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Quantitative assessment of left ventricular mechanical dyssynchrony using cine cardiovascular magnetic resonance imaging: Inter-study reproducibility

Research output: Contribution to journalArticle

Johannes Tammo Kowallick, Geraint Morton, Pablo Lamata de la Orden, Roy Ramesh Jogiya, Shelby Kutty, Gerd Hasenfuß, Joachim Lotz, Amedeo Chiribiri, Eike Caspar Cornelius Nagel, Andreas Schuster

Original languageEnglish
JournalJRSM cardiovascular disease
Early online date15 May 2017
DOIs
StateE-pub ahead of print - 15 May 2017

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Abstract

Objectives
To determine the inter-study reproducibility of left ventricular (LV) mechanical dyssynchrony measures based on standard cardiovascular magnetic resonance (CMR) cine images.

Design
Steady-state free precession (SSFP) LV short-axis stacks and three long-axes were acquired on the same day at three time points. Circumferential strain systolic dyssynchrony indexes (SDI), area-SDI as well as circumferential and radial uniformity ratio estimates (CURE and RURE, respectively) were derived from CMR myocardial feature-tracking (CMR-FT) based on the tracking of three SSFP short-axis planes. Furthermore, 4D-LV-analysis based on SSFP short-axis stacks and longitudinal planes was performed to quantify 4D-volume-SDI.

Setting
A single-centre London teaching hospital.

Participants
16 healthy volunteers.

Main outcome measures
Inter-study reproducibility between the repeated exams.

Results
CURE and RURE as well as 4D-volume-SDI showed good inter-study reproducibility (coefficient of variation [CoV] 6.4%–12.9%). Circumferential strain and area-SDI showed higher variability between the repeated measurements (CoV 24.9%–37.5%). Uniformity ratio estimates showed the lowest inter-study variability (CoV 6.4%–8.5%).

Conclusions
Derivation of LV mechanical dyssynchrony measures from standard cine images is feasible using CMR-FT and 4D-LV-analysis tools. Uniformity ratio estimates and 4D-volume-SDI showed good inter-study reproducibility. Their clinical value should next be explored in patients who potentially benefit from cardiac resynchronization therapy.

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