Heart deformation analysis for automated quantification of cardiac function and regional myocardial motion patterns: A proof of concept study in patients with cardiomyopathy and healthy subjects.
OBJECTIVE
To test the performance of HDA in characterizing left ventricular (LV) function and regional myocardial motion patterns in the context of cardiomyopathy based on cine cardiovascular magnetic resonance (CMR).


METHODS
Following the approval of the institutional review board (IRB), standard cine images of 45 subjects, including 15 healthy volunteers, 15 patients with hypertrophic cardiomyopathy (HCM) and 15 patients with dilated cardiomyopathy (DCM) were retrospectively analyzed using HDA. The variations of LV ejection fraction (LVEF), LV mass (LVM), and regional myocardial motion indices, including radial (Drr), circumferential (Dcc) displacement, radial (Vrr) and circumferential (Vcc) velocity, radial (Err), circumferential (Ecc) and shear (Ess) strain and radial (SRr) and circumferential (SRc) strain rate, were calculated and compared among subject groups. Inter-study reproducibility of HDA-derived myocardial motion indices were tested on 15 volunteers by using intra-class correlation coefficient (ICC) and coefficient of variation (CoV).


RESULTS
HDA identified significant differences in cardiac function and motion indices between subject groups. DCM patients had significantly lower LVEF (33.5±9.65%), LVM (105.88±21.93g), peak Drr (0.29±0.11cm), Vrr-sys (2.14±0.72cm/s), Err (0.17±0.08), Ecc (-0.08±0.03), SRr-sys (0.91±0.44s(-1)) and SRc-sys (-0.64±0.27s(-1)) compared to the other two groups. HCM patients demonstrated increased LVM (171.69±34.19) and lower peak Vcc-dia (0.78±0.30cm/s) than other subjects. Good inter-study reproducibility was found for all HDA-derived myocardial indices in healthy volunteers (ICC=0.664-0.942, CoV=15.1%-37.1%).


CONCLUSIONS
Without the need for operator interaction, HDA is a reproducible method for the automated characterization of global and regional LV function in the context of cardiomyopathy.
Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611, United States. Electronic address: kai-lin@northwestern.edu.
Kai
K
Lin
Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611, United States.
Jeremy D
JD
Collins
Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611, United States.
Varun
V
Chowdhary
Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611, United States.
Michael
M
Markl
Department of Radiology, Northwestern University, 737 N Michigan Avenue, Suite 1600, Chicago, IL 60611, United States.
James C
JC
Carr
D000368:Aged; D001696:Biomechanical Phenomena; D002302:Cardiac Output; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005240:Feasibility Studies; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D016277:Ventricular Function, Left / Q000502:physiology*
Cardiomyopathy; Cardiovascular magnetic resonance; Heart deformation analysis; Strain analysis
Circulation. 2006 Apr 11;113(14):1807-16
16567565
JACC Cardiovasc Imaging. 2010 Feb;3(2):144-51
20159640
J Cardiovasc Magn Reson. 2012 Jun 21;14:43
22721175
Acad Radiol. 2016 Mar;23 (3):321-5
26749328
Med Phys. 2008 Mar;35(3):1008-18
18404936
Radiology. 1988 Oct;169(1):59-63
3420283
Radiology. 2006 Mar;238(3):816-26
16424246
J Am Coll Cardiol. 2013 Oct 15;62(16):e147-239
23747642
Magn Reson Med. 2010 Oct;64(4):1089-97
20574967
Med Image Anal. 2009 Apr;13(2):354-61
18948056
Int J Cardiovasc Imaging. 2016 Jul;32(7):1103-11
27076222
J Am Coll Cardiol. 2011 Dec 13;58(25):e212-60
22075469
Magn Reson Med. 2006 Apr;55(4):937-42
16450375
Magn Reson Med Sci. 2013 Mar 25;12(1):69-75
23474965
J Cardiovasc Magn Reson. 2014 Jan 22;16:10
24450803