Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy: A multisoftware feasibility and clinical implementation study

Mimount Bourfiss, Davis M. Vigneault, Mounes Aliyari Ghasebeh, Brittney Murray, Cynthia Anne James, Crystal Tichnell, Firdaus A. Mohamed Hoesein, Stefan Zimmerman, Ihab R Kamel, Hugh Calkins, Harikrishna Tandri, Birgitta K. Velthuis, David A. Bluemke, Anneline S.J.M. Te Riele

Research output: Contribution to journalArticle

Abstract

Background: Regional right ventricular (RV) dysfunction is the hallmark of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), but is currently only qualitatively evaluated in the clinical setting. Feature Tracking Cardiovascular Magnetic Resonance (FT-CMR) is a novel quantitative method that uses cine CMR to calculate strain values. However, most prior FT-CMR studies in ARVD/C have focused on global RV strain using different software methods, complicating implementation of FT-CMR in clinical practice. We aimed to assess the clinical value of global and regional strain using FT-CMR in ARVD/C and to determine differences between commercially available FT-CMR software packages. Methods: We analyzed cine CMR images of 110 subjects (39 overt ARVD/C [mutation+/phenotype+], 40 preclinical ARVD/C [mutation+/phenotype-] and 31 control) for global and regional (subtricuspid, anterior, apical) RV strain in the horizontal longitudinal axis using four FT-CMR software methods (Multimodality Tissue Tracking, TomTec, Medis and Circle Cardiovascular Imaging). Intersoftware agreement was assessed using Bland Altman plots. Results: For global strain, all methods showed reduced strain in overt ARVD/C patients compared to control subjects (p < 0.041), whereas none distinguished preclinical from control subjects (p > 0.275). For regional strain, overt ARVD/C patients showed reduced strain compared to control subjects in all segments which reached statistical significance in the subtricuspid region for all software methods (p < 0.037), in the anterior wall for two methods (p < 0.005) and in the apex for one method (p = 0.012). Preclinical subjects showed abnormal subtricuspid strain compared to control subjects using one of the software methods (p = 0.009). Agreement between software methods for absolute strain values was low (Intraclass Correlation Coefficient = 0.373). Conclusions: Despite large intersoftware variability of FT-CMR derived strain values, all four software methods distinguished overt ARVD/C patients from control subjects by both global and subtricuspid strain values. In the subtricuspid region, one software package distinguished preclinical from control subjects, suggesting the potential to identify early ARVD/C prior to overt disease expression.

Original languageEnglish (US)
Article number66
JournalJournal of Cardiovascular Magnetic Resonance
Volume19
Issue number1
DOIs
StatePublished - Sep 1 2017

Fingerprint

Arrhythmogenic Right Ventricular Dysplasia
Software
Magnetic Resonance Spectroscopy
Clinical Studies
Right Ventricular Dysfunction
Phenotype
Mutation

Keywords

  • Arrhythmogenic right ventricular dysplasia/Cardiomyopathy
  • Feature tracking cardiac magnetic resonance imaging
  • Global myocardial strain
  • Regional myocardial strain
  • Software comparison study

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine
  • Family Practice

Cite this

Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy : A multisoftware feasibility and clinical implementation study. / Bourfiss, Mimount; Vigneault, Davis M.; Aliyari Ghasebeh, Mounes; Murray, Brittney; James, Cynthia Anne; Tichnell, Crystal; Mohamed Hoesein, Firdaus A.; Zimmerman, Stefan; Kamel, Ihab R; Calkins, Hugh; Tandri, Harikrishna; Velthuis, Birgitta K.; Bluemke, David A.; Te Riele, Anneline S.J.M.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 19, No. 1, 66, 01.09.2017.

Research output: Contribution to journalArticle

Bourfiss, Mimount ; Vigneault, Davis M. ; Aliyari Ghasebeh, Mounes ; Murray, Brittney ; James, Cynthia Anne ; Tichnell, Crystal ; Mohamed Hoesein, Firdaus A. ; Zimmerman, Stefan ; Kamel, Ihab R ; Calkins, Hugh ; Tandri, Harikrishna ; Velthuis, Birgitta K. ; Bluemke, David A. ; Te Riele, Anneline S.J.M. / Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy : A multisoftware feasibility and clinical implementation study. In: Journal of Cardiovascular Magnetic Resonance. 2017 ; Vol. 19, No. 1.
@article{f574b47d02e34dfe8fbdb9689c9e99a9,
title = "Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy: A multisoftware feasibility and clinical implementation study",
abstract = "Background: Regional right ventricular (RV) dysfunction is the hallmark of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), but is currently only qualitatively evaluated in the clinical setting. Feature Tracking Cardiovascular Magnetic Resonance (FT-CMR) is a novel quantitative method that uses cine CMR to calculate strain values. However, most prior FT-CMR studies in ARVD/C have focused on global RV strain using different software methods, complicating implementation of FT-CMR in clinical practice. We aimed to assess the clinical value of global and regional strain using FT-CMR in ARVD/C and to determine differences between commercially available FT-CMR software packages. Methods: We analyzed cine CMR images of 110 subjects (39 overt ARVD/C [mutation+/phenotype+], 40 preclinical ARVD/C [mutation+/phenotype-] and 31 control) for global and regional (subtricuspid, anterior, apical) RV strain in the horizontal longitudinal axis using four FT-CMR software methods (Multimodality Tissue Tracking, TomTec, Medis and Circle Cardiovascular Imaging). Intersoftware agreement was assessed using Bland Altman plots. Results: For global strain, all methods showed reduced strain in overt ARVD/C patients compared to control subjects (p < 0.041), whereas none distinguished preclinical from control subjects (p > 0.275). For regional strain, overt ARVD/C patients showed reduced strain compared to control subjects in all segments which reached statistical significance in the subtricuspid region for all software methods (p < 0.037), in the anterior wall for two methods (p < 0.005) and in the apex for one method (p = 0.012). Preclinical subjects showed abnormal subtricuspid strain compared to control subjects using one of the software methods (p = 0.009). Agreement between software methods for absolute strain values was low (Intraclass Correlation Coefficient = 0.373). Conclusions: Despite large intersoftware variability of FT-CMR derived strain values, all four software methods distinguished overt ARVD/C patients from control subjects by both global and subtricuspid strain values. In the subtricuspid region, one software package distinguished preclinical from control subjects, suggesting the potential to identify early ARVD/C prior to overt disease expression.",
keywords = "Arrhythmogenic right ventricular dysplasia/Cardiomyopathy, Feature tracking cardiac magnetic resonance imaging, Global myocardial strain, Regional myocardial strain, Software comparison study",
author = "Mimount Bourfiss and Vigneault, {Davis M.} and {Aliyari Ghasebeh}, Mounes and Brittney Murray and James, {Cynthia Anne} and Crystal Tichnell and {Mohamed Hoesein}, {Firdaus A.} and Stefan Zimmerman and Kamel, {Ihab R} and Hugh Calkins and Harikrishna Tandri and Velthuis, {Birgitta K.} and Bluemke, {David A.} and {Te Riele}, {Anneline S.J.M.}",
year = "2017",
month = "9",
day = "1",
doi = "10.1186/s12968-017-0380-4",
language = "English (US)",
volume = "19",
journal = "Journal of Cardiovascular Magnetic Resonance",
issn = "1097-6647",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy

T2 - A multisoftware feasibility and clinical implementation study

AU - Bourfiss, Mimount

AU - Vigneault, Davis M.

AU - Aliyari Ghasebeh, Mounes

AU - Murray, Brittney

AU - James, Cynthia Anne

AU - Tichnell, Crystal

AU - Mohamed Hoesein, Firdaus A.

AU - Zimmerman, Stefan

AU - Kamel, Ihab R

AU - Calkins, Hugh

AU - Tandri, Harikrishna

AU - Velthuis, Birgitta K.

AU - Bluemke, David A.

AU - Te Riele, Anneline S.J.M.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Background: Regional right ventricular (RV) dysfunction is the hallmark of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), but is currently only qualitatively evaluated in the clinical setting. Feature Tracking Cardiovascular Magnetic Resonance (FT-CMR) is a novel quantitative method that uses cine CMR to calculate strain values. However, most prior FT-CMR studies in ARVD/C have focused on global RV strain using different software methods, complicating implementation of FT-CMR in clinical practice. We aimed to assess the clinical value of global and regional strain using FT-CMR in ARVD/C and to determine differences between commercially available FT-CMR software packages. Methods: We analyzed cine CMR images of 110 subjects (39 overt ARVD/C [mutation+/phenotype+], 40 preclinical ARVD/C [mutation+/phenotype-] and 31 control) for global and regional (subtricuspid, anterior, apical) RV strain in the horizontal longitudinal axis using four FT-CMR software methods (Multimodality Tissue Tracking, TomTec, Medis and Circle Cardiovascular Imaging). Intersoftware agreement was assessed using Bland Altman plots. Results: For global strain, all methods showed reduced strain in overt ARVD/C patients compared to control subjects (p < 0.041), whereas none distinguished preclinical from control subjects (p > 0.275). For regional strain, overt ARVD/C patients showed reduced strain compared to control subjects in all segments which reached statistical significance in the subtricuspid region for all software methods (p < 0.037), in the anterior wall for two methods (p < 0.005) and in the apex for one method (p = 0.012). Preclinical subjects showed abnormal subtricuspid strain compared to control subjects using one of the software methods (p = 0.009). Agreement between software methods for absolute strain values was low (Intraclass Correlation Coefficient = 0.373). Conclusions: Despite large intersoftware variability of FT-CMR derived strain values, all four software methods distinguished overt ARVD/C patients from control subjects by both global and subtricuspid strain values. In the subtricuspid region, one software package distinguished preclinical from control subjects, suggesting the potential to identify early ARVD/C prior to overt disease expression.

AB - Background: Regional right ventricular (RV) dysfunction is the hallmark of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), but is currently only qualitatively evaluated in the clinical setting. Feature Tracking Cardiovascular Magnetic Resonance (FT-CMR) is a novel quantitative method that uses cine CMR to calculate strain values. However, most prior FT-CMR studies in ARVD/C have focused on global RV strain using different software methods, complicating implementation of FT-CMR in clinical practice. We aimed to assess the clinical value of global and regional strain using FT-CMR in ARVD/C and to determine differences between commercially available FT-CMR software packages. Methods: We analyzed cine CMR images of 110 subjects (39 overt ARVD/C [mutation+/phenotype+], 40 preclinical ARVD/C [mutation+/phenotype-] and 31 control) for global and regional (subtricuspid, anterior, apical) RV strain in the horizontal longitudinal axis using four FT-CMR software methods (Multimodality Tissue Tracking, TomTec, Medis and Circle Cardiovascular Imaging). Intersoftware agreement was assessed using Bland Altman plots. Results: For global strain, all methods showed reduced strain in overt ARVD/C patients compared to control subjects (p < 0.041), whereas none distinguished preclinical from control subjects (p > 0.275). For regional strain, overt ARVD/C patients showed reduced strain compared to control subjects in all segments which reached statistical significance in the subtricuspid region for all software methods (p < 0.037), in the anterior wall for two methods (p < 0.005) and in the apex for one method (p = 0.012). Preclinical subjects showed abnormal subtricuspid strain compared to control subjects using one of the software methods (p = 0.009). Agreement between software methods for absolute strain values was low (Intraclass Correlation Coefficient = 0.373). Conclusions: Despite large intersoftware variability of FT-CMR derived strain values, all four software methods distinguished overt ARVD/C patients from control subjects by both global and subtricuspid strain values. In the subtricuspid region, one software package distinguished preclinical from control subjects, suggesting the potential to identify early ARVD/C prior to overt disease expression.

KW - Arrhythmogenic right ventricular dysplasia/Cardiomyopathy

KW - Feature tracking cardiac magnetic resonance imaging

KW - Global myocardial strain

KW - Regional myocardial strain

KW - Software comparison study

UR - http://www.scopus.com/inward/record.url?scp=85028692695&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028692695&partnerID=8YFLogxK

U2 - 10.1186/s12968-017-0380-4

DO - 10.1186/s12968-017-0380-4

M3 - Article

C2 - 28863780

AN - SCOPUS:85028692695

VL - 19

JO - Journal of Cardiovascular Magnetic Resonance

JF - Journal of Cardiovascular Magnetic Resonance

SN - 1097-6647

IS - 1

M1 - 66

ER -