Key result
CMR strain correlates with low voltage zones, yielding ~89% concordance versus conventional LGE in NICM.
Why the study?
LGE detected by CMR has low correlation with low voltage zones detected by EAM, prompting investigation into myocardial strain by CMR-FT alongside LGE.
Does myocardial strain by CMR-FT correlate better with electrical low voltage zones than conventional LGE in patients with nonischemic cardiomyopathy?
Observational (n=19)
No
Does myocardial strain by CMR-FT correlate better with electrical low voltage zones than conventional LGE in patients with nonischemic cardiomyopathy?
Answers are grounded in this paper and cite their sources.
Myocardial strain by CMR-FT correlates better with electrical low voltage zones than conventional LGE in patients with nonischemic cardiomyopathy, potentially improving substrate identification.
BACKGROUND: Late gadolinium enhancement (LGE) detected by cardiac MRI (CMR) has low correlation with low voltage zones (LVZs) detected by electroanatomical mapping (EAM). We aim to study correlation of myocardial strain by CMR- Feature Tracking (FT) alongside LGE with LVZs detected by EAM. METHODS: Nineteen consecutive CMRs of patients with EAM were analyzed offline by CMR-FT. Peak value of circumferential strain (CS), longitudinal strain (LS), and LGE was measured in each segment of the left ventricle (17-segment model). The percentage of myocardial segments with CS and LS > -17% was determined. Percentage area of LGE-scar was calculated. Global and segment-wise bipolar and unipolar voltage was collected. Percentage area of bipolar LVZ (<1.5 mV) and unipolar LVZ (<8.3 mV) was calculated. RESULTS: Mean age was 62±11 years. Mean LVEF was 37±13%. Mean global CS was -11.8±5%. Mean global LS was -11.2±4%. LGE-scar was noted in 74% of the patients. Mean percentage area of LGE-scar was 5%. There was significant correlation between percentage abnormality detected by LS with percentage bipolar LVZ (r = +0.5, p = 0.03) and combined percentage CS+LS abnormality with percentage unipolar LVZ (r = +0.5, p = 0.02). Per-unit increase in CS increased the percentage area of unipolar LVZ by 2.09 (p = 0.07) and per-unit increase in LS increased the percentage area of unipolar LVZ by 2.49 (p = 0.06). The concordance rates between CS and LS to localize segments with bipolar/unipolar LVZ were 79% and 95% compared to 63% with LGE. CONCLUSIONS: Myocardial strain detected by CMR-FT has a better correlation with electrical low voltage zones than the conventional LGE.
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Raja et al. (2023) conducted an observational in Nonischemic cardiomyopathy (n=19). Cardiac magnetic resonance feature tracking (CMR-FT) myocardial strain vs. Late gadolinium enhancement (LGE) was evaluated on Correlation between percentage abnormality detected by longitudinal strain and percentage bipolar low voltage zone (r = +0.5, p=0.03). Myocardial strain detected by CMR-feature tracking showed a significant correlation with electrical low voltage zones and had higher concordance rates than conventional late gadolinium enhancement in patients with nonischemic cardiomyopathy.
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