Myocardial Feature Tracking Reduces Observer-Dependence in Low-Dose Dobutamine Stress Cardiovascular Magnetic Resonance

2015 | journal article. A publication with affiliation to the University of Göttingen.

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​Myocardial Feature Tracking Reduces Observer-Dependence in Low-Dose Dobutamine Stress Cardiovascular Magnetic Resonance​
Schuster, A.; Paul, M.; Bettencourt, N.; Hussain, S. T.; Morton, G.; Kutty, S. & Bigalke, B. et al.​ (2015) 
PLoS ONE10(4) art. UNSP e0122858​.​ DOI: https://doi.org/10.1371/journal.pone.0122858 

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Authors
Schuster, Andreas; Paul, Matthias; Bettencourt, Nuno; Hussain, Shazia T.; Morton, Geraint; Kutty, Shelby; Bigalke, Boris; Chiribiri, Amedeo; Perera, Divaka; Nagel, Eike; Beerbaum, Philipp
Abstract
Objectives To determine whether quantitative wall motion assessment by CMR myocardial feature tracking (CMR-FT) would reduce the impact of observer experience as compared to visual analysis in patients with ischemic cardiomyopathy (ICM). Methods 15 consecutive patients with ICM referred for assessment of hibernating myocardium were studied at 3 Tesla using SSFP cine images at rest and during low dose dobutamine stress (5 and 10 mu g/kg/min of dobutamine). Conventional visual, qualitative analysis was performed independently and blinded by an experienced and an inexperienced reader, followed by post-processing of the same images by CMR-FT to quantify subendocardial and subepicardial circumferential (Ecc(endo) and Ecc(epi)) and radial (Err) strain. Receiver operator characteristics (ROC) were assessed for each strain parameter and operator to detect the presence of inotropic reserve as visually defined by the experienced observer. Results 141 segments with wall motion abnormalities at rest were eligible for the analysis. Visual scoring of wall motion at rest and during dobutamine was significantly different between the experienced and the inexperienced observer (p<0.001). All strain values (Ecc(endo), Ecc(epi) and Err) derived during dobutamine stress (5 and 10 mu g/kg/min) showed similar diagnostic accuracy for the detection of contractile reserve for both operators with no differences in ROC (p>0.05). Eccendo was the most accurate (AUC of 0.76, 10 mu g/kg/min of dobutamine) parameter. Diagnostic accuracy was worse for resting strain with differences between operators for Eccendo and Eccepi (p<0.05) but not Err (p>0.05). Conclusion Whilst visual analysis remains highly dependent on operator experience, quantitative CMR-FT analysis of myocardial wall mechanics during DS-CMR provides diagnostic accuracy for the detection of inotropic reserve regardless of operator experience and hence may improve diagnostic robustness of low-dose DS-CMR in clinical practice.
Issue Date
2015
Status
published
Publisher
Public Library Science
Journal
PLoS ONE 
ISSN
1932-6203
Sponsor
Open-Access-Publikationsfonds 2015

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