Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy
Purpose To investigate whether magnetic resonance imaging (MRI) cine‐derived dyssynchrony indices provide additional information compared to conventional tagged MRI (tMRI) acquisitions in heart failure patients undergoing cardiac resynchronization therapy (CRT). Materials and Methods Patients schedu...
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| Veröffentlicht in: | Journal of magnetic resonance imaging 2016-12, Vol.44 (6), p.1483-1492 |
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| creator | Werys, Konrad Petryka-Mazurkiewicz, Joanna Błaszczyk, Łukasz Miśko, Jolanta Śpiewak, Mateusz Małek, Łukasz A. Mazurkiewicz, Łukasz Miłosz-Wieczorek, Barbara Marczak, Magdalena Kubik, Agata Dąbrowska, Agnieszka Piątkowska-Janko, Ewa Sawionek, Błażej Wijesurendra, Rohan Piechnik, Stefan K. Bogorodzki, Piotr |
| description | Purpose
To investigate whether magnetic resonance imaging (MRI) cine‐derived dyssynchrony indices provide additional information compared to conventional tagged MRI (tMRI) acquisitions in heart failure patients undergoing cardiac resynchronization therapy (CRT).
Materials and Methods
Patients scheduled for CRT (n = 52) underwent preprocedure MRI including cine and tMRI acquisitions. Segmental strain curves were calculated for both cine and tMRI to produce a range of standard indices for direct comparison between modalities. We also proposed and evaluated a novel index of “dyscontractility,” which detects the presence of focal areas with paradoxically positive circumferential strain.
Results
Across conventional strain indices, there was only moderate‐to‐poor (R = 0.3–0.6) correlation between modalities; eight cine‐derived indices showed statistically significant (P < 0.05) relations to CRT outcome compared to just two tMRI‐based counterparts. The novel dyscontractility index calculated on basal slice cine images (cine dyscontractility index, “CDI”) was the single best predictor of clinical response to CRT (area under the curve AUC = 0.81, P < 0.001). While poorly correlated to its tMRI counterpart (R = 0.33), CDI performed significantly better in predicting response to CRT (P < 0.005), and was also numerically better than all other tMRI indices (AUC 0.53–0.76, all P for AUC comparisons |
| doi_str_mv | 10.1002/jmri.25295 |
| format | Article |
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To investigate whether magnetic resonance imaging (MRI) cine‐derived dyssynchrony indices provide additional information compared to conventional tagged MRI (tMRI) acquisitions in heart failure patients undergoing cardiac resynchronization therapy (CRT).
Materials and Methods
Patients scheduled for CRT (n = 52) underwent preprocedure MRI including cine and tMRI acquisitions. Segmental strain curves were calculated for both cine and tMRI to produce a range of standard indices for direct comparison between modalities. We also proposed and evaluated a novel index of “dyscontractility,” which detects the presence of focal areas with paradoxically positive circumferential strain.
Results
Across conventional strain indices, there was only moderate‐to‐poor (R = 0.3–0.6) correlation between modalities; eight cine‐derived indices showed statistically significant (P < 0.05) relations to CRT outcome compared to just two tMRI‐based counterparts. The novel dyscontractility index calculated on basal slice cine images (cine dyscontractility index, “CDI”) was the single best predictor of clinical response to CRT (area under the curve AUC = 0.81, P < 0.001). While poorly correlated to its tMRI counterpart (R = 0.33), CDI performed significantly better in predicting response to CRT (P < 0.005), and was also numerically better than all other tMRI indices (AUC 0.53–0.76, all P for AUC comparisons <0.17).
Conclusion
Cine‐derived strain indices offer potentially new information compared to tMRI. Specifically, the novel CDI is most strongly linked to response to cardiac resynchronization therapy in a contemporary patient cohort. It utilizes readily available MRI data, is relatively straightforward to process, and compares favorably with any conventional tagging index. J. Magn. Reson. Imaging 2016;44:1483–1492.</description><identifier>ISSN: 1053-1807</identifier><identifier>EISSN: 1522-2586</identifier><identifier>DOI: 10.1002/jmri.25295</identifier><identifier>PMID: 27131044</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Beta blockers ; Biomarkers ; cardiac magnetic resonance imaging ; Cardiac Resynchronization Therapy ; cine ; dyssynchrony index ; Excitation Contraction Coupling ; Female ; Heart Failure - diagnostic imaging ; Heart Failure - physiopathology ; Heart Failure - prevention & control ; Humans ; Image Interpretation, Computer-Assisted - methods ; image registration ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Cine - methods ; Male ; Middle Aged ; Myocardial Contraction ; NMR ; Nuclear magnetic resonance ; Prognosis ; Reproducibility of Results ; Sensitivity and Specificity ; strain ; Stroke Volume ; Treatment Outcome ; Ventricular Dysfunction, Left - diagnostic imaging ; Ventricular Dysfunction, Left - physiopathology ; Ventricular Dysfunction, Left - prevention & control</subject><ispartof>Journal of magnetic resonance imaging, 2016-12, Vol.44 (6), p.1483-1492</ispartof><rights>2016 International Society for Magnetic Resonance in Medicine</rights><rights>2016 International Society for Magnetic Resonance in Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4295-85f33c4868beabcf315809b2f6fe376e90b484a647123669dd8c42cddc6e35013</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjmri.25295$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjmri.25295$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27131044$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Werys, Konrad</creatorcontrib><creatorcontrib>Petryka-Mazurkiewicz, Joanna</creatorcontrib><creatorcontrib>Błaszczyk, Łukasz</creatorcontrib><creatorcontrib>Miśko, Jolanta</creatorcontrib><creatorcontrib>Śpiewak, Mateusz</creatorcontrib><creatorcontrib>Małek, Łukasz A.</creatorcontrib><creatorcontrib>Mazurkiewicz, Łukasz</creatorcontrib><creatorcontrib>Miłosz-Wieczorek, Barbara</creatorcontrib><creatorcontrib>Marczak, Magdalena</creatorcontrib><creatorcontrib>Kubik, Agata</creatorcontrib><creatorcontrib>Dąbrowska, Agnieszka</creatorcontrib><creatorcontrib>Piątkowska-Janko, Ewa</creatorcontrib><creatorcontrib>Sawionek, Błażej</creatorcontrib><creatorcontrib>Wijesurendra, Rohan</creatorcontrib><creatorcontrib>Piechnik, Stefan K.</creatorcontrib><creatorcontrib>Bogorodzki, Piotr</creatorcontrib><title>Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy</title><title>Journal of magnetic resonance imaging</title><addtitle>J. Magn. Reson. Imaging</addtitle><description>Purpose
To investigate whether magnetic resonance imaging (MRI) cine‐derived dyssynchrony indices provide additional information compared to conventional tagged MRI (tMRI) acquisitions in heart failure patients undergoing cardiac resynchronization therapy (CRT).
Materials and Methods
Patients scheduled for CRT (n = 52) underwent preprocedure MRI including cine and tMRI acquisitions. Segmental strain curves were calculated for both cine and tMRI to produce a range of standard indices for direct comparison between modalities. We also proposed and evaluated a novel index of “dyscontractility,” which detects the presence of focal areas with paradoxically positive circumferential strain.
Results
Across conventional strain indices, there was only moderate‐to‐poor (R = 0.3–0.6) correlation between modalities; eight cine‐derived indices showed statistically significant (P < 0.05) relations to CRT outcome compared to just two tMRI‐based counterparts. The novel dyscontractility index calculated on basal slice cine images (cine dyscontractility index, “CDI”) was the single best predictor of clinical response to CRT (area under the curve AUC = 0.81, P < 0.001). While poorly correlated to its tMRI counterpart (R = 0.33), CDI performed significantly better in predicting response to CRT (P < 0.005), and was also numerically better than all other tMRI indices (AUC 0.53–0.76, all P for AUC comparisons <0.17).
Conclusion
Cine‐derived strain indices offer potentially new information compared to tMRI. Specifically, the novel CDI is most strongly linked to response to cardiac resynchronization therapy in a contemporary patient cohort. It utilizes readily available MRI data, is relatively straightforward to process, and compares favorably with any conventional tagging index. J. Magn. Reson. Imaging 2016;44:1483–1492.</description><subject>Adult</subject><subject>Beta blockers</subject><subject>Biomarkers</subject><subject>cardiac magnetic resonance imaging</subject><subject>Cardiac Resynchronization Therapy</subject><subject>cine</subject><subject>dyssynchrony index</subject><subject>Excitation Contraction Coupling</subject><subject>Female</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - prevention & control</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted - methods</subject><subject>image registration</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Contraction</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>strain</subject><subject>Stroke Volume</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction, Left - diagnostic imaging</subject><subject>Ventricular Dysfunction, Left - physiopathology</subject><subject>Ventricular Dysfunction, Left - prevention & control</subject><issn>1053-1807</issn><issn>1522-2586</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1v1DAQhiMEoqVw4QcgS1y4pPg7DrdqBaWwgLQCwc1ynInWS9ZObS80HPnleLtLD5w4eeR53pFmnqp6SvA5wZi-3GyjO6eCtuJedUoEpTUVSt4vNRasJgo3J9WjlDYY47bl4mF1QhvCCOb8tPq9cB5QPycbfI7GZje6PCPne7h5hS6QDz9gRFsTv0NEYUBbsGvjnTXjPpRmb9cx-BnltcloitA7mxOKkKbgE6AckDWxd8bu_460-2WyC75kIJppflw9GMyY4MnxPau-vHn9efG2Xn66vFpcLGvLy2q1EgNjliupOjCdHRgRCrcdHeQArJHQ4o4rbiRvCGVStn2vStD2vZXABCbsrHpxmDvFcL2DlPXWJQvjaDyEXdJECdw0SpL2P1AqZblrywv6_B90E3bRl0UKxQWmoigq1LMjteu20OspunLTWf8VUQByAH66Eea7PsF6r1jvFetbxfrdh9XVbVUy9SHjUoabu0xxpWXDGqG_frzUK_mtle_JSi_ZH6FlqfI</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Werys, Konrad</creator><creator>Petryka-Mazurkiewicz, Joanna</creator><creator>Błaszczyk, Łukasz</creator><creator>Miśko, Jolanta</creator><creator>Śpiewak, Mateusz</creator><creator>Małek, Łukasz A.</creator><creator>Mazurkiewicz, Łukasz</creator><creator>Miłosz-Wieczorek, Barbara</creator><creator>Marczak, Magdalena</creator><creator>Kubik, Agata</creator><creator>Dąbrowska, Agnieszka</creator><creator>Piątkowska-Janko, Ewa</creator><creator>Sawionek, Błażej</creator><creator>Wijesurendra, Rohan</creator><creator>Piechnik, Stefan K.</creator><creator>Bogorodzki, Piotr</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QO</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201612</creationdate><title>Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy</title><author>Werys, Konrad ; Petryka-Mazurkiewicz, Joanna ; Błaszczyk, Łukasz ; Miśko, Jolanta ; Śpiewak, Mateusz ; Małek, Łukasz A. ; Mazurkiewicz, Łukasz ; Miłosz-Wieczorek, Barbara ; Marczak, Magdalena ; Kubik, Agata ; Dąbrowska, Agnieszka ; Piątkowska-Janko, Ewa ; Sawionek, Błażej ; Wijesurendra, Rohan ; Piechnik, Stefan K. ; Bogorodzki, Piotr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4295-85f33c4868beabcf315809b2f6fe376e90b484a647123669dd8c42cddc6e35013</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Beta blockers</topic><topic>Biomarkers</topic><topic>cardiac magnetic resonance imaging</topic><topic>Cardiac Resynchronization Therapy</topic><topic>cine</topic><topic>dyssynchrony index</topic><topic>Excitation Contraction Coupling</topic><topic>Female</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - prevention & control</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted - methods</topic><topic>image registration</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Contraction</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>strain</topic><topic>Stroke Volume</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction, Left - diagnostic imaging</topic><topic>Ventricular Dysfunction, Left - physiopathology</topic><topic>Ventricular Dysfunction, Left - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Werys, Konrad</creatorcontrib><creatorcontrib>Petryka-Mazurkiewicz, Joanna</creatorcontrib><creatorcontrib>Błaszczyk, Łukasz</creatorcontrib><creatorcontrib>Miśko, Jolanta</creatorcontrib><creatorcontrib>Śpiewak, Mateusz</creatorcontrib><creatorcontrib>Małek, Łukasz A.</creatorcontrib><creatorcontrib>Mazurkiewicz, Łukasz</creatorcontrib><creatorcontrib>Miłosz-Wieczorek, Barbara</creatorcontrib><creatorcontrib>Marczak, Magdalena</creatorcontrib><creatorcontrib>Kubik, Agata</creatorcontrib><creatorcontrib>Dąbrowska, Agnieszka</creatorcontrib><creatorcontrib>Piątkowska-Janko, Ewa</creatorcontrib><creatorcontrib>Sawionek, Błażej</creatorcontrib><creatorcontrib>Wijesurendra, Rohan</creatorcontrib><creatorcontrib>Piechnik, Stefan K.</creatorcontrib><creatorcontrib>Bogorodzki, Piotr</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of magnetic resonance imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Werys, Konrad</au><au>Petryka-Mazurkiewicz, Joanna</au><au>Błaszczyk, Łukasz</au><au>Miśko, Jolanta</au><au>Śpiewak, Mateusz</au><au>Małek, Łukasz A.</au><au>Mazurkiewicz, Łukasz</au><au>Miłosz-Wieczorek, Barbara</au><au>Marczak, Magdalena</au><au>Kubik, Agata</au><au>Dąbrowska, Agnieszka</au><au>Piątkowska-Janko, Ewa</au><au>Sawionek, Błażej</au><au>Wijesurendra, Rohan</au><au>Piechnik, Stefan K.</au><au>Bogorodzki, Piotr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy</atitle><jtitle>Journal of magnetic resonance imaging</jtitle><addtitle>J. Magn. Reson. Imaging</addtitle><date>2016-12</date><risdate>2016</risdate><volume>44</volume><issue>6</issue><spage>1483</spage><epage>1492</epage><pages>1483-1492</pages><issn>1053-1807</issn><eissn>1522-2586</eissn><abstract>Purpose
To investigate whether magnetic resonance imaging (MRI) cine‐derived dyssynchrony indices provide additional information compared to conventional tagged MRI (tMRI) acquisitions in heart failure patients undergoing cardiac resynchronization therapy (CRT).
Materials and Methods
Patients scheduled for CRT (n = 52) underwent preprocedure MRI including cine and tMRI acquisitions. Segmental strain curves were calculated for both cine and tMRI to produce a range of standard indices for direct comparison between modalities. We also proposed and evaluated a novel index of “dyscontractility,” which detects the presence of focal areas with paradoxically positive circumferential strain.
Results
Across conventional strain indices, there was only moderate‐to‐poor (R = 0.3–0.6) correlation between modalities; eight cine‐derived indices showed statistically significant (P < 0.05) relations to CRT outcome compared to just two tMRI‐based counterparts. The novel dyscontractility index calculated on basal slice cine images (cine dyscontractility index, “CDI”) was the single best predictor of clinical response to CRT (area under the curve AUC = 0.81, P < 0.001). While poorly correlated to its tMRI counterpart (R = 0.33), CDI performed significantly better in predicting response to CRT (P < 0.005), and was also numerically better than all other tMRI indices (AUC 0.53–0.76, all P for AUC comparisons <0.17).
Conclusion
Cine‐derived strain indices offer potentially new information compared to tMRI. Specifically, the novel CDI is most strongly linked to response to cardiac resynchronization therapy in a contemporary patient cohort. It utilizes readily available MRI data, is relatively straightforward to process, and compares favorably with any conventional tagging index. J. Magn. Reson. Imaging 2016;44:1483–1492.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>27131044</pmid><doi>10.1002/jmri.25295</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Beta blockers Biomarkers cardiac magnetic resonance imaging Cardiac Resynchronization Therapy cine dyssynchrony index Excitation Contraction Coupling Female Heart Failure - diagnostic imaging Heart Failure - physiopathology Heart Failure - prevention & control Humans Image Interpretation, Computer-Assisted - methods image registration Magnetic resonance imaging Magnetic Resonance Imaging, Cine - methods Male Middle Aged Myocardial Contraction NMR Nuclear magnetic resonance Prognosis Reproducibility of Results Sensitivity and Specificity strain Stroke Volume Treatment Outcome Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - physiopathology Ventricular Dysfunction, Left - prevention & control |
| title | Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy |
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