Echocardiography and cardiovascular magnetic resonance based evaluation of myocardial strain and relationship with late gadolinium enhancement
Key result
Cardiovascular magnetic resonance-derived global circumferential strain was significantly associated with the presence of late gadolinium enhancement (OR 1.41), whereas echocardiography strain was not.
Why the study?
CMR strain measurements are not yet standardized, and it is unclear whether CMR and echocardiography strain measurements are interchangeable or can serve as an alternative to LGE.
How do CMR-derived and STE-derived myocardial strain measurements compare in agreement, reproducibility, and association with late gadolinium enhancement?
Comparison
STE vs CMR feature tracking vs CMR strain-encoding
Design
Cross-sectional comparative study
Authors
Discussion
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Member takes
Implication
CMR strain may better detect fibrosis than echocardiography; hypothesis-generating and should not yet change practice.
Study Design
Type
Observational (n=50)
Blinding
Blinded readers
Multicenter
No
Structured PICO
How do CMR-derived and STE-derived myocardial strain measurements compare in agreement, reproducibility, and association with late gadolinium enhancement?
P
Population
50 patients undergoing 2D echocardiography and 1.5 T cardiovascular magnetic resonance (CMR)
I
Intervention
Myocardial strain evaluation using cardiovascular magnetic resonance (CMR) with strain-encoding (SENC) and feature tracking (FT)
C
Comparator
Speckle tracking echocardiography (STE) derived strain
O
Outcome
Agreement in CMR and STE derived strain measurements, reproducibility, and relationship with CMR late gadolinium enhancement (LGE)surrogate
Main Result
Effect estimate: OR 1.41 (95% CI 1.14-1.74)
p-value: p=0.002
CMR and STE strain measurements show good agreement and reproducibility, but CMR-derived circumferential strain is better associated with the presence of late gadolinium enhancement than longitudinal strain.
Limitations
- Retrospective study with no fully standardized protocol of image acquisition
- Single-center study with a relatively small sample size
- Focused only on global strain, which does not provide information on the location of scar
- Did not include CMR-tagging or displacement encoding with stimulated echo (DENSE) strain imaging
Cite This Study
Erley et al. (2019) conducted an observational in Ischemic and non-ischemic heart disease (n=50). Cardiovascular magnetic resonance (CMR) strain (Feature Tracking and Strain-Encoding) vs. Speckle tracking echocardiography (STE) strain was evaluated on Association of SENC-derived global circumferential strain (GCS) with the presence of late gadolinium enhancement (LGE) (OR 1.41, 95% CI 1.14-1.74, p=0.002). Cardiovascular magnetic resonance-derived global circumferential strain was significantly associated with the presence of late gadolinium enhancement (OR 1.41), whereas echocardiography strain was not.