Comparison of cardiovascular magnetic resonance feature tracking and tagging for the assessment of left ventricular systolic strain in acute myocardial infarction.
OBJECTIVE
To assess the feasibility of feature tracking (FT)-measured systolic strain post acute ST-segment elevation myocardial infarction (STEMI) and compare strain values to those obtained with tagging.


METHODS
Cardiovascular MRI at 1.5T was performed in 24 patients, 2.2 days post STEMI. Global and segmental circumferential (Ecc) and longitudinal (Ell) strain were assessed using FT and tagging, and correlated with total and segmental infarct size, area at risk and myocardial salvage.


RESULTS
All segments tracked satisfactorily with FT (p<0.001 vs. tagging). Total analysis time per patient was shorter with FT (38.2±3.8 min vs. 63.7±10.3 min, p<0.001 vs. tagging). Global Ecc and Ell were higher with FT than with tagging, apart from FT Ecc using the average of endocardial and epicardial contours (-13.45±4.1 [FT] vs. -13.85±3.9 [tagging], p=0.66). Intraobserver and interobserver agreement for global strain were excellent for FT (ICC 0.906-0.990) but interobserver agreement for tagging was lower (ICC<0.765). Interobserver and intraobserver agreement for segmental strain was good for both techniques (ICC>0.7) apart from tagging Ell, which was poor (ICC=0.15). FT-derived Ecc significantly correlated with total infarct size (r=0.44, p=0.03) and segmental infarct extent (r=0.44, p<0.01), and best distinguished transmurally infarcted segments (AUC 0.77) and infarcted from adjacent and remote segments. FT-derived Ecc correlated strongest with segmental myocardial salvage (rs=-0.406).


CONCLUSIONS
FT global Ecc and Ell measurement in acute STEMI is feasible and robust. FT-derived strain is quicker to analyse, tracks myocardium better, has better interobserver variability and correlated more strongly with infarct, area at risk (oedema), myocardial salvage and infarct transmurality.
Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. Electronic address: jk211@le.ac.uk.
Jamal N
JN
Khan
Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. Electronic address: as707@le.ac.uk.
Anvesha
A
Singh
Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. Electronic address: sn191@le.ac.uk.
Sheraz A
SA
Nazir
Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. Electronic address: pk214@le.ac.uk.
Prathap
P
Kanagala
Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. Electronic address: agershlick@aol.com.
Anthony H
AH
Gershlick
Department of Cardiovascular Sciences, Clinical Sciences Wing, University of Leicester and the NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK. Electronic address: gerry.mccann@uhl-tr.nhs.uk.
Gerry P
GP
McCann
D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000473:pathology* / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology* / Q000503:physiopathology; D009206:Myocardium; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013318:Stroke Volume; D016277:Ventricular Function, Left
Cardiovascular magnetic resonance; Feature tracking; Infarct size; Myocardial infarction; Strain; Tagging