Cardiovascular Magnetic Resonance-derived Left Ventricular Mechanics-strain, Cardiac Power and End-systolic Elastance Under Various Inotropic States in Swine

Overview

Journal J Cardiovasc Magn Reson

Publisher Elsevier

Specialties Cardiology & Vascular Diseases
Radiology

Date 2020 Dec 1

PMID 33256761

Citations 7

Authors

A Faragli

R Tanacli

C Kolp

D Abawi

T Lapinskas

C Stehning

B Schnackenburg

F P Lo Muzio

L Fassina

B Pieske

E Nagel

H Post

S Kelle

A Alogna

Affiliations

Soon will be listed here.

Abstract

Background: Cardiovascular magnetic resonance (CMR) strain imaging is an established technique to quantify myocardial deformation. However, to what extent left ventricular (LV) systolic strain, and therefore LV mechanics, reflects classical hemodynamic parameters under various inotropic states is still not completely clear. Therefore, the aim of this study was to investigate the correlation of LV global strain parameters measured via CMR feature tracking (CMR-FT, based on conventional cine balanced steady state free precession (bSSFP) images) with hemodynamic parameters such as cardiac index (CI), cardiac power output (CPO) and end-systolic elastance (Ees) under various inotropic states.

Methods: Ten anaesthetized, healthy Landrace swine were acutely instrumented closed-chest and transported to the CMR facility for measurements. After baseline measurements, two steps were performed: (1) dobutamine-stress (Dobutamine) and (2) verapamil-induced cardiovascular depression (Verapamil). During each protocol, CMR images were acquired in the short axisand apical 2Ch, 3Ch and 4Ch views. MEDIS software was utilized to analyze global longitudinal (GLS), global circumferential (GCS), and global radial strain (GRS).

Results: Dobutamine significantly increased heart rate, CI, CPO and Ees, while Verapamil decreased them. Absolute values of GLS, GCS and GRS accordingly increased during Dobutamine infusion, while GLS and GCS decreased during Verapamil. Linear regression analysis showed a moderate correlation between GLS, GCS and LV hemodynamic parameters, while GRS correlated poorly. Indexing global strain parameters for indirect measures of afterload, such as mean aortic pressure or wall stress, significantly improved these correlations, with GLS indexed for wall stress reflecting LV contractility as the clinically widespread LV ejection fraction.

Conclusion: GLS and GCS correlate accordingly with LV hemodynamics under various inotropic states in swine. Indexing strain parameters for indirect measures of afterload substantially improves this correlation, with GLS being as good as LV ejection fraction in reflecting LV contractility. CMR-FT-strain imaging may be a quick and promising tool to characterize LV hemodynamics in patients with varying degrees of LV dysfunction.

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References

Williams S, Cooke G, Wright D, Parsons W, RILEY R, Marshall P . Peak exercise cardiac power output; a direct indicator of cardiac function strongly predictive of prognosis in chronic heart failure. Eur Heart J. 2001; 22(16):1496-503. DOI: 10.1053/euhj.2000.2547. View

Alogna A, Manninger M, Schwarzl M, Zirngast B, Steendijk P, Verderber J . Inotropic Effects of Experimental Hyperthermia and Hypothermia on Left Ventricular Function in Pigs-Comparison With Dobutamine. Crit Care Med. 2015; 44(3):e158-67. DOI: 10.1097/CCM.0000000000001358. View

Barreiro-Perez M, Curione D, Symons R, Claus P, Voigt J, Bogaert J . Left ventricular global myocardial strain assessment comparing the reproducibility of four commercially available CMR-feature tracking algorithms. Eur Radiol. 2018; 28(12):5137-5147. DOI: 10.1007/s00330-018-5538-4. View

Abawi D, Faragli A, Schwarzl M, Manninger M, Zweiker D, Kresoja K . Cardiac power output accurately reflects external cardiac work over a wide range of inotropic states in pigs. BMC Cardiovasc Disord. 2019; 19(1):217. PMC: 6792198. DOI: 10.1186/s12872-019-1212-2. View

Cotter G, Williams S, Vered Z, Tan L . Role of cardiac power in heart failure. Curr Opin Cardiol. 2003; 18(3):215-22. DOI: 10.1097/00001573-200305000-00007. View

Weidemann F, Jamal F, Kowalski M, Kukulski T, Dhooge J, Bijnens B . Can strain rate and strain quantify changes in regional systolic function during dobutamine infusion, B-blockade, and atrial pacing--implications for quantitative stress echocardiography. J Am Soc Echocardiogr. 2002; 15(5):416-24. DOI: 10.1067/mje.2002.116535. View

Kelly R, Ting C, Yang T, Liu C, Maughan W, Chang M . Effective arterial elastance as index of arterial vascular load in humans. Circulation. 1992; 86(2):513-21. DOI: 10.1161/01.cir.86.2.513. View

Onishi T, Saha S, Delgado-Montero A, Ludwig D, Onishi T, Schelbert E . Global longitudinal strain and global circumferential strain by speckle-tracking echocardiography and feature-tracking cardiac magnetic resonance imaging: comparison with left ventricular ejection fraction. J Am Soc Echocardiogr. 2015; 28(5):587-96. DOI: 10.1016/j.echo.2014.11.018. View

Schmidt B, Dick A, Treutlein M, Schiller P, Bunck A, Maintz D . Intra- and inter-observer reproducibility of global and regional magnetic resonance feature tracking derived strain parameters of the left and right ventricle. Eur J Radiol. 2017; 89:97-105. DOI: 10.1016/j.ejrad.2017.01.025. View

10.

Swoboda P, Larghat A, Zaman A, Fairbairn T, Motwani M, Greenwood J . Reproducibility of myocardial strain and left ventricular twist measured using complementary spatial modulation of magnetization. J Magn Reson Imaging. 2013; 39(4):887-94. DOI: 10.1002/jmri.24223. View

11.

Rhea I, Uppuluri S, Sawada S, Schneider B, Feigenbaum H . Incremental prognostic value of echocardiographic strain and its association with mortality in cancer patients. J Am Soc Echocardiogr. 2015; 28(6):667-73. DOI: 10.1016/j.echo.2015.02.006. View

12.

Carlsson M, Andersson R, Markenroth Bloch K, Steding-Ehrenborg K, Mosen H, Stahlberg F . Cardiac output and cardiac index measured with cardiovascular magnetic resonance in healthy subjects, elite athletes and patients with congestive heart failure. J Cardiovasc Magn Reson. 2012; 14:51. PMC: 3419124. DOI: 10.1186/1532-429X-14-51. View

13.

Seemann F, Arvidsson P, Nordlund D, Kopic S, Carlsson M, Arheden H . Noninvasive Quantification of Pressure-Volume Loops From Brachial Pressure and Cardiovascular Magnetic Resonance. Circ Cardiovasc Imaging. 2019; 12(1):e008493. DOI: 10.1161/CIRCIMAGING.118.008493. View

14.

Kass D, Maughan W . From 'Emax' to pressure-volume relations: a broader view. Circulation. 1988; 77(6):1203-12. DOI: 10.1161/01.cir.77.6.1203. View

15.

Fang Z, Yuda S, Anderson V, Short L, Case C, Marwick T . Echocardiographic detection of early diabetic myocardial disease. J Am Coll Cardiol. 2003; 41(4):611-7. DOI: 10.1016/s0735-1097(02)02869-3. View

16.

Schulz-Menger J, Bluemke D, Bremerich J, Flamm S, Fogel M, Friedrich M . Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson. 2013; 15:35. PMC: 3695769. DOI: 10.1186/1532-429X-15-35. View

17.

Dahlslett T, Karlsen S, Grenne B, Eek C, Sjoli B, Skulstad H . Early assessment of strain echocardiography can accurately exclude significant coronary artery stenosis in suspected non-ST-segment elevation acute coronary syndrome. J Am Soc Echocardiogr. 2014; 27(5):512-9. DOI: 10.1016/j.echo.2014.01.019. View

18.

Romano S, Judd R, Kim R, Kim H, Klem I, Heitner J . Feature-Tracking Global Longitudinal Strain Predicts Death in a Multicenter Population of Patients With Ischemic and Nonischemic Dilated Cardiomyopathy Incremental to Ejection Fraction and Late Gadolinium Enhancement. JACC Cardiovasc Imaging. 2018; 11(10):1419-1429. PMC: 6043421. DOI: 10.1016/j.jcmg.2017.10.024. View

19.

Yang H, Sun J, Lever H, Popovic Z, Drinko J, Greenberg N . Use of strain imaging in detecting segmental dysfunction in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2003; 16(3):233-9. DOI: 10.1067/mje.2003.60. View

20.

Amzulescu M, De Craene M, Langet H, Pasquet A, Vancraeynest D, Pouleur A . Myocardial strain imaging: review of general principles, validation, and sources of discrepancies. Eur Heart J Cardiovasc Imaging. 2019; 20(6):605-619. PMC: 6529912. DOI: 10.1093/ehjci/jez041. View