Cardiovascular magnetic resonance myocardial feature tracking detects quantitative wall motion during dobutamine stress

Andreas Schuster, Shelby Kutty, Asif Padiyath, Victoria Parish, Paul Gribben, David A. Danford, Marcus R. Makowski, Boris Bigalke, Philipp Beerbaum, Eike Nagel

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Abstract

Background: Dobutamine stress cardiovascular magnetic resonance (DS-CMR) is an established tool to assess hibernating myocardium and ischemia. Analysis is typically based on visual assessment with considerable operator dependency. CMR myocardial feature tracking (CMR-FT) is a recently introduced technique for tissue voxel motion tracking on standard steady-state free precession (SSFP) images to derive circumferential and radial myocardial mechanics. We sought to determine the feasibility and reproducibility of CMR-FT for quantitative wall motion assessment during intermediate dose DS-CMR. Methods. 10 healthy subjects were studied at 1.5 Tesla. Myocardial strain parameters were derived from SSFP cine images using dedicated CMR-FT software (Diogenes MRI prototype; Tomtec; Germany). Right ventricular (RV) and left ventricular (LV) longitudinal strain (Ell RVand Ell LV) and LV long-axis radial strain (Err LAX) were derived from a 4-chamber view at rest. LV short-axis circumferential strain (Ecc SAX) and Err SAX; LV ejection fraction (EF) and volumes were analyzed at rest and during dobutamine stress (10 and 20 g kg -1 min -1). Results: In all volunteers strain parameters could be derived from the SSFP images at rest and stress. Ecc SAXvalues showed significantly increased contraction with DSMR (rest: -24.1 6.7; 10 g: -32.7 11.4; 20 g: -39.2 15.2; p < 0.05). Err SAXincreased significantly with dobutamine (rest: 19.6 14.6; 10 g: 31.8 20.9; 20 g: 42.4 25.5; p < 0.05). In parallel with these changes; EF increased significantly with dobutamine (rest: 56.9 4.4%; 10 g: 70.7 8.1; 20 g: 76.8 4.6; p < 0.05). Observer variability was best for LV circumferential strain (Ecc SAX) and worst for RV longitudinal strain (Ell RV) as determined by 95% confidence intervals of the difference. Conclusions: CMR-FT reliably detects quantitative wall motion and strain derived from SSFP cine imaging that corresponds to inotropic stimulation. The current implementation may need improvement to reduce observer-induced variance. Within a given CMR lab; this novel technique holds promise of easy and fast quantification of wall mechanics and strain.

Original languageEnglish (US)
Article number58
JournalJournal of Cardiovascular Magnetic Resonance
Volume13
Issue number1
DOIs
StatePublished - Dec 1 2011

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ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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