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Method to create regional mechanical dyssynchrony maps from short‐axis cine steady‐state free‐precession images
Author(s) -
Suever Jonathan D.,
Fornwalt Brandon K.,
Neuman Lee R.,
Delfino Jana G.,
Lloyd Michael S.,
Oshinski John N.
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24257
Subject(s) - cardiac resynchronization therapy , steady state free precession imaging , medicine , ventricular dyssynchrony , qrs complex , cardiology , short axis , reproducibility , heart failure , nuclear medicine , radiology , magnetic resonance imaging , long axis , mathematics , statistics , geometry , ejection fraction
Purpose To develop a robust method to assess regional mechanical dyssynchrony from cine short‐axis MR images. Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure and evidence of left‐ventricular (LV) dyssynchrony. Patient response to CRT is greatest when the LV pacing lead is placed in the most dyssynchronous segment. Existing techniques for assessing regional dyssynchrony require difficult acquisition and/or postprocessing. Our goal was to develop a widely applicable and robust method to assess regional mechanical dyssynchrony. Materials and Methods Using the endocardial boundary, radial displacement curves (RDCs) were generated throughout the LV. Cross‐correlation was used to determine the delay time between each RDC and a patient‐specific reference. Delay times were projected onto the American Heart Association 17‐segment model creating a regional dyssynchrony map. Our method was tested in 10 normal individuals and 10 patients enrolled for CRT (QRS > 120 ms, NYHA III‐IV, EF < 35%). Results Delay times over the LV were 23.9 ± 33.8 ms and 93.1 ± 99.9 ms ( P < 0.001) in normal subjects and patients, respectively. Interobserver reproducibility for segment averages was 6.8 ± 39.3 ms and there was 70% agreement in identifying the latest contracting segment. Conclusion We have developed a method that can reliably calculate regional delay times from cine steady‐state free‐precession (SSFP) images. Maps of regional dyssynchrony could be used to identify the latest‐contracting segment to assist in CRT lead implantation. J. Magn. Reson. Imaging 2014;39:958–965. © 2013 Wiley Periodicals, Inc .