Top

Journal of Cardiovascular Magnetic Resonance

Published in:

Open Access 01-12-2015 | Research

Left atrial structure and functional quantitation using cardiovascular magnetic resonance and multimodality tissue tracking: validation and reproducibility assessment

Authors: Mytra Zareian, Luisa Ciuffo, Mohammadali Habibi, Anders Opdahl, Elzbieta H. Chamera, Colin O. Wu, David A. Bluemke, João A. C. Lima, Bharath Ambale Venkatesh

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2015

Abstract

Background

Left atrium (LA) strain, volume and function are important markers of cardiovascular disease and myocardial impairment. We aimed to assess the accuracy of LA biplane volume and function measured by Multimodality Tissue Tracking (MTT). Also we assessed the inter-study reproducibility for cardiovascular magnetic resonance (CMR) derived LA volume and function parameters.

Methods

Thirty subjects (mean age: 71.3 ± 8.7, 87 % male) including twenty subjects with cardiovascular events and ten healthy subjects, with CMR were evaluated in the Multi-Ethnic Study of Atherosclerosis (MESA). LA volumes were computed by the modified biplane method from 2- and 4-chamber projections and the Simpson’s method from short-axis slices using both methods - manual and semi-automated delineation using MTT. LA total, active and passive ejection fractions were calculated. Pearson’s correlation and Bland-Altman analysis were used to compare the measurements. In a second sample of 25 subjects (age: 65.7 ± 7.1, 72 % males) inter study, intra and inter reader reliability analysis was performed. The intra-class correlation coefficient (ICC) was evaluated.

Results

Left atrial MTT structural and functional parameters were not different from manual delineation, yet image analysis was only half as time consuming on average with MTT. Maximal volume MTT was not different between the Simpson’s and Biplane methods, functional parameters, however were different. MTT allowed us to measure multiple LA parameters with good-excellent (ICC; 0.88– 0.98, p < 0.001) intra-and inter reader reproducibility and fair-good (ICC; 0.44–0.82, p < 0.05–0.001) inter study reproducibility.

Conclusions

MTT derived LA biplane volume and function is accurate and reproducible and is suited for use in longitudinal studies.

Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, Tsang TS. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47(12):2357–63. doi:10.1016/j.jacc.2006.02.048.PubMedCrossRef

Roelandt J. The increasing importance of left atrial size assessment. J Cardiovasc Med (Hagerstown, Md). 2011, 12 (2):147. doi:10.2459/JCM.0b013e3283430a20.

Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002;90(12):1284–9.PubMedCrossRef

Yang WI, Shim CY, Kim YJ, Kim SA, Rhee SJ, Choi EY, Choi D, Jang Y, Chung N, Cho SY, Ha JW. Left atrial volume index: a predictor of adverse outcome in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2009;22(12):1338–43. doi:10.1016/j.echo.2009.09.016.PubMedCrossRef

Maceira AM, Cosin-Sales J, Roughton M, Prasad SK, Pennell DJ. Reference left atrial dimensions and volumes by steady state free precession cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2010;12:65. doi:10.1186/1532-429x-12-65.PubMedCentralPubMedCrossRef

Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63. doi:10.1016/j.echo.2005.10.005.PubMedCrossRef

Vizzardi E, D’Aloia A, Rocco E, Lupi L, Rovetta R, Quinzani F, Bontempi L, Curnis Md A, Dei Cas L. How should we measure left atrium size and function? J Clin Ultrasound. 2012;40(3):155–66. doi:10.1002/jcu.21871.PubMedCrossRef

Hudsmith LE, Petersen SE, Francis JM, Robson MD, Neubauer S. Normal human left and right ventricular and left atrial dimensions using steady state free precession magnetic resonance imaging. J Cardiovasc Magn Reson. 2005;7(5):775–82.PubMedCrossRef

Tee M, Noble JA, Bluemke DA. Imaging techniques for cardiac strain and deformation: comparison of echocardiography, cardiac magnetic resonance and cardiac computed tomography. Exp Rev Cardiovasc Ther. 2013;11(2):221–31. doi:10.1586/erc.12.182.CrossRef

10.

Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR, Greenland P, Jacob DR Jr, Kronmal R, Liu K, Nelson JC, O’Leary D, Saad MF, Shea S, Szklo M, Tracy RP. Multi-ethnic study of atherosclerosis: objectives and design. Am J Epidemiol. 2002;156(9):871–81.PubMedCrossRef

11.

Habibi M, Chahal H, Opdahl A, Gjesdal O, Helle-Valle TM, Heckbert SR, McClelland R, Wu C, Shea S, Hundley G, Bluemke DA, Lima JA. Association of CMR-measured LA function with heart failure development: results from the MESA study. JACC Cardiovasc Imaging. 2014;7(6):570–9. doi:10.1016/j.jcmg.2014.01.016.PubMedCentralPubMedCrossRef

12.

Ogawa K, Hozumi T, Sugioka K, Matsumura Y, Nishiura M, Kanda R, Abe Y, Takemoto Y, Yoshiyama M, Yoshikawa J. Usefulness of automated quantitation of regional left ventricular wall motion by a novel method of two-dimensional echocardiographic tracking. Am J Cardiol. 2006;98(11):1531–7. doi:10.1016/j.amjcard.2006.06.060.PubMedCrossRef

13.

Imai M, Venkatesh BA, Samiei S, Donekal S, Habibi M, Armstrong AC, Heckbert SR, Wu CO, Bluemke DA, Lima JA. Multi-ethnic study of atherosclerosis: association between left atrial function using tissue tracking from Cine MR imaging and myocardial fibrosis. Radiology. 2014; 131971. doi:10.1148/radiol.14131971.

14.

Van Beeumen K, Duytschaever M, Tavernier R, Van de Veire N, De Sutter J. Intra- and interatrial asynchrony in patients with heart failure. Am J Cardiol. 2007;99(1):79–83. doi:10.1016/j.amjcard.2006.07.066.PubMedCrossRef

15.

Ludbrook J. Linear regression analysis for comparing two measurers or methods of measurement: but which regression? Clin Exp Pharmacol Physiol. 2010;37(7):692–9. doi:10.1111/j.1440-1681.2010.05376.x.PubMedCrossRef

16.

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1(8476):307–10.PubMedCrossRef

17.

Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005;19(1):231–40. doi:10.1519/15184.1.PubMed

18.

Grothues F, Smith GC, Moon JC, Bellenger NG, Collins P, Klein HU, Pennell DJ. Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy. Am J Cardiol. 2002;90(1):29–34.PubMedCrossRef

19.

Takagi Y, Ehara S, Okuyama T, Shirai N, Yamashita H, Sugioka K, Kitamura H, Ujino K, Hozumi T, Yoshiyama M. Comparison of determinations of left atrial volume by the biplane area-length and Simpson’s methods using 64-slice computed tomography. J Cardiol. 2009;53(2):257–64. doi:10.1016/j.jjcc.2008.11.012.PubMedCrossRef

20.

Sievers B, Kirchberg S, Addo M, Bakan A, Brandts B, Trappe HJ. Assessment of left atrial volumes in sinus rhythm and atrial fibrillation using the biplane area-length method and cardiovascular magnetic resonance imaging with TrueFISP. J Cardiovasc Magn Reson. 2004;6(4):855–63.PubMedCrossRef

21.

Harrild DM, Han Y, Geva T, Zhou J, Marcus E, Powell AJ. Comparison of cardiac MRI tissue tracking and myocardial tagging for assessment of regional ventricular strain. Int J Cardiovasc Imaging. 2012;28(8):2009–18. doi:10.1007/s10554-012-0035-3.PubMedCrossRef

22.

Nacif MS, Barranhas AD, Turkbey E, Marchiori E, Kawel N, Mello RA, Falcao RO, Oliveira AC Jr, Rochitte CE. Left atrial volume quantification using cardiac MRI in atrial fibrillation: comparison of the Simpson’s method with biplane area-length, ellipse, and three-dimensional methods. Diagn Interv Radiol. 2013;19(3):213–20. doi:10.5152/dir.2012.002.PubMed

23.

Aurigemma GP, Gottdiener JS, Arnold AM, Chinali M, Hill JC, Kitzman D. Left atrial volume and geometry in healthy aging: the Cardiovascular Health Study. Circ Cardiovasc Imaging. 2009;2(4):282–9. doi:10.1161/circimaging.108.826602.PubMedCentralPubMedCrossRef

24.

Ujino K, Barnes ME, Cha SS, Langins AP, Bailey KR, Seward JB, Tsang TS. Two-dimensional echocardiographic methods for assessment of left atrial volume. Am J Cardiol. 2006;98(9):1185–8. doi:10.1016/j.amjcard.2006.05.040.PubMedCrossRef

25.

Hor KN, Gottliebson WM, Carson C, Wash E, Cnota J, Fleck R, Wansapura J, Klimeczek P, Al-Khalidi HR, Chung ES, Benson DW, Mazur W. Comparison of magnetic resonance feature tracking for strain calculation with harmonic phase imaging analysis. JACC Cardiovasc Imaging. 2010;3(2):144–51. doi:10.1016/j.jcmg.2009.11.006.PubMedCrossRef

26.

Schuster A, Morton G, Hussain ST, Jogiya R, Kutty S, Asrress KN, Makowski MR, Bigalke B, Perera D, Beerbaum P, Nagel E. The intra-observer reproducibility of cardiovascular magnetic resonance myocardial feature tracking strain assessment is independent of field strength. Eur J Radiol. 2013;82(2):296–301. doi:10.1016/j.ejrad.2012.11.012.PubMedCrossRef

27.

Singh A, Steadman CD, Khan JN, Horsfield MA, Bekele S, Nazir SA, Kanagala P, Masca NG, Clarysse P, McCann GP. Intertechnique agreement and interstudy reproducibility of strain and diastolic strain rate at 1.5 and 3 tesla: a comparison of feature-tracking and tagging in patients with aortic stenosis. J Magn Reson Imaging. 2014; doi:10.1002/jmri.24625

28.

Oxborough D, George K, Birch KM. Intraobserver reliability of two-dimensional ultrasound derived strain imaging in the assessment of the left ventricle, right ventricle, and left atrium of healthy human hearts. Echocardiography. 2012;29(7):793–802. doi:10.1111/j.1540-8175.2012.01698.x.PubMedCrossRef

Title: Left atrial structure and functional quantitation using cardiovascular magnetic resonance and multimodality tissue tracking: validation and reproducibility assessment
Authors: Mytra Zareian
Luisa Ciuffo
Mohammadali Habibi
Anders Opdahl
Elzbieta H. Chamera
Colin O. Wu
David A. Bluemke
João A. C. Lima
Bharath Ambale Venkatesh
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Journal of Cardiovascular Magnetic Resonance / Issue 1/2015
Electronic ISSN: 1532-429X
DOI: https://doi.org/10.1186/s12968-015-0152-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Left atrial structure and functional quantitation using cardiovascular magnetic resonance and multimodality tissue tracking: validation and reproducibility assessment

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2015

Optimization of dual-saturation single bolus acquisition for quantitative cardiac perfusion and myocardial blood flow maps

Time elapsed after contrast injection is crucial to determine infarct transmurality and myocardial functional recovery after an acute myocardial infarction

Feasibility of high-resolution quantitative perfusion analysis in patients with heart failure

Fast assessment of long axis strain with standard cardiovascular magnetic resonance: a validation study of a novel parameter with reference values

The association between cardiovascular risk and cardiovascular magnetic resonance measures of fibrosis: the Multi-Ethnic Study of Atherosclerosis (MESA)

Two repetition time saturation transfer (TwiST) with spill-over correction to measure creatine kinase reaction rates in human hearts