Cardiovascular MRI Feature-Tracking Strain Rate for Assessment of Diastolic Function.
IF 4.2
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Jian L Yeo, Abhishek Dattani, Aseel Alfuhied, Anna-Marie Marsh, Kelly S Parke, Sarah L Ayton, Lavanya Athithan, Joanna M Bilak, Alastair J Moss, Emer M Brady, J Ranjit Arnold, Prathap Kanagala, Christopher D Steadman, Matthew P M Graham-Brown, Melanie J Davies, Anvesha Singh, Iain B Squire, Leong L Ng, Gaurav S Gulsin, Gerry P McCann
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Abstract
Purpose To compare left ventricular (LV) peak early diastolic strain rate (PEDSR) and peak late diastolic strain rate (PLDSR) using cardiac MRI feature tracking (FT) across a spectrum of diastolic dysfunction and determine the association between diastolic strain rates and cardiac remodeling. Materials and Methods Between October 2008 and December 2022, cardiac MRI and echocardiography were performed in prospectively recruited cohorts with type 2 diabetes mellitus, heart failure with preserved ejection fraction, and severe aortic stenosis, as well as asymptomatic participants without diabetes. Diastolic dysfunction was classified using established echocardiography guidelines. Global circumferential and longitudinal PEDSR and PLDSR were measured at cardiac MRI. Linear regression was performed to identify independent associations between LV diastolic strain rates and remodeling. Results A total of 600 participants (mean age, 65.2 years ± 8.4 [SD]; 361 of 600 male participants [60%]) were included. Proportions of participants with normal diastolic function and those with grade 1, indeterminate, and grade 2 or 3 diastolic dysfunction were 92 of 600 (15%), 401 of 600 (67%), 85 of 600 (14%), and 22 of 600 (4%), respectively. Compared with participants who had normal function, PEDSR decreased in those with grade 1 dysfunction (circumferential PEDSR, 0.99 sec-1 ± 0.22 vs 0.81 sec-1 ± 0.24 [P < .001]; longitudinal PEDSR, 0.79 sec-1 ± 0.19 vs 0.60 sec-1 ± 0.19 [P < .001]) and remained low throughout worsening stages of diastolic dysfunction. In contrast, compared with participants who had normal diastolic function, PLDSR increased in those with grade 1 dysfunction (circumferential PLDSR, 0.70 sec-1 ± 0.17 vs 0.82 sec-1 ± 0.23 [P < .001]; longitudinal PLDSR, 0.73 sec-1 ± 0.18 vs 0.80 sec-1 ± 0.27 [P < .001]) and declined progressively with worsening diastolic dysfunction. After multivariable adjustment for risk factors, inverse associations persisted between PEDSR and PLDSR with cardiac remodeling. Conclusion A distinctive pattern of cardiac MRI FT early and late diastolic strain rates was observed across the range of diastolic dysfunction. Keywords: Diastolic Dysfunction, Peak Early Diastolic Strain Rate, Peak Late Diastolic Strain Rate, Feature Tracking Supplemental material is available for this article. © The Author(s) 2025. Published by the Radiological Society of North America under a CC BY 4.0 license.
心血管MRI特征跟踪应变率评估舒张功能。
目的利用心脏MRI特征跟踪(FT)技术比较左室(LV)舒张早期峰值应变率(PEDSR)和舒张晚期峰值应变率(PLDSR)在舒张功能障碍频谱上的差异,并确定舒张期应变率与心脏重构之间的关系。材料和方法在2008年10月至2022年12月期间,对前瞻性招募的2型糖尿病、保留射血分数的心力衰竭、严重主动脉瓣狭窄以及无糖尿病的无症状参与者进行心脏MRI和超声心动图检查。舒张功能障碍的分类使用既定的超声心动图指南。在心脏MRI上测量整体周向和纵向PEDSR和PLDSR。进行线性回归以确定左室舒张应变率与重构之间的独立关联。结果共纳入600例受试者,平均年龄65.2岁±8.4 [SD]; 600例男性受试者中有361例(60%)。舒张功能正常和1级、不确定、2级或3级舒张功能不全的参与者比例分别为600人中92人(15%)、600人中401人(67%)、600人中85人(14%)和22人(4%)。与功能正常的受试者相比,1级功能障碍患者的PEDSR降低(环向PEDSR, 0.99秒-1±0.22 vs 0.81秒-1±0.24 [P < .001];纵向PEDSR, 0.79秒-1±0.19 vs 0.60秒-1±0.19 [P < .001]),并在舒张功能障碍恶化阶段保持较低水平。相比之下,与舒张功能正常的参与者相比,1级功能障碍患者的PLDSR增加(环向PLDSR, 0.70秒-1±0.17 vs 0.82秒-1±0.23 [P < 0.001];纵向PLDSR, 0.73秒-1±0.18 vs 0.80秒-1±0.27 [P < 0.001]),并随着舒张功能障碍的恶化而逐渐下降。在对危险因素进行多变量调整后,PEDSR和PLDSR与心脏重构之间仍然存在负相关。结论在舒张功能不全范围内,心脏MRI - FT舒张早期和晚期应变率具有独特的模式。关键词:舒张功能障碍,舒张早期峰值应变率,舒张晚期峰值应变率,特征跟踪©作者2025。由北美放射学会在CC by 4.0许可下发布。
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