocardiography correlate with pressure-volume loop-derived contractility indices in a rat model of athlete’s heart. Am J Physiol Heart Circ Physiol 308:H743-748CrossRef

21.

de Lucia C, Wallner M, Eaton DM, Zhao H, Houser SR, Koch WJ (2019) Echocardiographic strain analysis for the early detection of left ventricular systolic/diastolic dysfunction and dyssynchrony in a mouse model of physiological aging. J Gerontol A Biol Sci Med Sci 74:455–461CrossRef

22.

Stokke TM, Hasselberg NE, Smedsrud MK, Sarvari SI, Haugaa KH, Smiseth OA, Edvardsen T, Remme EW (2017) Geometry as a confounder when assessing ventricular systolic function: comparison between ejection fraction and strain. J Am Coll Cardiol 70:942–954CrossRef

23.

Park JJ, Park JB, Park JH, Cho GY (2018) Global longitudinal strain to predict mortality in patients with acute heart failure. J Am Coll Cardiol 71:1947–1957CrossRef

24.

Cho GY, Marwick TH, Kim HS, Kim MK, Hong KS, Oh DJ (2009) Global 2-dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol 54:618–624CrossRef

25.

Ammon F, Bittner D, Hell M, Mansour H, Achenbach S, Arnold M, Marwan M (2019) CT-derived left ventricular global strain: a head-to-head comparison with speckle tracking echocardiography. Int J Cardiovasc Imaging 35:1701–1707CrossRef

26.

Stocker TJ, Deseive S, Leipsic J, Hadamitzky M, Chen MY, Rubinshtein R, Heckner M, Bax JJ, Fang XM, Grove EL, Lesser J, Maurovich-Horvat P, Otton J, Shin S, Pontone G, Marques H, Chow B, Nomura CH, Tabbalat R, Schmermund A, Kang JW, Naoum C, Atkins M, Martuscelli E, Massberg S, Hausleiter J (2018) Reduction in radiation exposure in cardiovascular computed tomography imaging: results from the PROspective multicenter registry on radiaTion dose. Estimates of cardiac CT angiography in daily practice in 2017 (PROTECTION VI). Eur Heart J 39:3715–3723CrossRef

27.

Andersen NH, Terkelsen CJ, Sloth E, Poulsen SH (2004) Influence of preload alterations on parameters of systolic left ventricular long-axis function: a Doppler tissue study. J Am Soc Echocardiogr 17:941–947CrossRef

28.

Xu TY, Sun JP, Lee AP, Yang XS, Qiao Z, Luo X, Fang F, Li Y, Yu CM, Wang JG (2014) Three-dimensional speckle strain echocardiography is more accurate and efficient than 2D strain in the evaluation of left ventricular function. Int J Cardiol 176:360–366CrossRef

29.

Buss SJ, Schulz F, Mereles D, Hosch W, Galuschky C, Schummers G, Stapf D, Hofmann N, Giannitsis E, Hardt SE, Kauczor HU, Katus HA, Korosoglou G (2014) Quantitative analysis of left ventricular strain using cardiac computed tomography. Eur J Radiol 83:e123–e130CrossRef

30.

Tee MW, Won S, Raman FS, Yi C, Vigneault DM, Davies-Venn C, Liu S, Lardo AC, Lima JA, Noble JA, Emter CA, Bluemke DA (2015) Regional strain analysis with multidetector CT in a swine cardiomyopathy model: relationship to cardiac MR tagging and myocardial fibrosis. Radiology 277:88–94CrossRef

31.

Gupta V, Lantz J, Henriksson L, Engvall J, Karlsson M, Persson A, Ebbers T (2018) Automated three-dimensional tracking of the left ventricular myocardium in time-resolved and dose-modulated cardiac CT images using deformable image registration. J Cardiovasc Comput Tomogr 12:139–148CrossRef

32.

Wang R, Fang Z, Wang H, Schoepf UJ, Emrich T, Giovagnoli D, Biles E, Zhou Z, Du Z, Liu T, Xu L (2021) Quantitative analysis of three-dimensional left ventricular global strain using coronary computed tomography angiography in patients with heart failure: Comparison with 3T cardiac MR. Eur J Radiol 135:109485CrossRef

Title: Left ventricular longitudinal strain is a major determinant of CT-derived three-dimensional maximum principal strain: comparison with two-dimensional speckle tracking echocardiography
Authors: Masaki Kinoshita
Yuki Tanabe
Kazuki Yoshida
Akira Kurata
Yusuke Kobayashi
Teruyoshi Uetani
Katsuji Inoue
Kazuhisa Nishimura
Shuntaro Ikeda
Teruhito Mochizuki
Teruhito Kido
Osamu Yamaguchi
Publication date: 01-01-2022
Publisher: Springer Japan
Keywords: Computed Tomography
Echocardiography
Computed Tomography
CT Angiography
Echocardiography
Published in: Heart and Vessels / Issue 1/2022
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-021-01901-3

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Left ventricular longitudinal strain is a major determinant of CT-derived three-dimensional maximum principal strain: comparison with two-dimensional speckle tracking echocardiography

Abstract

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2022

Computed tomography imaging using split-bolus contrast injection with volume scan of aortic root and heart for preoperative evaluation of transcatheter aortic valve implantation

Decrease in red cell distribution width as a useful predictor of success after catheter ablation for atrial fibrillation: a retrospective multi-center study

Anti-inflammatory HDL effects are impaired in atrial fibrillation

Fluoroscopy and contrast media use in cryoballoon ablation of atrial fibrillation using a novel imaging system

Transition of the heart rate and atrial premature complex after cryoballoon vs. radiofrequency ablation for paroxysmal atrial fibrillation

Changes in prognostic nutritional index during hospitalization and outcomes in patients with acute heart failure

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page