Circulation, Vol 84, 67-74, Copyright © 1991 by American Heart Association
NR Clark, N Reichek, P Bergey, EA Hoffman, D Brownson, L Palmon and L Axel
BACKGROUND. Conventional cardiac imaging methods do not depict true
segmental myocardial shortening, since they cannot determine segment length
between fixed points in the myocardium. METHODS AND RESULTS. We used
electrocardiographically gated magnetic resonance imaging with spatial
modulation of magnetization to noninvasively "tag" the myocardium with dark
stripes at uniform 7-mm intervals center to center at end diastole. We then
determined end-systolic stripe separation and thereby calculated
circumferential shortening. When end systole was not reached in the first
image series, a second temporally overlapped series starting in late
systole was used to determine late-systolic shortening. Septal, anterior,
lateral, and inferior segments were assessed at endocardium, midwall, and
epicardium on five midventricular short-axis sections each in 10 normal
volunteers. A transmural gradient in circumferential shortening was
observed, with the percentage of endocardial segment shortening
consistently greater than epicardial segment shortening (epicardial, 22 +/-
5%; midwall, 30 +/- 6%; and endocardial, 44 +/- 6%; p less than 0.0001 by
analysis of variance). Circumferential shortening varied from apex to base
with slices closer to the base of the left ventricle showing less
shortening at the midwall (28 +/- 9%) and endocardium (39 +/- 6%) than more
apical slices at the midwall (34 +/- 13%) and endocardium (49 +/- 9%) (p
less than 0.05 and p less than 0.01, respectively, by analysis of
variance). CONCLUSIONS. Transmural and longitudinal heterogeneity of
circumferential shortening is present in the normal human left ventricle.
Magnetic resonance imaging with spatial modulation of magnetization is a
powerful new tool for assessment of circumferential shortening and provides
information unobtainable with conventional imaging methods.
ARTICLES
Circumferential myocardial shortening in the normal human left ventricle. Assessment by magnetic resonance imaging using spatial modulation of magnetization
Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104.
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