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Author Notes:

Corresponding Author: Jonathan D. Suever, BS, Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, 1364 Clifton Road, Suite AG30, Atlanta, Georgia 30322, Tel 256.513.9513, Fax 404.712.5948, suever@gatech.edu.

The authors would like to thank Susan Eder, RT(MR) for assisting with image acquisition.

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Research Funding:

Funding for this research was provided by AHA Grant-in-Aid (JNO), the National Science Foundation Graduate Research Fellowship Program (JDS), and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR000454.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Radiology, Nuclear Medicine & Medical Imaging
  • cardiac resynchronization therapy
  • mechanical dyssynchrony
  • magnetic resonance imaging
  • CARDIAC RESYNCHRONIZATION THERAPY
  • LEFT-VENTRICULAR DYSSYNCHRONY
  • MAGNETIC-RESONANCE IMAGES
  • TIME 3-DIMENSIONAL ECHOCARDIOGRAPHY
  • HEART-FAILURE PATIENTS
  • BUNDLE-BRANCH BLOCK
  • MOTION
  • MRI
  • QUANTIFICATION
  • CONTRACTION

Method to Create Regional Mechanical Dyssynchrony Maps From Short-Axis Cine Steady-State Free-Precession Images

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Journal Title:

Journal of Magnetic Resonance Imaging

Volume:

Volume 39, Number 4

Publisher:

, Pages 958-965

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Purpose To develop a robust method to assess regional mechanical dyssynchrony from cine short-axis MR images. Cardiac resynchronization therapy (CRT) is an effective treatment for patients with heart failure and evidence of left-ventricular (LV) dyssynchrony. Patient response to CRT is greatest when the LV pacing lead is placed in the most dyssynchronous segment. Existing techniques for assessing regional dyssynchrony require difficult acquisition and/or postprocessing. Our goal was to develop a widely applicable and robust method to assess regional mechanical dyssynchrony. Materials and Methods Using the endocardial boundary, radial displacement curves (RDCs) were generated throughout the LV. Cross-correlation was used to determine the delay time between each RDC and a patient-specific reference. Delay times were projected onto the American Heart Association 17-segment model creating a regional dyssynchrony map. Our method was tested in 10 normal individuals and 10 patients enrolled for CRT (QRS > 120 ms, NYHA III-IV, EF < 35%). Results Delay times over the LV were 23.9 ± 33.8 ms and 93.1 ± 99.9 ms (P < 0.001) in normal subjects and patients, respectively. Interobserver reproducibility for segment averages was 6.8 ± 39.3 ms and there was 70% agreement in identifying the latest contracting segment. Conclusion We have developed a method that can reliably calculate regional delay times from cine steady-state free-precession (SSFP) images. Maps of regional dyssynchrony could be used to identify the latest-contracting segment to assist in CRT lead implantation.

Copyright information:

© 2013 Wiley Periodicals, Inc.

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