1. Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy: a multisoftware feasibility and clinical implementation study.
- Author
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Bourfiss, Mimount, Vigneault, Davis, Aliyari Ghasebeh, Mounes, Murray, Brittney, James, Cynthia, Tichnell, Crystal, Mohamed Hoesein, Firdaus, Zimmerman, Stefan, Kamel, Ihab, Calkins, Hugh, Tandri, Harikrishna, Velthuis, Birgitta, Bluemke, David, and te Riele, Anneline
- Subjects
MAGNETIC resonance imaging ,PROBABILITY theory ,PILOT projects ,CONTROL groups ,DATA analysis software ,ARRHYTHMOGENIC right ventricular dysplasia - Abstract
Background: Regional right ventricular (RV) dysfunction is the hallmark of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), but is currently only qualitatively evaluated in the clinical setting. Feature Tracking Cardiovascular Magnetic Resonance (FT-CMR) is a novel quantitative method that uses cine CMR to calculate strain values. However, most prior FT-CMR studies in ARVD/C have focused on global RV strain using different software methods, complicating implementation of FT-CMR in clinical practice. We aimed to assess the clinical value of global and regional strain using FT-CMR in ARVD/C and to determine differences between commercially available FT-CMR software packages. Methods: We analyzed cine CMR images of 110 subjects (39 overt ARVD/C [mutation+/phenotype+], 40 preclinical ARVD/C [mutation+/phenotype-] and 31 control) for global and regional (subtricuspid, anterior, apical) RV strain in the horizontal longitudinal axis using four FT-CMR software methods (Multimodality Tissue Tracking, TomTec, Medis and Circle Cardiovascular Imaging). Intersoftware agreement was assessed using Bland Altman plots. Results: For global strain, all methods showed reduced strain in overt ARVD/C patients compared to control subjects ( p < 0.041), whereas none distinguished preclinical from control subjects ( p > 0.275). For regional strain, overt ARVD/C patients showed reduced strain compared to control subjects in all segments which reached statistical significance in the subtricuspid region for all software methods ( p < 0.037), in the anterior wall for two methods ( p < 0.005) and in the apex for one method ( p = 0.012). Preclinical subjects showed abnormal subtricuspid strain compared to control subjects using one of the software methods ( p = 0.009). Agreement between software methods for absolute strain values was low (Intraclass Correlation Coefficient = 0.373). Conclusions: Despite large intersoftware variability of FT-CMR derived strain values, all four software methods distinguished overt ARVD/C patients from control subjects by both global and subtricuspid strain values. In the subtricuspid region, one software package distinguished preclinical from control subjects, suggesting the potential to identify early ARVD/C prior to overt disease expression. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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