Advertisement

Altered regional myocardial velocities by tissue phase mapping and feature tracking in pediatric patients with hypertrophic cardiomyopathy

  • Arleen Li
  • Alexander Ruh
  • Haben Berhane
  • Joshua D. Robinson
  • Michael Markl
  • Cynthia K. RigsbyEmail author
Original Article
  • 39 Downloads

Abstract

Background

Hypertrophic cardiomyopathy (HCM) is associated with heart failure, atrial fibrillation and sudden death. Reduced myocardial function has been reported in HCM despite normal left ventricular (LV) ejection fraction. Additionally, LV fibrosis is associated with elevated T1 and might be an outcome predictor.

Objective

To systematically compare tissue phase mapping and feature tracking for assessing regional LV function in children and young adults with HCM and pediatric controls, and to evaluate structure–function relationships among myocardial velocities, LV wall thickness and myocardial T1.

Materials and methods

Seventeen pediatric patients with HCM and 21 age-matched controls underwent cardiac MRI including standard cine imaging, tissue phase mapping (two-dimensional cine phase contrast with three-directional velocity encoding), and modified Look-Locker inversion recovery to calculate native global LV T1. Maximum LV wall thickness was measured on cine images. LV radial, circumferential and long-axis myocardial velocity time courses, as well as global and segmental systolic and diastolic peak velocities, were quantified from tissue phase mapping and feature tracking.

Results

Both tissue phase mapping and feature tracking detected significantly decreased global and segmental diastolic radial and long-axis peak velocities (by 12–51%, P<0.001–0.05) in pediatric patients with HCM vs. controls. Feature tracking peak velocities were lower than directly measured tissue phase mapping velocities (mean bias = 0.3–2.9 cm/s). Diastolic global peak velocities correlated moderately with global T1 (r = −0.57 to −0.72, P<0.01) and maximum wall thickness (r = −0.37 to −0.61, P<0.05).

Conclusion

Both tissue phase mapping and feature tracking detected myocardial velocity changes in children and young adults with HCM vs. controls. Associations between impaired diastolic LV velocities and elevated T1 indicate structure–function relationships in HCM.

Keywords

Children Feature tracking Heart Hypertrophic cardiomyopathy Left ventricle Magnetic resonance imaging Myocardial velocity Myocardium Tissue phase mapping 

Notes

Acknowledgments

Dr. Michael Markl received grant support from the National Institute of Heart, Lung and Blood Disorders.

Compliance with ethical standards

Conflicts of interest

None

References

  1. 1.
    Maron BJ (2018) Clinical course and management of hypertrophic cardiomyopathy. N Engl J Med 379:655–668CrossRefGoogle Scholar
  2. 2.
    Simpson RM, Keegan J, Firmin DN (2013) MR assessment of regional myocardial mechanics. J Magn Reson Imaging 37:576–599CrossRefGoogle Scholar
  3. 3.
    Modesto K, Sengupta PP (2014) Myocardial mechanics in cardiomyopathies. Prog Cardiovasc Dis 57:111–124CrossRefGoogle Scholar
  4. 4.
    Schelbert EB, Messroghli DR (2016) State of the art: clinical applications of cardiac T1 mapping. Radiology 278:658–676CrossRefGoogle Scholar
  5. 5.
    Dass S, Suttie JJ, Piechnik SK et al (2012) Myocardial tissue characterization using magnetic resonance noncontrast T1 mapping in hypertrophic and dilated cardiomyopathy. Circ Cardiovasc Imaging 5:726–733CrossRefGoogle Scholar
  6. 6.
    Wu LM, An DAL, Yao QY et al (2017) Hypertrophic cardiomyopathy and left ventricular hypertrophy in hypertensive heart disease with mildly reduced or preserved ejection fraction: insight from altered mechanics and native T1 mapping. Clin Radiol 72:835–843CrossRefGoogle Scholar
  7. 7.
    Swoboda PP, McDiarmid AK, Erhayiem B et al (2017) Effect of cellular and extracellular pathology assessed by T1 mapping on regional contractile function in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 19:16CrossRefGoogle Scholar
  8. 8.
    Zerhouni EA, Parish DM, Rogers WJ et al (1988) Human heart: tagging with MR imaging — a method for noninvasive assessment of myocardial motion. Radiology 169:59–63CrossRefGoogle Scholar
  9. 9.
    Aletras AH, Balaban RS, Wen H (1999) High-resolution strain analysis of the human heart with fast-DENSE. J Magn Reson 140:41–57CrossRefGoogle Scholar
  10. 10.
    Osman NF, Sampath S, Atalar E, Prince JL (2001) Imaging longitudinal cardiac strain on short-axis images using strain-encoded MRI. Magn Reson Med 46:324–334CrossRefGoogle Scholar
  11. 11.
    Hennig J, Schneider B, Peschl S et al (1998) Analysis of myocardial motion based on velocity measurements with a black blood prepared segmented gradient-echo sequence: methodology and applications to normal volunteers and patients. J Magn Reson Imaging 8:868–877CrossRefGoogle Scholar
  12. 12.
    Jung B, Föll D, Böttler P et al (2006) Detailed analysis of myocardial motion in volunteers and patients using high-temporal-resolution MR tissue phase mapping. J Magn Reson Imaging 24:1033–1039CrossRefGoogle Scholar
  13. 13.
    Petersen SE, Jung BA, Wiesmann F et al (2006) Myocardial tissue phase mapping with cine phase-contrast MR imaging: regional wall motion analysis in healthy volunteers. Radiology 238:816–826CrossRefGoogle Scholar
  14. 14.
    Hor KN, Gottliebson WM, Carson C et al (2010) Comparison of magnetic resonance feature tracking for strain calculation with harmonic phase imaging analysis. JACC Cardiovasc Imaging 3:144–151CrossRefGoogle Scholar
  15. 15.
    Schuster A, Hor KN, Kowallick JT et al (2016) Cardiovascular magnetic resonance myocardial feature tracking: concepts and clinical applications. Circ Cardiovasc Imaging 9:e004077CrossRefGoogle Scholar
  16. 16.
    Maceira AM, Tuset-Sanchis L, López-Garrido M et al (2018) Feasibility and reproducibility of feature-tracking-based strain and strain rate measures of the left ventricle in different diseases and genders. J Magn Reson Imaging 47:1415–1425CrossRefGoogle Scholar
  17. 17.
    Ennis DB, Epstein FH, Kellman P et al (2003) Assessment of regional systolic and diastolic dysfunction in familial hypertrophic cardiomyopathy using MR tagging. Magn Reson Med 50:638–642CrossRefGoogle Scholar
  18. 18.
    Smith BM, Dorfman AL, Yu S et al (2014) Relation of strain by feature tracking and clinical outcome in children, adolescents, and young adults with hypertrophic cardiomyopathy. Am J Cardiol 114:1275–1280CrossRefGoogle Scholar
  19. 19.
    Nucifora G, Muser D, Gianfagna P et al (2015) Systolic and diastolic myocardial mechanics in hypertrophic cardiomyopathy and their link to the extent of hypertrophy, replacement fibrosis and interstitial fibrosis. Int J Cardiovasc Imaging 31:1603–1610CrossRefGoogle Scholar
  20. 20.
    Bogarapu S, Puchalski MD, Everitt MD et al (2016) Novel cardiac magnetic resonance feature tracking (CMR-FT) analysis for detection of myocardial fibrosis in pediatric hypertrophic cardiomyopathy. Pediatr Cardiol 37:663–673CrossRefGoogle Scholar
  21. 21.
    Hinojar R, Fernández-Golfín C, González-Gómez A et al (2017) Prognostic implications of global myocardial mechanics in hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking. Relations to left ventricular hypertrophy and fibrosis. Int J Cardiol 249:467–472CrossRefGoogle Scholar
  22. 22.
    Mazurkiewicz Ł, Ziółkowska L, Petryka J et al (2017) Left-ventricular mechanics in children with hypertrophic cardiomyopathy. CMR study. Magn Reson Imaging 43:56–65CrossRefGoogle Scholar
  23. 23.
    Kitaoka H, Kubo T, Hayashi K et al (2013) Tissue Doppler imaging and prognosis in asymptomatic or mildly symptomatic patients with hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 14:544–549CrossRefGoogle Scholar
  24. 24.
    Collins J, Sommerville C, Magrath P et al (2015) Extracellular volume fraction is more closely associated with altered regional left ventricular velocities than left ventricular ejection fraction in nonischemic cardiomyopathy. Circ Cardiovasc Imaging 8:e001998CrossRefGoogle Scholar
  25. 25.
    Messroghli DR, Radjenovic A, Kozerke S et al (2004) Modified Look-Locker inversion recovery (MOLLI) for high-resolution T1 mapping of the heart. Magn Reson Med 52:141–146CrossRefGoogle Scholar
  26. 26.
    Parekh K, Markl M, Deng J et al (2017) T1 mapping in children and young adults with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 33:109–117CrossRefGoogle Scholar
  27. 27.
    Cerqueira MD, Weissman NJ, Dilsizian V et al (2002) Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation 105:539–542Google Scholar
  28. 28.
    Kellman P, Wilson JR, Xue H et al (2012) Extracellular volume fraction mapping in the myocardium, part 1: evaluation of an automated method. J Cardiovasc Magn Reson 14:63CrossRefGoogle Scholar
  29. 29.
    Ruh A, Sarnari R, Berhane H et al (2019) Impact of age and cardiac disease on regional left and right ventricular myocardial motion in healthy controls and patients with repaired tetralogy of Fallot. Int J Cardiovasc Imaging 35:1119–1132CrossRefGoogle Scholar
  30. 30.
    Cornicelli MD, Rigsby CK, Rychlik K et al (2019) Diagnostic performance of cardiovascular magnetic resonance native T1 and T2 mapping in pediatric patients with acute myocarditis. J Cardiovasc Magn Reson 21:40CrossRefGoogle Scholar
  31. 31.
    Pasipoularides A (2011) LV twisting and untwisting in HCM: ejection begets filling. Diastolic functional aspects of HCM. Am Heart J 162:798–810CrossRefGoogle Scholar
  32. 32.
    Carasso S, Yang H, Woo A et al (2010) Diastolic myocardial mechanics in hypertrophic cardiomyopathy. J Am Soc Echocardiogr 23:164–171CrossRefGoogle Scholar
  33. 33.
    Soullier C, Obert P, Doucende G et al (2012) Exercise response in hypertrophic cardiomyopathy: blunted left ventricular deformational and twisting reserve with altered systolic-diastolic coupling. Circ Cardiovasc Imaging 5:324–332CrossRefGoogle Scholar
  34. 34.
    Urbano-Moral JA, Rowin EJ, Maron MS et al (2014) Investigation of global and regional myocardial mechanics with 3-dimensional speckle tracking echocardiography and relations to hypertrophy and fibrosis in hypertrophic cardiomyopathy. Circ Cardiovasc Imaging 7:11–19CrossRefGoogle Scholar
  35. 35.
    Krishnamurthy R, Pednekar A, Cheong B, Muthupillai R (2010) High temporal resolution SSFP cine MRI for estimation of left ventricular diastolic parameters. J Magn Reson Imaging 31:872–880CrossRefGoogle Scholar
  36. 36.
    Cao JJ, Ngai N, Duncanson L et al (2018) A comparison of both DENSE and feature tracking techniques with tagging for the cardiovascular magnetic resonance assessment of myocardial strain. J Cardiovasc Magn Reson 20:26CrossRefGoogle Scholar
  37. 37.
    Wehner GJ, Jing L, Haggerty CM et al (2018) Comparison of left ventricular strains and torsion derived from feature tracking and DENSE CMR. J Cardiovasc Magn Reson 20:63CrossRefGoogle Scholar
  38. 38.
    D’Hooge J, Heimdal A, Jamal F et al (2000) Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur J Echocardiogr 1:154–170CrossRefGoogle Scholar
  39. 39.
    Paul J, Wundrak S, Bernhardt P et al (2016) Self-gated tissue phase mapping using golden angle radial sparse SENSE. Magn Reson Med 75:789–800CrossRefGoogle Scholar
  40. 40.
    Ferrazzi G, Bassenge JP, Wink C et al (2019) Autocalibrated multiband CAIPIRINHA with through-time encoding: proof of principle and application to cardiac tissue phase mapping. Magn Reson Med 81:1016–1030CrossRefGoogle Scholar
  41. 41.
    Lin K, Chowdhary V, Benzuly KH et al (2016) Reproducibility and observer variability of tissue phase mapping for the quantification of regional myocardial velocities. Int J Cardiovasc Imaging 32:1227–1234CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Department of Radiology, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  3. 3.Department of Medical Imaging, Ann & Robert H. Lurie Children’s Hospital of Chicago225 E. Chicago Ave.ChicagoUSA
  4. 4.Department of Pediatrics, Division of Pediatric CardiologyAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA
  5. 5.Department of Pediatrics, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  6. 6.Department of Biomedical Engineering, McCormick School of EngineeringNorthwestern UniversityChicagoUSA

Personalised recommendations