Quantifying left atrial structure and function using single-plane tissue-tracking cardiac magnetic resonance

Susumu Tao; Luisa A Ciuffo; Joao A C Lima; Katherine C Wu; Hiroshi Ashikaga

doi:10.1016/j.mri.2017.06.003

Quantifying left atrial structure and function using single-plane tissue-tracking cardiac magnetic resonance

Magn Reson Imaging. 2017 Oct:42:130-138. doi: 10.1016/j.mri.2017.06.003. Epub 2017 Jun 19.

Authors

Susumu Tao¹, Luisa A Ciuffo², Joao A C Lima³, Katherine C Wu⁴, Hiroshi Ashikaga⁵

Affiliations

¹ Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: stao5@jhmi.edu.
² Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: lciuffo1@jhmi.edu.
³ Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: jlima@jhmi.edu.
⁴ Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: kwu@jhmi.edu.
⁵ Division of Cardiology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA. Electronic address: hashika1@jhmi.edu.

Abstract

Purpose: Left atrial (LA) structure and function are important markers of adverse cardiovascular outcomes. Tissue-tracking cardiovascular magnetic resonance (CMR) accurately quantifies LA volume, strain, and strain rate based on biplane long-axis imaging. We aimed to assess the accuracy of the LA indices quantification from single-plane tissue-tracking CMR.

Methods: We included 388 subjects (mean age 57±13, male 70%) whose cine CMR images in sinus rhythm were available in both four-chamber and two-chamber views: 162 patients from the Prospective Observational Study of Implantable Cardioverter-Defibrillators (PROSE-ICD) Study, 208 patients from atrial fibrillation cohort, and 18 healthy volunteers. The group was divided into the training set (n=291) and the test set (n=97). In the training set, we compared the LA indices derived from biplane imaging and single-plane imaging (a four-chamber view), and developed regression equations. In the test set, we used the regression equations to estimate the LA indices from the single-plane imaging, and quantified the accuracy of the estimation against the LA indices from the biplane.

Results: In the training set, all the LA indices from the single-plane imaging tended to be systematically underestimated compared with those from the biplane imaging, however, the correlation coefficient was high (r²=0.73-0.90, p<0.001). In the test set, LA volumetric indices showed excellent reproducibility (intra-class correlation coefficient (ICC): 0.91-0.92) with relatively low variability (16.3-22.3%); For LA strain and strain rate indices, reproducibility was excellent (ICC: 0.81-0.93), however, the variability was slightly higher than that of volumetric indices (21.7-25.4%).

Conclusions: LA volumetric indices measured from single-plane tissue-tracking CMR are highly accurate and reproducible with reference to those derived from the standard biplane imaging. The reproducibility of LA strain and strain rate indices from single-plane tissue-tracking CMR is excellent but the variability is higher than that of the volumetric indices.

Keywords: Cardiovascular magnetic resonance; Left atrium; Structure and function; Tissue tracking.

Publication types

Observational Study

MeSH terms

Adult
Aged
Atrial Fibrillation / diagnostic imaging
Atrial Function, Left / physiology*
Female
Heart Atria / diagnostic imaging*
Heart Atria / physiopathology
Humans
Magnetic Resonance Imaging, Cine*
Magnetic Resonance Spectroscopy*
Male
Middle Aged
Observer Variation
Prospective Studies
Regression Analysis
Reproducibility of Results
Stress, Mechanical

Grants and funding

R01 HL103812/HL/NHLBI NIH HHS/United States