What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy volunteers (n=21). Intervention: Strain-encoding (SENC) cardiovascular magnetic resonance vs. Spatial Modulation of Magnetization (SPAMM) CMR. Primary outcome: Intra- and inter-observer variabilities of right ventricular peak systolic strain measurements.

What does this research mean for the field?

Strain-encoding cardiovascular magnetic resonance (SENC CMR) enables rapid and highly reproducible quantification of right ventricular regional function, demonstrating low intra- and inter-observer variability. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2008Open Access

Strain-encoding cardiovascular magnetic resonance for assessment of right-ventricular regional function

Key Result

Strain-encoding cardiovascular magnetic resonance allowed for rapid quantification of right ventricular regional function with low intra- and inter-observer mean differences of 0.11% and 0.32%.

Study Design

Type

Cross-Sectional (n=21)

Blinding

Single-blind

Multicenter

Structured PICO

Does strain-encoding (SENC) CMR provide reproducible measurements of right ventricular regional function in healthy volunteers?

Population

21 healthy volunteers with no history of heart disease and no abnormal cardiac structure or function, mean age 35 +/- 7 years.

Intervention

Strain-encoding (SENC) cardiovascular magnetic resonance (CMR) imaging

Comparator

Spatial Modulation of Magnetization (SPAMM) tagged images

Outcome

Intra- and inter-observer variabilities of right ventricular (RV) peak systolic strain measurementssurrogate

SENC CMR allows for rapid and reproducible quantification of right ventricular regional function, offering a potential tool for evaluating patients with RV dysfunction.

Limitations

Diagnostic utility of the strain measurements were not tested on patients with known RV dysfunction
Scan-rescan reproducibility for the same subjects was not examined
Evaluation of regional heart function from a single circumferential plane
Imaging technique did not correct for tissue through-plane motion

Abstract

BACKGROUND: Tissue tagging by cardiovascular magnetic resonance (CMR) is a comprehensive method for the assessment of cardiac regional function. However, imaging the right ventricle (RV) using this technique is problematic due to the thin wall of the RV relative to tag spacing which limits assessment of regional function using conventional in-plane tagging. HYPOTHESIS: We hypothesize that the use of through-plane tags in the strain-encoding (SENC) CMR technique would result in reproducible measurements of the RV regional function due to the high image quality and spatial resolution possible with SENC. AIM: To test the intra- and inter-observer variabilities of RV peak systolic strain measurements with SENC CMR for assessment of RV regional function (systolic strain) in healthy volunteers. METHODS: Healthy volunteers (n = 21) were imaged using SENC. A four-chamber view was acquired in a single breath-hold. Circumferential strain was measured during systole at six equidistant points along the RV free wall. Peak contraction is defined as the maximum value of circumferential strain averaged from the six points, and regional function is defined as the strain value at each point at the time of peak contraction. RESULTS: Mean values for peak circumferential strain (+/- standard deviation) of the basal, mid, and apical regions of the RV free wall were -20.4 +/- 2.9%, -18.8 +/- 3.9%, and -16.5 +/- 5.7%, Altman plots showed good intra- and inter-observer agreements with mean difference of 0.11% and 0.32% and limits of agreement of -4.038 to 4.174 and -4.903 to 5.836, respectively. CONCLUSION: SENC CMR allows for rapid quantification of RV regional function with low intra- and inter-observer variabilities, which could permit accurate quantification of regional strain in patients with RV dysfunction.

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