Myocardial strain measurement with feature-tracking cardiovascular magnetic resonance: normal values

• DOI: 10.1093/ehjci/jev006
• Publication Date: 2015-02-26T05:22:44Z
• Authors: Robin J. Taylor; William E. Moody; Fraz Umar; Nicola C. Edwards; Tiffany J. Taylor; Berthold Stegemann; John N. Townend; Kan N. Hor; Richard P. Steeds; Wojciech Mazur; Francisco Leyva
• Keywords: Adult; Male; Reproducibility of Results; Middle Aged; Magnetic Resonance Imaging; Myocardial Contraction; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Reference Values; Humans; Female; Aged

Myocardial deformation is a key to clinical decision-making. Feature-tracking cardiovascular magnetic resonance (FT-CMR) provides quantification of motion and strain using standard steady-state in free-precession (SSFP) imaging, which is part of a routine CMR left ventricular (LV) study protocol. An accepted definition of a normal range is essential if this technique is to enter the clinical arena.One hundred healthy individuals, with 10 men and women in each of 5 age deciles from 20 to 70 years, without a history of cardiovascular disease, diabetes, renal impairment, or family history of cardiovascular disease, and with a normal stress echocardiogram, underwent FT-CMR assessment of LV myocardial strain and strain rate using SSFP cines.Peak systolic longitudinal strain (Ell) was -21.3 ± 4.8%, peak systolic circumferential strain (Ecc) was -26.1 ± 3.8%, and peak systolic radial strain (Err) was 39.8 ± 8.3%. On Bland-Altman analyses, peak systolic Ecc had the best inter-observer agreement (bias 0.63 ± 1.29% and 95% CI -1.90 to 3.16) and peak systolic Err the least inter-observer agreement (bias 0.13 ± 6.41 and 95% CI -12.44 to 12.71). There was an increase in the magnitude of peak systolic Ecc with advancing age, which was greatest in subjects over the age of 50 years (R(2) = 0.11, P = 0.003). There were significant gender differences (P < 0.001) in peak systolic Ell, with a greater magnitude of deformation in females (-22.7%) than in males (-19.3%).Normal values for myocardial strain measurements using FT-CMR are provided. All circumferential and longitudinal based variables had excellent intra- and inter-observer variability.