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Correlation between left ventricular fractal dimension and impaired strain assessed by cardiac MRI feature tracking in patients with left ventricular noncompaction and normal left ventricular ejection fraction

  • Cardiac
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Abstract

Objectives

To investigate the correlation between the extent of excessive trabeculation assessed by fractal dimension (FD) and myocardial contractility assessed by cardiac MRI feature tracking in patients with left ventricular noncompaction (LVNC) and normal left ventricular ejection fraction (LVEF).

Methods

Forty-one LVNC patients with normal LVEF (≥ 50%) and 41 healthy controls were retrospectively included. All patients fulfilled three available diagnostic criteria on MRI. Cardiac MRI feature tracking was performed on cine images to determine left ventricular (LV) peak strains in three directions: global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS). The complexity of excessive trabeculation was quantified by fractal analysis on short-axis cine stacks.

Results

Compared with controls, patients with LVNC had impaired GRS, GCS, and GLS (all p < 0.05). The global, maximal, and regional FD values of the LVNC population were all significantly higher than those of the controls (all p < 0.05). Global FD was positively correlated with the end-diastolic volume index, end-systolic volume index, and stroke volume index (r = 0.483, 0.505, and 0.335, respectively, all p < 0.05), but negatively correlated with GRS and GCS (r =  − 0.458 and 0.508, respectively, both p < 0.001). Moreover, apical FD was also weakly associated with LVEF and GLS (r =  − 0.249 and 0.252, respectively, both p < 0.05).

Conclusion

In patients with LVNC, LV systolic dysfunction was detected early by cardiac MRI feature tracking despite the presence of normal LVEF and was associated with excessive trabecular complexity assessed by FD.

Key Points

• Left ventricular global strain was already impaired in patients with extremely prominent excessive trabeculation but normal left ventricular ejection fraction.

• An increased fractal dimension was associated with impaired deformation in left ventricular noncompaction.

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Abbreviations

AUC:

Area under the curve

CI:

Cardiac index

EDVi:

End-diastolic volume index

ESVi:

End-systolic volume index

FD:

Fractal dimension

GCS:

Global circumferential strain

GLS:

Global longitudinal strain

GRS:

Global radial strain

IQR:

Interquartile range

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

LVNC:

Left ventricular noncompaction

SVi:

Stroke volume index

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Funding

This study was co-funded by the National Natural Science Foundation of China (No. 81930044, No. 81620108015).

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Authors and Affiliations

  1. MR Center, Fuwai Hospital, Stata Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing, 100037, China

    Shiqin Yu, Xiuyu Chen, Kai Yang, Jiaxin Wang, Wenhao Dong, Weipeng Yan & Shihua Zhao

  2. Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, SZ University Town, Shenzhen, 518055, China

    Kankan Zhao

  3. Department of Cardiology, Jinan Central Hospital, Shandong First Medical University and Shandong Academy of Medical Sciences, No. 105 Jiefang Road, Jinan, 250013, Shandong, China

    Guohai Su

Authors
  1. Shiqin Yu
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  9. Shihua Zhao
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Corresponding authors

Correspondence to Guohai Su or Shihua Zhao.

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The scientific guarantor of this publication is Shihua Zhao.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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Yu, S., Chen, X., Yang, K. et al. Correlation between left ventricular fractal dimension and impaired strain assessed by cardiac MRI feature tracking in patients with left ventricular noncompaction and normal left ventricular ejection fraction. Eur Radiol 32, 2594–2603 (2022). https://doi.org/10.1007/s00330-021-08346-2

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  • DOI: https://doi.org/10.1007/s00330-021-08346-2

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