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Cine dyscontractility index: A novel marker of mechanical dyssynchrony that predicts response to cardiac resynchronization therapy
Author(s) -
Werys Konrad,
PetrykaMazurkiewicz Joanna,
Błaszczyk Łukasz,
Miśko Jolanta,
Śpiewak Mateusz,
Małek Łukasz A.,
Mazurkiewicz Łukasz,
MiłoszWieczorek Barbara,
Marczak Magdalena,
Kubik Agata,
Dąbrowska Agnieszka,
PiątkowskaJanko Ewa,
Sawionek Błażej,
Wijesurendra Rohan,
Piechnik Stefan K.,
Bogorodzki Piotr
Publication year - 2016
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.25295
Subject(s) - cardiac resynchronization therapy , medicine , magnetic resonance imaging , cardiac magnetic resonance imaging , cardiac magnetic resonance , cardiology , area under the curve , heart failure , nuclear medicine , radiology , ejection fraction
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.