Universität zu Köln

Dick, Anastasia, Schmidt, Bjoern, Michels, Guido, Bunck, Alexander C., Maintz, David and Baessler, Bettina ORCID: 0000-0002-3244-3864 (2017). Left and right atrial feature tracking in acute myocarditis: A feasibility study. Eur. J. Radiol., 89. S. 72 - 81. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-7727

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Abstract

Purpose: The present study aims at evaluating the feasibility and reproducibility of cardiac magnetic resonance (CMR) feature tracking (FT) derived strain and strain rate (SR) parameters of the left and right atrium (LA, RA) in patients with acute myocarditis as well as their potential to detect diastolic dysfunction. In addition, the diagnostic value of LA and RA strain parameters in the setting of acute myocarditis is investigated. Methods: CMR cine data of 30 patients with CMR-positive acute myocarditis were retrospectively analyzed. 25 age-and gender-matched healthy individuals served as a control. Analysis of longitudinal strain and SR of both atria was performed in two long-axis views using a dedicated FT-software. LA and RA deformation was analyzed including reservoir function (total strain [epsilon(s)], peak positive SR [SRs]), conduit function (passive strain [epsilon(e)], peak early negative SR [SRe]) and booster pump function (active strain [epsilon(a)], peak late negative SR [SRa]). Intra-and inter-observer reproducibility was assessed for all strain and SR parameters using Bland-Altman analyses, intra-class correlation coefficients (ICCs) and coefficients of variation (CV). Results: FT analyses of both atria were feasible in all patients and controls. Reproducibility was good for reservoir and conduit function parameters and moderate for booster pump function parameters. Myocarditis patients demonstrated an impaired LA reservoir and conduit function when compared to healthy controls (LA epsilon(s): 32 +/- 17 vs. 46 +/- 13, p = 0.019; LA SRs: 1.5 +/- 0.5 vs. 1.8 +/- 0.5, p = 0.117; LA SRe: -1.3 +/- 0.5 vs. -1.9 +/- 0.5, p < 0.001), while LA booster pump function was preserved. In logistic regression and ROC-analyses, LA SRe proved to be the best independent predictor of acute myocarditis (AUC 0.80), and using LA SRe with a cut-off of -1.6 s(-1) resulted in a diagnostic sensitivity of 83% and a specificity of 80%. Changes in RA phasic function parameters showed a tendency to parallel those of the LA and showed no additional effect with respect to the diagnostic potential in acute myocarditis. Conclusions: Myocarditis patients exhibit an impaired atrial reservoir and conduit function, what might be indicative of ventricular diastolic dysfunction. LA SRe was the best predictor for the presence of acute myocarditis in our study, pointing towards the discriminative power of atrial strain analysis in the CMR-based diagnosis of acute myocarditis. (C) 2017 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Dick, Anastasia UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED Michels, Guido UNSPECIFIED UNSPECIFIED UNSPECIFIED Bunck, Alexander C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maintz, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Baessler, Bettina UNSPECIFIED orcid.org/0000-0002-3244-3864 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-234550
DOI:	10.1016/j.ejrad.2017.01.028
Journal or Publication Title:	Eur. J. Radiol.
Volume:	89
Page Range:	S. 72 - 81
Date:	2017
Publisher:	ELSEVIER IRELAND LTD
Place of Publication:	CLARE
ISSN:	1872-7727
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARDIOVASCULAR MAGNETIC-RESONANCE; SYSTOLIC HEART-FAILURE; ECHOCARDIOGRAPHIC-ASSESSMENT; CLINICAL-IMPLICATIONS; STRAIN ASSESSMENT; SPECKLE TRACKING; DEFORMATION; PATHOPHYSIOLOGY; REPRODUCIBILITY; PHYSIOLOGY Multiple languages Radiology, Nuclear Medicine & Medical Imaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23455