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  • 1
    In: Journal of Cardiovascular Development and Disease, MDPI AG, Vol. 10, No. 7 ( 2023-07-11), p. 294-
    Abstract: Background: Left ventricular global longitudinal strain (LV GLS) is a superior predictor of adverse cardiac events in patients with myocardial infarction and heart failure. We investigated the ability of morphological features of infarcted myocardium to detect acute left ventricular (LV) dysfunction and predict LV functional recovery after three months in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: Sixty-six STEMI patients were included in the C-reactive protein (CRP) apheresis in Acute Myocardial Infarction Study (CAMI-1). LV ejection fraction (LVEF), LV GLS, LV global circumferential strain (LV GCS), infarct size (IS), area-at-risk (AAR), and myocardial salvage index (MSI) were assessed by CMR 5 ± 3 days (baseline) and 12 ± 2 weeks after (follow-up) the diagnosis of first acute STEMI. Results: Significant changes in myocardial injury parameters were identified after 12 weeks of STEMI diagnosis. IS decreased from 23.59 ± 11.69% at baseline to 18.29 ± 8.32% at follow-up (p 〈 0.001). AAR and MVO also significantly reduced after 12 weeks. At baseline, there were reasonably moderate correlations between IS and LVEF (r = −0.479, p 〈 0.001), LV GLS (r = 0.441, p 〈 0.001) and LV GCS (r = 0.396, p = 0.001) as well as between AAR and LVEF (r = −0.430, p = 0.003), LV GLS (r = 0.501, p 〈 0.001) and weak with LV GCS (r = 0.342, p = 0.020). At follow-up, only MSI and change in LV GCS over time showed a weak but significant correlation (r = −0.347, p = 0.021). Patients with larger AAR at baseline improved more in LVEF (p = 0.019) and LV GLS (p = 0.020) but not in LV GCS. Conclusion: The CMR tissue characteristics of myocardial injury correlate with the magnitude of LV dysfunction during the acute stage of STEMI. AAR predicts improvement in LVEF and LV GLS, while MSI is a sensitive marker of LV GCS recovery at three months follow-up after STEMI.
    Type of Medium: Online Resource
    ISSN: 2308-3425
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2777082-5
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  • 2
    In: Journal of Clinical Medicine, MDPI AG, Vol. 8, No. 9 ( 2019-09-10), p. 1423-
    Abstract: In this study, we used a single commercially available software solution to assess global longitudinal (GLS) and global circumferential strain (GCS) using cardiac computed tomography (CT) and cardiac magnetic resonance (CMR) feature tracking (FT). We compared agreement and reproducibility between these two methods and the reference standard, CMR tagging (TAG). Twenty-seven patients with severe aortic stenosis underwent CMR and cardiac CT examinations. FT analysis was performed using Medis suite version 3.0 (Leiden, The Netherlands) software. Segment (Medviso) software was used for GCS assessment from tagged images. There was a trend towards the underestimation of GLS by CT-FT when compared to CMR-FT (19.4 ± 5.04 vs. 22.40 ± 5.69, respectively; p = 0.065). GCS values between TAG, CT-FT, and CMR-FT were similar (p = 0.233). CMR-FT and CT-FT correlated closely for GLS (r = 0.686, p 〈 0.001) and GCS (r = 0.707, p 〈 0.001), while both of these methods correlated moderately with TAG for GCS (r = 0.479, p 〈 0.001 for CMR-FT vs. TAG; r = 0.548 for CT-FT vs. TAG). Intraobserver and interobserver agreement was excellent in all techniques. Our findings show that, in elderly patients with severe aortic stenosis (AS), the FT algorithm performs equally well in CMR and cardiac CT datasets for the assessment of GLS and GCS, both in terms of reproducibility and agreement with the gold standard, TAG.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2662592-1
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  • 3
    In: ESC Heart Failure, Wiley, Vol. 7, No. 2 ( 2020-04), p. 523-532
    Abstract: A multitude of cardiac magnetic resonance (CMR) techniques are used for myocardial strain assessment; however, studies comparing them are limited. We sought to compare global longitudinal (GLS), circumferential (GCS), segmental longitudinal (SLS), and segmental circumferential (SCS) strain values, as well as reproducibility between CMR feature tracking (FT), tagging (TAG), and fast‐strain‐encoded (fast‐SENC) CMR techniques. Methods and results Eighteen subjects (11 healthy volunteers and seven patients with heart failure) underwent two CMR scans (1.5T, Philips) with identical parameters. Global and segmental strain values were measured using FT (Medis), TAG (Medviso), and fast‐SENC (Myocardial Solutions). Friedman's test, linear regression, Pearson's correlation coefficient, and Bland–Altman analyses were used to assess differences and correlation in measured GLS and GCS between the techniques. Two‐way mixed intra‐class correlation coefficient (ICC), coefficient of variance (COV), and Bland–Altman analysis were used for reproducibility assessment. All techniques correlated closely for GLS (Pearson's r : 0.86–0.92) and GCS (Pearson's r : 0.85–0.94). Intra‐observer and inter‐observer reproducibility was excellent in all techniques for both GLS (ICC 0.92–0.99, CoV 2.6–10.1%) and GCS (ICC 0.89–0.99, CoV 4.3–10.1%). Inter‐study reproducibility was similar for all techniques for GLS (ICC 0.91–0.96, CoV 9.1–10.8%) and GCS (ICC 0.95–0.97, CoV 7.6–10.4%). Combined segmental intra‐observer reproducibility was good in all techniques for SLS (ICC 0.914–0.953, CoV 12.35–24.73%) and SCS (ICC 0.885–0.978, CoV 10.76–19.66%). Combined inter‐study SLS reproducibility was the worst in FT (ICC 0.329, CoV 42.99%), while fast‐SENC performed the best (ICC 0.844, CoV 21.92%). TAG had the best reproducibility for combined inter‐study SCS (ICC 0.902, CoV 19.08%), while FT performed the worst (ICC 0.766, CoV 32.35%). Bland–Altman analysis revealed considerable inter‐technique biases for GLS (FT vs. fast‐SENC 3.71%; FT vs. TAG 8.35%; and TAG vs. fast‐SENC 4.54%) and GCS (FT vs. fast‐SENC 2.15%; FT vs. TAG 6.92%; and TAG vs. fast‐SENC 2.15%). Limits of agreement for GLS ranged from ±3.1 (TAG vs. fast‐SENC) to ±4.85 (FT vs. TAG) for GLS and ±2.98 (TAG vs. fast‐SENC) to ±5.85 (FT vs. TAG) for GCS. Conclusions We found significant differences in measured GLS and GCS between FT, TAG, and fast‐SENC. Global strain reproducibility was excellent for all techniques. Acquisition‐based techniques had better reproducibility than FT for segmental strain.
    Type of Medium: Online Resource
    ISSN: 2055-5822 , 2055-5822
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2814355-3
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  • 4
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2019-11-11)
    Abstract: Heart failure (HF) is associated with progressive ventricular remodeling and impaired contraction that affects distinctly various regions of the myocardium. Our study applied cardiac magnetic resonance (CMR) feature tracking (FT) to assess comparatively myocardial strain at 3 distinct levels: subendocardial (Endo-), mid (Myo-) and subepicardial (Epi-) myocardium across an extended spectrum of patients with HF. 59 patients with HF, divided into 3 subgroups as follows: preserved ejection fraction (HFpEF, N = 18), HF with mid-range ejection fraction (HFmrEF, N = 21), HF with reduced ejection fraction (HFrEF, N = 20) and a group of age- gender- matched volunteers (N = 17) were included. Using CMR FT we assessed systolic longitudinal and circumferential strain and strain-rate at Endo-, Myo- and Epi- levels. Strain values were the highest in the Endo- layer and progressively lower in the Myo- and Epi- layers respectively, this gradient was present in all the patients groups analyzed but decreased progressively in HFmrEF and further on in HFrEF groups. GLS decreased with the severity of the disease in all 3 layers: Normal  〉  HFpEF  〉  HFmrEF  〉  HFrEF (Endo-: −23.0 ± 3.5  〉  −20.0 ± 3.3  〉  −16.4 ± 2.2  〉  −11.0 ± 3.2, p  〈  0.001, Myo-: −20.7 ± 2.4  〉  −17.5.0 ± 2.6  〉  −14.5 ± 2.1  〉  −9.6 ± 2.7, p  〈  0.001; Epi-: −15.7 ± 1.9  〉  −12.2 ± 2.1  〉  −10.6 ± 2.3  〉  −7.7 ± 2.3, p  〈  0.001). In contrast, GCS was not different between the Normal and HFpEF (Endo-: −34.5 ± 6.2 vs −33.9 ± 5.7, p = 0.51; Myo-: −21.9 ± 3.8 vs −21.3 ± 2.2, p = 0.39, Epi-: −11.4 ± 2.0 vs −10.9 ± 2.3, p = 0.54) but was, as well, markedly lower in the systolic heart failure groups: Normal  〉  HFmrEF  〉  HFrEF (Endo-: −34.5 ± 6.2  〉  −20.0 ± 4.2  〉  12.3 ± 4.2, p  〈  0.001; Myo-: −21.9 ± 3.8  〉  −13.0 ± 3.4  〉  −8.0 ± 2.7. p  〈  0.001; Epi-: −11.4 ± 2.0  〉  −7.9 ± 2.3  〉  −4.5 ± 1.9. p  〈  0.001). CMR feature tracking multilayer strain assessment identifies large range differences between distinct myocardial regions. Our data emphasizes the importance of sub-endocardial myocardium for cardiac contraction and thus, its predilect role in imaging detection of functional impairment. CMR feature tracking offers a convenient, readily available, platform to evaluate myocardial contraction with excellent spatial resolution, rendering further details about discrete areas of the myocardium. Using this technique across distinct groups of patients with heart failure (HF), we demonstrate that subendocardial regions of the myocardium exhibit much higher strain values than mid-myocardium or subepicardial and are more sensitive to detect contractile impairment. We also show comparatively higher values of circumferential strain compared with longitudinal and a higher sensitivity to detect contractile impairment. A newly characterized group of patients, HF with mid-range ejection fraction (EF), shows similar traits of decompensation but has relatively higher strain values as patients with HF with reduced EF.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2615211-3
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  • 5
    In: Journal of Clinical Medicine, MDPI AG, Vol. 8, No. 11 ( 2019-11-05), p. 1877-
    Abstract: The characteristics and optimal management of heart failure with a moderately reduced ejection fraction (HFmrEF, LV-EF 40–50%) are still unclear. Advanced cardiac MRI offers information about function, fibrosis and inflammation of the myocardium, and might help to characterize HFmrEF in terms of adverse cardiac remodeling. We, therefore, examined 17 patients with HFpEF, 18 with HFmrEF, 17 with HFrEF and 17 healthy, age-matched controls with cardiac MRI (Phillips 1.5 T). T1 and T2 relaxation time mapping was performed and the extracellular volume (ECV) was calculated. Global circumferential (GCS) and longitudinal strain (GLS) were derived from cine images. GLS (−15.7 ± 2.1) and GCS (−19.9 ± 4.1) were moderately reduced in HFmrEF, resembling systolic dysfunction. Native T1 relaxation times were elevated in HFmrEF (1027 ± 40 ms) and HFrEF (1033 ± 54 ms) compared to healthy controls (972 ± 31 ms) and HFpEF (985 ± 32 ms). T2 relaxation times were elevated in HFmrEF (55.4 ± 3.4 ms) and HFrEF (56.0 ± 6.0 ms) compared to healthy controls (50.6 ± 2.1 ms). Differences in ECV did not reach statistical significance. HFmrEF differs from healthy controls and shares similarities with HFrEF in cardiac MRI parameters of fibrosis and inflammation.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    Language: English
    Publisher: MDPI AG
    Publication Date: 2019
    detail.hit.zdb_id: 2662592-1
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  • 6
    In: Medical Engineering & Physics, Elsevier BV, Vol. 74 ( 2019-12), p. 65-72
    Type of Medium: Online Resource
    ISSN: 1350-4533
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2019106-6
    SSG: 12
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