Speckle myocardial imaging modalities for early detection of myocardial impairment in isolated left ventricular non-compaction

Diego Bellavia, Hector I Michelena, Matthew Martinez, Patricia Pellikka, Charles J Bruce, Heidi M. Connolly, Hector R Vilarraga, Gabriella Veress, Jae Kuen Oh, Fletcher A Jr. Miller

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Abstract

Objective: To examine the hypothesis that speckle myocardial imaging (SMI) modalities, including longitudinal, radial and circumferential systolic (s) and diastolic (d) myocardial velocity imaging, displacement (D), strain rate (SR) and strain (S), as well as left ventricular (LV) rotation/torsion are sensitive for detecting early myocardial dysfunction in isolated LV non-compaction (iLVNC). Design and results: Twenty patients with iLVNC diagnosed by cardiac magnetic resonance (15) or echocardiography (5) were included. Patients were divided into two groups: ejection fraction (EF)>50% (n=10) and EF≤50% (n=10). Standard measures of systolic and diastolic function including pulsed wave tissue Doppler Imaging (PWTDI) were obtained. Longitudinal, radial and circumferential SMI, and LV rotation/torsion were compared with values for 20 age/sex-matched controls. EF, PWTDI E', E/E' and all of the SMI modalities were significantly abnormal for patients with EF≤50% compared with controls. In contrast, EF and PWTDI E', E/E' were not significantly different between controls and patients with iLVNC (EF>50%). However, SMI-derived longitudinal sS, sSR, sD and radial sS, as well as LV rotation/torsion values, were all reduced in iLVNC (EF>50%) compared with controls. Measurements with the highest discriminating power between iLVNC (EF>50%) and controls were longitudinal sS mean of the six apical segments (area under the curve (AUC)=0.94), sS global average (AUC=0.94), LV rotation apical mean (AUC=0.94); LV torsion (AUC=0.93) LV torsion rate (AUC=0.94). Conclusions: LV SMI values are reduced in patients with iLVNC, even those with normal EF and PWTDI. The most accurate SMI modalities to discriminate between patients and controls are longitudinal sS mean of the six apical segments, LV apical rotation or LV torsion rate.

Original languageEnglish (US)
Pages (from-to)440-447
Number of pages8
JournalHeart
Volume96
Issue number6
DOIs
StatePublished - Mar 2010

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Area Under Curve
Echocardiography
Magnetic Resonance Spectroscopy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Speckle myocardial imaging modalities for early detection of myocardial impairment in isolated left ventricular non-compaction. / Bellavia, Diego; Michelena, Hector I; Martinez, Matthew; Pellikka, Patricia; Bruce, Charles J; Connolly, Heidi M.; Vilarraga, Hector R; Veress, Gabriella; Oh, Jae Kuen; Miller, Fletcher A Jr.

In: Heart, Vol. 96, No. 6, 03.2010, p. 440-447.

Research output: Contribution to journalArticle

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abstract = "Objective: To examine the hypothesis that speckle myocardial imaging (SMI) modalities, including longitudinal, radial and circumferential systolic (s) and diastolic (d) myocardial velocity imaging, displacement (D), strain rate (SR) and strain (S), as well as left ventricular (LV) rotation/torsion are sensitive for detecting early myocardial dysfunction in isolated LV non-compaction (iLVNC). Design and results: Twenty patients with iLVNC diagnosed by cardiac magnetic resonance (15) or echocardiography (5) were included. Patients were divided into two groups: ejection fraction (EF)>50{\%} (n=10) and EF≤50{\%} (n=10). Standard measures of systolic and diastolic function including pulsed wave tissue Doppler Imaging (PWTDI) were obtained. Longitudinal, radial and circumferential SMI, and LV rotation/torsion were compared with values for 20 age/sex-matched controls. EF, PWTDI E', E/E' and all of the SMI modalities were significantly abnormal for patients with EF≤50{\%} compared with controls. In contrast, EF and PWTDI E', E/E' were not significantly different between controls and patients with iLVNC (EF>50{\%}). However, SMI-derived longitudinal sS, sSR, sD and radial sS, as well as LV rotation/torsion values, were all reduced in iLVNC (EF>50{\%}) compared with controls. Measurements with the highest discriminating power between iLVNC (EF>50{\%}) and controls were longitudinal sS mean of the six apical segments (area under the curve (AUC)=0.94), sS global average (AUC=0.94), LV rotation apical mean (AUC=0.94); LV torsion (AUC=0.93) LV torsion rate (AUC=0.94). Conclusions: LV SMI values are reduced in patients with iLVNC, even those with normal EF and PWTDI. The most accurate SMI modalities to discriminate between patients and controls are longitudinal sS mean of the six apical segments, LV apical rotation or LV torsion rate.",
author = "Diego Bellavia and Michelena, {Hector I} and Matthew Martinez and Patricia Pellikka and Bruce, {Charles J} and Connolly, {Heidi M.} and Vilarraga, {Hector R} and Gabriella Veress and Oh, {Jae Kuen} and Miller, {Fletcher A Jr.}",
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T1 - Speckle myocardial imaging modalities for early detection of myocardial impairment in isolated left ventricular non-compaction

AU - Bellavia, Diego

AU - Michelena, Hector I

AU - Martinez, Matthew

AU - Pellikka, Patricia

AU - Bruce, Charles J

AU - Connolly, Heidi M.

AU - Vilarraga, Hector R

AU - Veress, Gabriella

AU - Oh, Jae Kuen

AU - Miller, Fletcher A Jr.

PY - 2010/3

Y1 - 2010/3

N2 - Objective: To examine the hypothesis that speckle myocardial imaging (SMI) modalities, including longitudinal, radial and circumferential systolic (s) and diastolic (d) myocardial velocity imaging, displacement (D), strain rate (SR) and strain (S), as well as left ventricular (LV) rotation/torsion are sensitive for detecting early myocardial dysfunction in isolated LV non-compaction (iLVNC). Design and results: Twenty patients with iLVNC diagnosed by cardiac magnetic resonance (15) or echocardiography (5) were included. Patients were divided into two groups: ejection fraction (EF)>50% (n=10) and EF≤50% (n=10). Standard measures of systolic and diastolic function including pulsed wave tissue Doppler Imaging (PWTDI) were obtained. Longitudinal, radial and circumferential SMI, and LV rotation/torsion were compared with values for 20 age/sex-matched controls. EF, PWTDI E', E/E' and all of the SMI modalities were significantly abnormal for patients with EF≤50% compared with controls. In contrast, EF and PWTDI E', E/E' were not significantly different between controls and patients with iLVNC (EF>50%). However, SMI-derived longitudinal sS, sSR, sD and radial sS, as well as LV rotation/torsion values, were all reduced in iLVNC (EF>50%) compared with controls. Measurements with the highest discriminating power between iLVNC (EF>50%) and controls were longitudinal sS mean of the six apical segments (area under the curve (AUC)=0.94), sS global average (AUC=0.94), LV rotation apical mean (AUC=0.94); LV torsion (AUC=0.93) LV torsion rate (AUC=0.94). Conclusions: LV SMI values are reduced in patients with iLVNC, even those with normal EF and PWTDI. The most accurate SMI modalities to discriminate between patients and controls are longitudinal sS mean of the six apical segments, LV apical rotation or LV torsion rate.

AB - Objective: To examine the hypothesis that speckle myocardial imaging (SMI) modalities, including longitudinal, radial and circumferential systolic (s) and diastolic (d) myocardial velocity imaging, displacement (D), strain rate (SR) and strain (S), as well as left ventricular (LV) rotation/torsion are sensitive for detecting early myocardial dysfunction in isolated LV non-compaction (iLVNC). Design and results: Twenty patients with iLVNC diagnosed by cardiac magnetic resonance (15) or echocardiography (5) were included. Patients were divided into two groups: ejection fraction (EF)>50% (n=10) and EF≤50% (n=10). Standard measures of systolic and diastolic function including pulsed wave tissue Doppler Imaging (PWTDI) were obtained. Longitudinal, radial and circumferential SMI, and LV rotation/torsion were compared with values for 20 age/sex-matched controls. EF, PWTDI E', E/E' and all of the SMI modalities were significantly abnormal for patients with EF≤50% compared with controls. In contrast, EF and PWTDI E', E/E' were not significantly different between controls and patients with iLVNC (EF>50%). However, SMI-derived longitudinal sS, sSR, sD and radial sS, as well as LV rotation/torsion values, were all reduced in iLVNC (EF>50%) compared with controls. Measurements with the highest discriminating power between iLVNC (EF>50%) and controls were longitudinal sS mean of the six apical segments (area under the curve (AUC)=0.94), sS global average (AUC=0.94), LV rotation apical mean (AUC=0.94); LV torsion (AUC=0.93) LV torsion rate (AUC=0.94). Conclusions: LV SMI values are reduced in patients with iLVNC, even those with normal EF and PWTDI. The most accurate SMI modalities to discriminate between patients and controls are longitudinal sS mean of the six apical segments, LV apical rotation or LV torsion rate.

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