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Journal of Cardiovascular Magnetic Resonance
Published in: Journal of Cardiovascular Magnetic Resonance 1/2021

Open Access 01-12-2021 | Left Bundle Branch Block | Research

Segment length in cine (SLICE) strain analysis: a practical approach to estimate potential benefit from cardiac resynchronization therapy

Authors: Alwin Zweerink, Robin Nijveldt, Natalia J. Braams, Alexander H. Maass, Kevin Vernooy, Frederik J. de Lange, Mathias Meine, Bastiaan Geelhoed, Michiel Rienstra, Isabelle C. van Gelder, Marc A. Vos, Albert C. van Rossum, Cornelis P. Allaart

Published in: Journal of Cardiovascular Magnetic Resonance | Issue 1/2021

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Abstract

Background

Segment length in cine (SLICE) strain analysis on standard cardiovascular magnetic resonance (CMR) cine images was recently validated against gold standard myocardial tagging. The present study aims to explore predictive value of SLICE for cardiac resynchronization therapy (CRT) response.

Methods and results

Fifty-seven patients with heart failure and left bundle branch block (LBBB) were prospectively enrolled in this multi-center study and underwent CMR examination before CRT implantation. Circumferential strains of the septal and lateral wall were measured by SLICE on short-axis cine images. In addition, timing and strain pattern parameters were assessed. After twelve months, CRT response was quantified by the echocardiographic change in left ventricular (LV) end-systolic volume (LVESV). In contrast to timing parameters, strain pattern parameters being systolic rebound stretch of the septum (SRSsep), systolic stretch index (SSIsep-lat), and internal stretch factor (ISFsep-lat) all correlated significantly with LVESV change (R − 0.56; R − 0.53; and R − 0.58, respectively). Of all strain parameters, end-systolic septal strain (ESSsep) showed strongest correlation with LVESV change (R − 0.63). Multivariable analysis showed ESSsep to be independently related to LVESV change together with age and QRSAREA.

Conclusion

The practicable SLICE strain technique may help the clinician to estimate potential benefit from CRT by analyzing standard CMR cine images without the need for commercial software. Of all strain parameters, end-systolic septal strain (ESSsep) demonstrates the strongest correlation with reverse remodeling after CRT. This parameter may be of special interest in patients with non-strict LBBB morphology for whom CRT benefit is doubted.
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Metadata
Title
Segment length in cine (SLICE) strain analysis: a practical approach to estimate potential benefit from cardiac resynchronization therapy
Authors
Alwin Zweerink
Robin Nijveldt
Natalia J. Braams
Alexander H. Maass
Kevin Vernooy
Frederik J. de Lange
Mathias Meine
Bastiaan Geelhoed
Michiel Rienstra
Isabelle C. van Gelder
Marc A. Vos
Albert C. van Rossum
Cornelis P. Allaart
Publication date
01-12-2021

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