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Background  Left ventricular segmental wall motion analysis is important for clinical decision making in cardiac diseases. Strain analysis with myocardial tissue tagging is the non-invasive gold standard for quantitative assessment, however, it is time-consuming. Cardiovascular magnetic resonance myocardial feature-tracking (CMR-FT) can rapidly perform strain analysis, because it can be employed with standard CMR cine-imaging. The aim is to validate segmental peak systolic circumferential strain (peak SCS) and time to peak systolic circumferential strain (T2P-SCS) analysed by CMR-FT against tissue tagging, and determine its intra and inter-observer variability.    Methods  Patients in whom both cine CMR and tissue tagging has been performed were selected. CMR-FT analysis was done using endocardial (CMR-FT endo ) and mid-wall contours (CMR-FT mid ). The Intra Class Correlation Coefficient (ICC) and Pearson correlation were calculated.    Results  10 healthy volunteers, 10 left bundle branch block (LBBB) and 10 hypertrophic cardiomyopathy patients were selected. With CMR-FT all 480 segments were analyzable and with tissue tagging 464 segments.  Significant differences in mean peak SCS values of the total study group were present between CMR-FT endo  and tissue tagging (-23.8 ± 9.9% vs -13.4 ± 3.3%, p < 0.001). Differences were smaller between CMR-FT mid  and tissue tagging (-16.4 ± 6.1% vs -13.4 ± 3.3%, p = 0.001). The ICC of the mean peak SCS of the total study group between CMR-FT endo  and tissue tagging was low (0.19 (95%-CI-0.10-0.49), p = 0.02). Comparable results were seen between CMR-FT mid  and tissue tagging. In LBBB patients, mean T2P-SCS values measured with CMR-FT endo  and CMR-FT mid  were 418 ± 66 ms, 454 ± 60 ms, which were longer than with tissue tagging, 376 ± 55 ms, both p < 0.05. ICC of the mean T2P-SCS between CMR-FT endo  and tissue tagging was 0.64 (95%-CI-0.36-0.81), p < 0.001, this was better in the healthy volunteers and LBBB group, whereas the ICC between CMR-FT mid  and tissue tagging was lower.  The intra and inter-observer agreement of segmental peak SCS with CMR-FT mid  was lower compared with tissue tagging; similar results were seen for segmental T2P-SCS.    Conclusions  The intra and inter-observer agreement of segmental peak SCS and T2P-SCS is substantially lower with CMR-FT mid  compared with tissue tagging. Therefore, current segmental CMR-FT mid  techniques are not yet applicable for clinical and research purposes.

Feature tracking compared with tissue tagging measurements of segmental strain by cardiovascular magnetic resonance