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• W2214442029 abstract "Risk stratification of patients with pulmonary hypertension (PH) using non-invasive techniques is challenging. Right ventricular (RV) four-dimensional (4D) strain analysis may improve identification of high-risk individuals. Conventional strain metrics pose limitations for asymmetrical RV geometry and fibre orientations. In this study we examine a novel 4D strain analysis tool affording calculation of axis-independent principal strains for assessment of RV mechanics acquired from magnetic resonance imaging (MRI) among PH patients compared with healthy controls. Fifteen patients with prior PH diagnosis and 18 healthy volunteers were included. A standardized imaging protocol was performed using a 3T MRI Scanner. Off-line analysis was performed using GIUSEPPE, a custom Matlab-based (Mathworks, USA) software: a 3-dimensional end-diastolic RV mesh model was generated from RV wall contours at three cine SSFP middle short-axis slices. A 4D displacement field was obtained throughout the cardiac cycle through slice-pertinent feature-based tracking of local velocity at every pixel for long and short-axis image data. The 4D displacement field was positioned to patient location and orientation and rescaled according to slice-specific DICOM metadata. The 3D end-diastolic mesh was immersed within the 4D displacement field and deformed according to local velocity at each time-step of the cardiac cycle. The deformed mesh elements allowed computation of contraction in the dominant direction, or peak principal strain amplitude (PPSA). Time to peak contraction was normalized to the cardiac cycle duration (NTTP). A new metric describing normalized strain attainment rate (NorStAR) was computed as: PPSA/NNTP. Mean age of PH patients and healthy controls was 62.5±6.4 and 26.6±5.8 years, respectively. Mean pulmonary artery pressure (mPAP) among mild-moderate PH patients (n=10) was 39.2±9.4 mmHg, versus 62.4±9.0 mmHg among severe PH (defined as mPAP >55 mmHg) patients (n=5). A significant difference in NorStAR was observed between healthy controls and severe PH patients (-47±9 vs. -30±10, p=0.002). A non-significant difference in NorStAR was observed between mild and moderate PH patients (-44±10 vs. -47±9, p=NS). ROC analysis revealed AUC=0.85 for the identification of severe PH, with a threshold of -38 providing optimal sensitivity and specificity of 80% and 60%, respectively. In this pilot study we demonstrate the feasibility of 4D strain analysis using principal strains to characterize RV mechanical deformation in PH. NorStAR, a novel strain-based marker, accurately identified patients with invasive hemodynamic evidence of severe versus non-severe PH, and may be of value for risk stratification of this population." @default.
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• W2214442029 date "2015-10-01" @default.
• W2214442029 modified "2023-09-27" @default.
• W2214442029 title "4-DIMENSIONAL STRAIN IMAGING OF THE RIGHT VENTRICLE: APPLICATION OF A NOVEL DEFORMATION PARAMETER IN PATIENTS WITH PULMONARY HYPERTENSION" @default.
• W2214442029 doi "https://doi.org/10.1016/j.cjca.2015.07.098" @default.
• W2214442029 hasPublicationYear "2015" @default.
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