Key result
A novel method to assess regional mechanical dyssynchrony from cine SSFP images identified significantly longer LV delay times in CRT patients compared to normal subjects (93.1 vs 23.9 ms, P<0.001).
Why the study?
Can regional mechanical dyssynchrony maps be reliably created from short-axis cine steady-state free-precession images to assist in CRT lead implantation?
Observational (n=20)
Can regional mechanical dyssynchrony maps be reliably created from short-axis cine steady-state free-precession images to assist in CRT lead implantation?
Absolute Event Rate: 93.1% vs 23.9%
p-value: p=<0.001
A novel method using cine SSFP MR images can reliably calculate regional delay times to assess mechanical dyssynchrony, potentially assisting in targeted CRT lead implantation.
PURPOSE: To develop a robust method to assess regional mechanical dyssynchrony from cine short-axis MR images. Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure and evidence of left-ventricular (LV) dyssynchrony. Patient response to CRT is greatest when the LV pacing lead is placed in the most dyssynchronous segment. Existing techniques for assessing regional dyssynchrony require difficult acquisition and/or postprocessing. Our goal was to develop a widely applicable and robust method to assess regional mechanical dyssynchrony. MATERIALS AND METHODS: Using the endocardial boundary, radial displacement curves (RDCs) were generated throughout the LV. Cross-correlation was used to determine the delay time between each RDC and a patient-specific reference. Delay times were projected onto the American Heart Association 17-segment model creating a regional dyssynchrony map. Our method was tested in 10 normal individuals and 10 patients enrolled for CRT (QRS > 120 ms, NYHA III-IV, EF < 35%). RESULTS: Delay times over the LV were 23.9 ± 33.8 ms and 93.1 ± 99.9 ms (P < 0.001) in normal subjects and patients, respectively. Interobserver reproducibility for segment averages was 6.8 ± 39.3 ms and there was 70% agreement in identifying the latest contracting segment. CONCLUSION: We have developed a method that can reliably calculate regional delay times from cine steady-state free-precession (SSFP) images. Maps of regional dyssynchrony could be used to identify the latest-contracting segment to assist in CRT lead implantation.
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Suever et al. (2013) conducted an observational in Heart failure with left-ventricular dyssynchrony (n=20). Regional mechanical dyssynchrony mapping from cine SSFP images vs. Normal subjects was evaluated on Delay times over the left ventricle (p=<0.001). A novel method to assess regional mechanical dyssynchrony from cine SSFP images identified significantly longer LV delay times in CRT patients compared to normal subjects (93.1 vs 23.9 ms, P<0.001).
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