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Assessment of myocardial deformation with CMR: a comparison with ultrasound speckle tracking

  • Cardiac
  • Published:
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Abstract

Objectives

Myocardial deformation integrated with cardiac dimensions provides a comprehensive assessment of cardiac function, which has proven useful to differentiate cardiac pathology from physiological adaptation to situations such as chronic intensive training. Feature tracking (FT) can measure myocardial deformation from cardiac magnetic resonance (CMR) cine sequences; however, its accuracy is not yet fully validated. Our aim was to compare the accuracy and reproducibility of FT with speckle tracking echocardiography (STE) in highly trained endurance athletes.

Methods

Ninety-three endurance athletes (> 12-h training/week during the last 5 years, 52% male, 35 ± 5.1 years old) and 72 age-matched controls underwent resting CMR and transthoracic echocardiography to assess biventricular exercise-induced remodeling and biventricular global longitudinal strain (GLS) by CMR-FT and STE.

Results

Strain values were significantly lower when assessed by CMR-FT compared to STE (p < 0.001), with good reproducibility for the left ventricle (bias = 3.94%, limit of agreement [LOA] = ± 4.27 %) but wider variability for right ventricle strain. Strain values by both techniques proportionally decreased with increasing ventricular volumes, potentially depicting the functional biventricular reserve that characterizes athletes’ hearts.

Conclusions

Biventricular longitudinal strain values were lower when assessed by FT as compared to STE. Both methods were statistically comparable when measuring LV strain but not RV strain. These differences might be justified by the lower in-plane spatial and temporal resolution of FT, which is particularly relevant for the complex anatomy of the RV.

Key Points

• Strain values were significantly lower when assessed by FT as compared to STE, which was expected due to the lower in-plane spatial and temporal resolution of FT versus STE.

• Both methods were statistically comparable when measuring LV strain but not for RV strain analysis.

• Characterizing the normal ranges and reproducibility of strain metrics by FT is an important step toward its clinical applicability, since it can be assessed offline and applied to routinely acquired cine CMR images.

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Abbreviations

CMR:

Cardiac magnetic resonance

EDV:

End-diastolic volume

FT:

Feature tracking

GLS:

Global longitudinal strain

LVEF:

Left ventricular ejection fraction

STE:

Speckle tracking echocardiography

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Funding

This work was partially funded by grants from AGAUR (M. Sanz-de la Garza, MD, PhD), Plan Nacional I. D, Del Programa Estatal de Fomento De La Investigación Científica y Técnica de Excelencia, Subprograma De Generación Del Conocimiento, Ministerio de Economía y Competitividad 2013 (grant number DEP2013–44923-P).

Author information

Authors and Affiliations

  1. Radiology Department, Hospital Clinic, Barcelona, Spain

    Blanca Domenech-Ximenos & Rosario Jesus Perea

  2. Cardiovascular Institute, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain

    Blanca Domenech-Ximenos, María Sanz-de la Garza, Daniel Lorenzatti, Susana Prat-Gonzalez & Marta Sitges

  3. Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Barcelona, Spain

    María Sanz-de la Garza & Marta Sitges

  4. Barcelona Center for Maternal-Fetal and Neonatal Medicine Hospital Clínic and Hospital Sant Joan de Deu, Universitat de Barcelona, CIBER-ER, Barcelona, Spain

    Álvaro Sepulveda-Martinez & Fatima Crispi

  5. Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Clínico Universidad de Chile, Santiago de Chile, Chile

    Álvaro Sepulveda-Martinez

  6. Montreal Heart Institute, Montreal, Canada

    François Simard

  7. Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    Fatima Crispi & Rosario Jesus Perea

Authors
  1. Blanca Domenech-Ximenos
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  2. María Sanz-de la Garza
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  9. Marta Sitges
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Corresponding author

Correspondence to Blanca Domenech-Ximenos.

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Guarantor

The scientific guarantor of this publication is Marta Sitges, MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in other papers but always with different objectives, in: Domenech-Ximenos, et al Journal of Cardiovascular Magnetic Resonance (2020) 22:62, Domenech-Ximenos, et al Eur J Prev Cardiol 2020 Apr, and M. Sanz-de la Garza, et al Eur J Prev Cardiol 2020 Sep.

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• performed at one institution

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Cite this article

Domenech-Ximenos, B., Sanz-de la Garza, M., Sepulveda-Martinez, Á. et al. Assessment of myocardial deformation with CMR: a comparison with ultrasound speckle tracking. Eur Radiol 31, 7242–7250 (2021). https://doi.org/10.1007/s00330-021-07857-2

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  • DOI: https://doi.org/10.1007/s00330-021-07857-2

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