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Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR
BACKGROUND: The purpose of this study was to quantify myocardial strain on the subendocardial and epicardial layers of the left ventricle (LV) using tagged cardiovascular magnetic resonance (CMR) and to investigate the transmural degree of contractile impairment in the chronic ischemic myocardium. M...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286365/ https://www.ncbi.nlm.nih.gov/pubmed/22300290 http://dx.doi.org/10.1186/1532-429X-14-14 |
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author | Nagao, Michinobu Hatakenaka, Masamitsu Matsuo, Yoshio Kamitani, Takeshi Higuchi, Ko Shikata, Fumiaki Nagashima, Mitsugi Mochizuki, Teruhito Honda, Hiroshi |
author_facet | Nagao, Michinobu Hatakenaka, Masamitsu Matsuo, Yoshio Kamitani, Takeshi Higuchi, Ko Shikata, Fumiaki Nagashima, Mitsugi Mochizuki, Teruhito Honda, Hiroshi |
author_sort | Nagao, Michinobu |
collection | PubMed |
description | BACKGROUND: The purpose of this study was to quantify myocardial strain on the subendocardial and epicardial layers of the left ventricle (LV) using tagged cardiovascular magnetic resonance (CMR) and to investigate the transmural degree of contractile impairment in the chronic ischemic myocardium. METHODS: 3T tagged CMR was performed at rest in 12 patients with severe coronary artery disease who had been scheduled for coronary artery bypass grafting. Circumferential strain (C-strain) at end-systole on subendocardial and epicardial layers was measured using the short-axis tagged images of the LV and available software (Intag; Osirix). The myocardial segment was divided into stenotic and non-stenotic segments by invasive coronary angiography, and ischemic and non-ischemic segments by stress myocardial perfusion scintigraphy. The difference in C-strain between the two groups was analyzed using the Mann-Whitney U-test. The diagnostic capability of C-strain was analyzed using receiver operating characteristics analysis. RESULTS: The absolute subendocardial C-strain was significantly lower for stenotic (-7.5 ± 12.6%) than non-stenotic segment (-18.8 ± 10.2%, p < 0.0001). There was no difference in epicardial C-strain between the two groups. Use of cutoff thresholds for subendocardial C-strain differentiated stenotic segments from non-stenotic segments with a sensitivity of 77%, a specificity of 70%, and areas under the curve (AUC) of 0.76. The absolute subendocardial C-strain was significantly lower for ischemic (-6.7 ± 13.1%) than non-ischemic segments (-21.6 ± 7.0%, p < 0.0001). The absolute epicardial C-strain was also significantly lower for ischemic (-5.1 ± 7.8%) than non-ischemic segments (-9.6 ± 9.1%, p < 0.05). Use of cutoff thresholds for subendocardial C-strain differentiated ischemic segments from non-ischemic segments with sensitivities of 86%, specificities of 84%, and AUC of 0.86. CONCLUSIONS: Analysis of tagged CMR can non-invasively demonstrate predominant impairment of subendocardial strain in the chronic ischemic myocardium at rest. |
format | Online Article Text |
id | pubmed-3286365 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32863652012-02-25 Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR Nagao, Michinobu Hatakenaka, Masamitsu Matsuo, Yoshio Kamitani, Takeshi Higuchi, Ko Shikata, Fumiaki Nagashima, Mitsugi Mochizuki, Teruhito Honda, Hiroshi J Cardiovasc Magn Reson Research BACKGROUND: The purpose of this study was to quantify myocardial strain on the subendocardial and epicardial layers of the left ventricle (LV) using tagged cardiovascular magnetic resonance (CMR) and to investigate the transmural degree of contractile impairment in the chronic ischemic myocardium. METHODS: 3T tagged CMR was performed at rest in 12 patients with severe coronary artery disease who had been scheduled for coronary artery bypass grafting. Circumferential strain (C-strain) at end-systole on subendocardial and epicardial layers was measured using the short-axis tagged images of the LV and available software (Intag; Osirix). The myocardial segment was divided into stenotic and non-stenotic segments by invasive coronary angiography, and ischemic and non-ischemic segments by stress myocardial perfusion scintigraphy. The difference in C-strain between the two groups was analyzed using the Mann-Whitney U-test. The diagnostic capability of C-strain was analyzed using receiver operating characteristics analysis. RESULTS: The absolute subendocardial C-strain was significantly lower for stenotic (-7.5 ± 12.6%) than non-stenotic segment (-18.8 ± 10.2%, p < 0.0001). There was no difference in epicardial C-strain between the two groups. Use of cutoff thresholds for subendocardial C-strain differentiated stenotic segments from non-stenotic segments with a sensitivity of 77%, a specificity of 70%, and areas under the curve (AUC) of 0.76. The absolute subendocardial C-strain was significantly lower for ischemic (-6.7 ± 13.1%) than non-ischemic segments (-21.6 ± 7.0%, p < 0.0001). The absolute epicardial C-strain was also significantly lower for ischemic (-5.1 ± 7.8%) than non-ischemic segments (-9.6 ± 9.1%, p < 0.05). Use of cutoff thresholds for subendocardial C-strain differentiated ischemic segments from non-ischemic segments with sensitivities of 86%, specificities of 84%, and AUC of 0.86. CONCLUSIONS: Analysis of tagged CMR can non-invasively demonstrate predominant impairment of subendocardial strain in the chronic ischemic myocardium at rest. BioMed Central 2012-02-02 /pmc/articles/PMC3286365/ /pubmed/22300290 http://dx.doi.org/10.1186/1532-429X-14-14 Text en Copyright ©2012 Nagao et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Nagao, Michinobu Hatakenaka, Masamitsu Matsuo, Yoshio Kamitani, Takeshi Higuchi, Ko Shikata, Fumiaki Nagashima, Mitsugi Mochizuki, Teruhito Honda, Hiroshi Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR |
title | Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR |
title_full | Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR |
title_fullStr | Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR |
title_full_unstemmed | Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR |
title_short | Subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3T tagged CMR |
title_sort | subendocardial contractile impairment in chronic ischemic myocardium: assessment by strain analysis of 3t tagged cmr |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286365/ https://www.ncbi.nlm.nih.gov/pubmed/22300290 http://dx.doi.org/10.1186/1532-429X-14-14 |
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