title: Magnetic resonance imaging-based multiparametric systolic strain analysis and regional contractile heterogeneity in patients with dilated cardiomyopathy.
abstract: BACKGROUND
  Myocardial systolic strain patterns in dilated cardiomyopathy are considered non-homogeneous but have not been investigated with magnetic resonance imaging (MRI)-based multiparametric systolic strain analysis. Left ventricular (LV) 3-dimensional (3D) multiparametric systolic strain analysis is sensitive to regional contractility and is generated from sequential MRI of tissue-tagging gridline-point displacements.
  
  
  METHODS
  Sixty normal human volunteers underwent MRI-based 3D systolic strain analysis to supply normal average and standard deviation values for each of three strain parameters at each of 15,300 individual LV grid-points. Patient-specific multiparametric systolic strain data from each dilated cardiomyopathy patient (n = 10) were then subjected to a point-by-point comparison (n = 15,300 LV points) to the normal strain database for three individual strain components (45,900 database comparisons per patient). The resulting composite multiparametric Z-score values (standard deviation from normal average) were color contour mapped over patient-specific 3D LV geometry to detect the normalized regional contractile patterns associated with dilated cardiomyopathy.
  
  
  RESULTS
  Average multiparametric strain Z-score values varied significantly according to ventricular level (p = 0.001) and region (p = 0.003). Apical Z-scores were significantly less than those in both the base (p = 0.037) and mid-ventricle (p = 0.002), whereas anterolateral wall Z-scores were less than those in the anteroseptal (p = 0.023) and posteroseptal walls (p = 0.028).
  
  
  CONCLUSIONS
  MRI-based multiparametric systolic strain analysis suggests that myocardial systolic strain in patients with dilated cardiomyopathy has a heterogeneous regional distribution and, on average, falls almost 2 standard deviations from normal.
authors.affiliation: Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Joseph
authors.forename: Nader
authors.initials: N
authors.lastname: Moazami
authors.forename: Brian P
authors.initials: BP
authors.lastname: Cupps
authors.forename: Analyn
authors.initials: A
authors.lastname: Howells
authors.forename: Heidi
authors.initials: H
authors.lastname: Craddock
authors.forename: Greg
authors.initials: G
authors.lastname: Ewald
authors.forename: Joseph
authors.initials: J
authors.lastname: Rogers
authors.forename: Michael K
authors.initials: MK
authors.lastname: Pasque