Myocardial viability mapping by magnetic resonance-based multiparametric systolic strain analysis.

Journal Article (Journal Article)

BACKGROUND: Regional myocardial contractility can be characterized by three-dimensional left ventricular (LV) multiparametric strain maps generated from sequential magnetic resonance imaging of radiofrequency tissue-tagging grid point displacements. METHODS: Normal average and standard deviation values for each of three strain indices at 15,300 LV points were determined from a normal volunteer human strain database (n = 50) by application of magnetic resonance-based three-dimensional strain analysis. Patient-specific multiparametric strain data from each ischemic cardiomyopathy patient (n = 20) were then submitted to a point-by-point comparison (n = 15,300 LV points) to the normal strain database. The resulting 15,300 composite multiparametric Z-score values (standard deviation from normal average) were color-contour mapped over patient-specific three-dimensional LV geometry to detect the abnormal contractile patterns associated with myocardial infarction and nonviable myocardium. RESULTS: The average multiparametric strain composite Z-score from each LV region (n = 120) was compared with the respective clinical standard viability testing result and used to construct a receiver-operator characteristic curve. The area under the curve was 0.941 (p < 0.001; 95% confidence interval: 0.897 to 0.985). A regional average Z-score threshold of 1.525 (> 1.525 being nonviable) resulted in a sensitivity of 90% and a specificity of 90%. Corresponding positive and negative predictive values were 84% and 95%, respectively. CONCLUSIONS: The clinical application of magnetic resonance-based multiparametric strain analysis allowed accurate regional characterization and visualization of LV myocardial viability.

Full Text

Duke Authors

Cited Authors

  • Cupps, BP; Bree, DR; Wollmuth, JR; Howells, AC; Voeller, RK; Rogers, JG; Pasque, MK

Published Date

  • November 2008

Published In

Volume / Issue

  • 86 / 5

Start / End Page

  • 1546 - 1553

PubMed ID

  • 19049746

Pubmed Central ID

  • PMC2635109

Electronic International Standard Serial Number (EISSN)

  • 1552-6259

Digital Object Identifier (DOI)

  • 10.1016/j.athoracsur.2008.06.072


  • eng

Conference Location

  • Netherlands