Three-dimensional regional strain analysis in porcine myocardial infarction

A 3T magnetic resonance tagging study

Sahar Soleimanifard, Khaled Z. Abd-Elmoniem, Tetsuo Sasano, Harsh K. Agarwal, M. Roselle Abraham, Theodore P. Abraham, Jerry Ladd Prince

Research output: Contribution to journalArticle

Abstract

Background: Previous studies of mechanical strain anomalies in myocardial infarction (MI) have been largely limited to analysis of one-dimensional (1D) and two-dimensional (2D) strain parameters. Advances in cardiovascular magnetic resonance (CMR) methods now permit a complete three-dimensional (3D) interrogation of myocardial regional strain. The aim of this study was to investigate the incremental value of CMR-based 3D strain and to test the hypothesis that 3D strain is superior to 1D or 2D strain analysis in the assessment of viability using a porcine model of infarction. Methods. Infarction was induced surgically in 20 farm pigs. Cine, late gadolinium enhancement, and CMR tagging images were acquired at 11 days before (baseline), and 11 days (early) and 1 month (late) after induction of infarct. Harmonic phase analysis was performed to measure circumferential, longitudinal, and radial strains in myocardial segments, which were defined based on the transmurality of delayed enhancement. Univariate, bivariate, and multivariate logistic regression models of strain parameters were created and analyzed to compare the overall diagnostic accuracy of 3D strain analysis with 1D and 2D analyses in identifying the infarct and its adjacent regions from healthy myocardium. Results: 3D strain differed significantly in infarct, adjacent, and remote segments (p <0.05) at early and late post-MI. In univariate, bivariate, and multivariate analyses, circumferential, longitudinal, and radial strains were significant factors (p <0.001) in differentiation of infarct and adjacent segments from baseline values. In identification of adjacent segments, receiver operating characteristic analysis using the 3D strain multivariate model demonstrated a significant improvement (p <0.01) in overall diagnostic accuracy in comparison with 2D (circumferential and radial) and 1D (circumferential) models (3D: 96%, 2D: 81%, and 1D: 71%). A similar trend was observed in identification of infarct segments. Conclusions: Cumulative 3D strain information accurately identifies infarcts and their neighboring regions from healthy myocardium. The 3D interrogation of myocardial contractility provides incremental diagnostic accuracy in delineating the dysfunctional and nonviable myocardium in comparison with 1D or 2D quantification of strain. The infarct neighboring regions are the major beneficiaries of the 3D assessment of regional strain.

Original languageEnglish (US)
Article number85
JournalJournal of Cardiovascular Magnetic Resonance
Volume14
Issue number1
DOIs
StatePublished - 2012

Fingerprint

Myocardium
Magnetic Resonance Spectroscopy
Swine
Myocardial Infarction
Infarction
Logistic Models
Gadolinium
ROC Curve
Multivariate Analysis
Farms

Keywords

  • Diagnostic accuracy
  • Harmonic phase analysis
  • Magnetic resonance tagging
  • Myocardial infarction
  • Three-dimensional regional strain

ASJC Scopus subject areas

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

Cite this

Three-dimensional regional strain analysis in porcine myocardial infarction : A 3T magnetic resonance tagging study. / Soleimanifard, Sahar; Abd-Elmoniem, Khaled Z.; Sasano, Tetsuo; Agarwal, Harsh K.; Abraham, M. Roselle; Abraham, Theodore P.; Prince, Jerry Ladd.

In: Journal of Cardiovascular Magnetic Resonance, Vol. 14, No. 1, 85, 2012.

Research output: Contribution to journalArticle

Soleimanifard, Sahar ; Abd-Elmoniem, Khaled Z. ; Sasano, Tetsuo ; Agarwal, Harsh K. ; Abraham, M. Roselle ; Abraham, Theodore P. ; Prince, Jerry Ladd. / Three-dimensional regional strain analysis in porcine myocardial infarction : A 3T magnetic resonance tagging study. In: Journal of Cardiovascular Magnetic Resonance. 2012 ; Vol. 14, No. 1.
@article{702f3fe4ed77405881fc9806df7db727,
title = "Three-dimensional regional strain analysis in porcine myocardial infarction: A 3T magnetic resonance tagging study",
abstract = "Background: Previous studies of mechanical strain anomalies in myocardial infarction (MI) have been largely limited to analysis of one-dimensional (1D) and two-dimensional (2D) strain parameters. Advances in cardiovascular magnetic resonance (CMR) methods now permit a complete three-dimensional (3D) interrogation of myocardial regional strain. The aim of this study was to investigate the incremental value of CMR-based 3D strain and to test the hypothesis that 3D strain is superior to 1D or 2D strain analysis in the assessment of viability using a porcine model of infarction. Methods. Infarction was induced surgically in 20 farm pigs. Cine, late gadolinium enhancement, and CMR tagging images were acquired at 11 days before (baseline), and 11 days (early) and 1 month (late) after induction of infarct. Harmonic phase analysis was performed to measure circumferential, longitudinal, and radial strains in myocardial segments, which were defined based on the transmurality of delayed enhancement. Univariate, bivariate, and multivariate logistic regression models of strain parameters were created and analyzed to compare the overall diagnostic accuracy of 3D strain analysis with 1D and 2D analyses in identifying the infarct and its adjacent regions from healthy myocardium. Results: 3D strain differed significantly in infarct, adjacent, and remote segments (p <0.05) at early and late post-MI. In univariate, bivariate, and multivariate analyses, circumferential, longitudinal, and radial strains were significant factors (p <0.001) in differentiation of infarct and adjacent segments from baseline values. In identification of adjacent segments, receiver operating characteristic analysis using the 3D strain multivariate model demonstrated a significant improvement (p <0.01) in overall diagnostic accuracy in comparison with 2D (circumferential and radial) and 1D (circumferential) models (3D: 96{\%}, 2D: 81{\%}, and 1D: 71{\%}). A similar trend was observed in identification of infarct segments. Conclusions: Cumulative 3D strain information accurately identifies infarcts and their neighboring regions from healthy myocardium. The 3D interrogation of myocardial contractility provides incremental diagnostic accuracy in delineating the dysfunctional and nonviable myocardium in comparison with 1D or 2D quantification of strain. The infarct neighboring regions are the major beneficiaries of the 3D assessment of regional strain.",
keywords = "Diagnostic accuracy, Harmonic phase analysis, Magnetic resonance tagging, Myocardial infarction, Three-dimensional regional strain",
author = "Sahar Soleimanifard and Abd-Elmoniem, {Khaled Z.} and Tetsuo Sasano and Agarwal, {Harsh K.} and Abraham, {M. Roselle} and Abraham, {Theodore P.} and Prince, {Jerry Ladd}",
year = "2012",
doi = "10.1186/1532-429X-14-85",
language = "English (US)",
volume = "14",
journal = "Journal of Cardiovascular Magnetic Resonance",
issn = "1097-6647",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Three-dimensional regional strain analysis in porcine myocardial infarction

T2 - A 3T magnetic resonance tagging study

AU - Soleimanifard, Sahar

AU - Abd-Elmoniem, Khaled Z.

AU - Sasano, Tetsuo

AU - Agarwal, Harsh K.

AU - Abraham, M. Roselle

AU - Abraham, Theodore P.

AU - Prince, Jerry Ladd

PY - 2012

Y1 - 2012

N2 - Background: Previous studies of mechanical strain anomalies in myocardial infarction (MI) have been largely limited to analysis of one-dimensional (1D) and two-dimensional (2D) strain parameters. Advances in cardiovascular magnetic resonance (CMR) methods now permit a complete three-dimensional (3D) interrogation of myocardial regional strain. The aim of this study was to investigate the incremental value of CMR-based 3D strain and to test the hypothesis that 3D strain is superior to 1D or 2D strain analysis in the assessment of viability using a porcine model of infarction. Methods. Infarction was induced surgically in 20 farm pigs. Cine, late gadolinium enhancement, and CMR tagging images were acquired at 11 days before (baseline), and 11 days (early) and 1 month (late) after induction of infarct. Harmonic phase analysis was performed to measure circumferential, longitudinal, and radial strains in myocardial segments, which were defined based on the transmurality of delayed enhancement. Univariate, bivariate, and multivariate logistic regression models of strain parameters were created and analyzed to compare the overall diagnostic accuracy of 3D strain analysis with 1D and 2D analyses in identifying the infarct and its adjacent regions from healthy myocardium. Results: 3D strain differed significantly in infarct, adjacent, and remote segments (p <0.05) at early and late post-MI. In univariate, bivariate, and multivariate analyses, circumferential, longitudinal, and radial strains were significant factors (p <0.001) in differentiation of infarct and adjacent segments from baseline values. In identification of adjacent segments, receiver operating characteristic analysis using the 3D strain multivariate model demonstrated a significant improvement (p <0.01) in overall diagnostic accuracy in comparison with 2D (circumferential and radial) and 1D (circumferential) models (3D: 96%, 2D: 81%, and 1D: 71%). A similar trend was observed in identification of infarct segments. Conclusions: Cumulative 3D strain information accurately identifies infarcts and their neighboring regions from healthy myocardium. The 3D interrogation of myocardial contractility provides incremental diagnostic accuracy in delineating the dysfunctional and nonviable myocardium in comparison with 1D or 2D quantification of strain. The infarct neighboring regions are the major beneficiaries of the 3D assessment of regional strain.

AB - Background: Previous studies of mechanical strain anomalies in myocardial infarction (MI) have been largely limited to analysis of one-dimensional (1D) and two-dimensional (2D) strain parameters. Advances in cardiovascular magnetic resonance (CMR) methods now permit a complete three-dimensional (3D) interrogation of myocardial regional strain. The aim of this study was to investigate the incremental value of CMR-based 3D strain and to test the hypothesis that 3D strain is superior to 1D or 2D strain analysis in the assessment of viability using a porcine model of infarction. Methods. Infarction was induced surgically in 20 farm pigs. Cine, late gadolinium enhancement, and CMR tagging images were acquired at 11 days before (baseline), and 11 days (early) and 1 month (late) after induction of infarct. Harmonic phase analysis was performed to measure circumferential, longitudinal, and radial strains in myocardial segments, which were defined based on the transmurality of delayed enhancement. Univariate, bivariate, and multivariate logistic regression models of strain parameters were created and analyzed to compare the overall diagnostic accuracy of 3D strain analysis with 1D and 2D analyses in identifying the infarct and its adjacent regions from healthy myocardium. Results: 3D strain differed significantly in infarct, adjacent, and remote segments (p <0.05) at early and late post-MI. In univariate, bivariate, and multivariate analyses, circumferential, longitudinal, and radial strains were significant factors (p <0.001) in differentiation of infarct and adjacent segments from baseline values. In identification of adjacent segments, receiver operating characteristic analysis using the 3D strain multivariate model demonstrated a significant improvement (p <0.01) in overall diagnostic accuracy in comparison with 2D (circumferential and radial) and 1D (circumferential) models (3D: 96%, 2D: 81%, and 1D: 71%). A similar trend was observed in identification of infarct segments. Conclusions: Cumulative 3D strain information accurately identifies infarcts and their neighboring regions from healthy myocardium. The 3D interrogation of myocardial contractility provides incremental diagnostic accuracy in delineating the dysfunctional and nonviable myocardium in comparison with 1D or 2D quantification of strain. The infarct neighboring regions are the major beneficiaries of the 3D assessment of regional strain.

KW - Diagnostic accuracy

KW - Harmonic phase analysis

KW - Magnetic resonance tagging

KW - Myocardial infarction

KW - Three-dimensional regional strain

UR - http://www.scopus.com/inward/record.url?scp=84870878765&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870878765&partnerID=8YFLogxK

U2 - 10.1186/1532-429X-14-85

DO - 10.1186/1532-429X-14-85

M3 - Article

VL - 14

JO - Journal of Cardiovascular Magnetic Resonance

JF - Journal of Cardiovascular Magnetic Resonance

SN - 1097-6647

IS - 1

M1 - 85

ER -