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(Circulation. 2000;101:981.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Fast Determination of Regional Myocardial Strain Fields From Tagged Cardiac Images Using Harmonic Phase MRI
From the Cardiology Division of the Department of Medicine (J.G., C.E.R., J.A.C.L.) and the Departments of Radiology (D.A.B., E.A.Z.) and Biomedical Engineering (E.R.M.) of the Johns Hopkins University School of Medicine, and the Department of Electrical and Computer Engineering of the Whiting School of Engineering (N.F.O., J.L.P.), Johns Hopkins University, Baltimore, Md.
Correspondence to João A.C. Lima, MD, Cardiology Division, Blalock 569, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287-6568. E-mail jlima{at}welchlink.welch.jhu.edu
Background—Tagged MRI of the heart is difficult to implement clinically because of the lack of fast analytical techniques. We investigated the accuracy of harmonic phase (HARP) imaging for rapid quantification of myocardial strains and for detailed analysis of left ventricular (LV) function during dobutamine stimulation.
Methods and Results—Tagged MRI was performed in 10 volunteers at rest and during 5 to 20 µg-1 · kg-1 · min-1 dobutamine and in 9 postinfarct patients at rest. We compared 2D myocardial strains (circumferential shortening, Ecc; maximal shortening, E2; and E2, direction) as assessed by a conventional technique and by HARP. Full quantitative analysis of the data was 10 times faster with HARP. For pooled data, the regression coefficient was r=0.93 for each strain (P<0.001). In volunteers, Ecc and E2 were greater in the free wall than in the septum (P<0.01), but recruitable myocardial strain at peak dobutamine was greater in the LV septum (P<0.01). E2 orientation shifted away from the circumferential direction at peak dobutamine (P<0.01). HARP accurately detected subtle changes in myocardial strain fields under increasing doses of dobutamine. In patients, HARP-determined Ecc and E2 values were dramatically reduced in the asynergic segments as compared with remote (P<0.001), and E2 direction shifted away from the circumferential direction (P<0.001).
Conclusions—HARP MRI provides fast, accurate assessment of myocardial strains from tagged MR images in normal subjects and in patients with coronary artery disease with wall motion abnormalities. HARP correctly indexes dobutamine-induced changes in strains and has the potential for on-line quantitative monitoring of LV function during stress testing.
Key Words: magnetic resonance imaging • ventricles • myocardium • contractility
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