title: Three-Dimensional Tricuspid Annular Motion Analysis from Cardiac Magnetic Resonance Feature-Tracking.
abstract: Right ventricular (RV) dysfunction is known to be highly correlated with mortality and morbidity; nevertheless, imaging-based assessment of RV anatomy and physiology lags far behind that of the left ventricle. In this study, we advance RV imaging using cardiac magnetic resonance (CMR) to accomplish the following aims: (i) track the motion of six tricuspid annular (TA) sites using a semi-automatic tracking system; (ii) extract clinically important TA measurements-systolic velocity (Sm), early diastolic velocity (Em), late diastolic velocity (Am), and TA plane systolic excursion (TAPSE)-for each TA site and compare these CMR-derived measurements in healthy subjects vs. patients with heart failure, repaired tetralogy of Fallot, pulmonary hypertension, and hypertrophic cardiomyopathy; (iii) investigate how the TA motion related measurements compare with information provided by invasive right heart catheterization (RHC); (iv) evaluate the rate of change in surface area swept out by the reconstructed tricuspid annulus over time and (v) assess the reproducibility of this CMR-based technique. Results indicate that TA motion parameter data obtained in three dimensions using the proposed CMR-based systematic methodology achieve superior diagnostic performance (Sm: AUC = 0.957; TAPSE: AUC = 0.981) compared to two-dimensional CMR imaging. Both Sm and TAPSE from CMR correlated positively with dP/dtmax/IP from RHC (Sm: r = 0.621, p < 0.01; TAPSE: r = 0.648, p < 0.01). Our highly reproducible and robust methodology holds potential for extending CMR imaging to characterization of TA morphology and dynamic behaviour, eventually leading to deeper understanding of RV function and improved diagnostic capability.
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
authors.forename: Shuang
authors.initials: S
authors.lastname: Leng
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, People's Republic of China.
authors.forename: Meng
authors.initials: M
authors.lastname: Jiang
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
authors.forename: Xiao-Dan
authors.initials: XD
authors.lastname: Zhao
authors.affiliation: Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
authors.forename: John Carson
authors.initials: JC
authors.lastname: Allen
authors.affiliation: California Medical Innovations Institute, San Diego, CA, 92121, USA.
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab
authors.affiliation: Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, People's Republic of China.
authors.forename: Rong-Zhen
authors.initials: RZ
authors.lastname: Ouyang
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
authors.forename: Ju-Le
authors.initials: JL
authors.lastname: Tan
authors.affiliation: Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, People's Republic of China. heben@medmail.com.cn.
authors.forename: Ben
authors.initials: B
authors.lastname: He
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.|Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
authors.forename: Ru-San
authors.initials: RS
authors.lastname: Tan
authors.affiliation: National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore. zhong.liang@nhcs.com.sg.|Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore. zhong.liang@nhcs.com.sg.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhong
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009038:Motion; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000503:physiopathology; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology
keywords: Cardiac magnetic resonance; Right ventricular function; Tricuspid annulus