Subendocardial contractile impairment in chronic ischemic myocardium

Assessment by strain analysis of 3T tagged CMR

Michinobu Nagao, Masamitsu Hatakenaka, Yoshio Matsuo, Takeshi Kamitani, Ko Higuchi, Fumiaki Shikata, Mitsugi Nagashima, Teruhito Mochizuki, Hiroshi Honda

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Article number14
JournalJournal of Cardiovascular Magnetic Resonance
Volume14
Issue number1
DOIs
Publication statusPublished - May 9 2012

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Myocardium
Magnetic Resonance Spectroscopy
Area Under Curve
Heart Ventricles
Myocardial Perfusion Imaging
Perfusion Imaging
Systole
Nonparametric Statistics
Coronary Angiography
Coronary Artery Bypass
ROC Curve
Coronary Artery Disease
Software
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

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

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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.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 14, No. 1, 14, 09.05.2012.

Research output: Contribution to journalArticle

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. In: Journal of Cardiovascular Magnetic Resonance. 2012 ; Vol. 14, No. 1.
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abstract = "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.",
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T2 - Assessment by strain analysis of 3T tagged CMR

AU - Nagao, Michinobu

AU - Hatakenaka, Masamitsu

AU - Matsuo, Yoshio

AU - Kamitani, Takeshi

AU - Higuchi, Ko

AU - Shikata, Fumiaki

AU - Nagashima, Mitsugi

AU - Mochizuki, Teruhito

AU - Honda, Hiroshi

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N2 - 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.

AB - 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.

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