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. 2016 Apr;75(4):1586-93.
doi: 10.1002/mrm.25760. Epub 2015 May 22.

Measuring age-dependent myocardial stiffness across the cardiac cycle using MR elastography: A reproducibility study

Peter A Wassenaar  1 , Chethanya N Eleswarpu  1   2 , Samuel A Schroeder  1   3 , Xiaokui Mo  4 , Brian D Raterman  1 , Richard D White  1   5 , Arunark Kolipaka  1   2   5
Affiliations

Measuring age-dependent myocardial stiffness across the cardiac cycle using MR elastography: A reproducibility study

Peter A Wassenaar et al. Magn Reson Med. 2016 Apr.

Abstract

Purpose: To assess reproducibility in measuring left ventricular (LV) myocardial stiffness in volunteers throughout the cardiac cycle using MR elastography (MRE) and to determine its correlation with age.

Methods: Cardiac MRE (CMRE) was performed on 29 normal volunteers, with ages ranging from 21 to 73 years. For assessing reproducibility of CMRE-derived stiffness measurements, scans were repeated per volunteer. Wave images were acquired throughout the LV myocardium, and were analyzed to obtain mean stiffness during the cardiac cycle. CMRE-derived stiffness values were correlated to age.

Results: Concordance correlation coefficient revealed good interscan agreement with rc of 0.77, with P-value < 0.0001. Significantly higher myocardial stiffness was observed during end-systole (ES) compared with end-diastole (ED) across all subjects. Additionally, increased deviation between ES and ED stiffness was observed with increased age.

Conclusion: CMRE-derived stiffness is reproducible, with myocardial stiffness changing cyclically across the cardiac cycle. Stiffness is significantly higher during ES compared with ED. With age, ES myocardial stiffness increases more than ED, giving rise to an increased deviation between the two.

Keywords: MR elastography; MRE; cardiac MRE; magnetic resonance elastography; myocardial stiffness.

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Figures

Figure 1
Figure 1
Schematic of the MRE driver setup. Acoustic waves are transmitted from the active to the passive driver through a plastic tube to induce noninvasive vibrations into the myocardium.
Figure 2
Figure 2
Left ventricular myocardial shear stiffness measurements obtained using 2D and 3D LFE inversion. a) Shows cyclic variation of stiffness measurements using 2D and 3D LFE in one of the volunteers. b) Plot shows that 2D LFE measurements are significantly higher than 3D LFE measurements.
Figure 3
Figure 3
Concordance plot demonstrating the correlation of stiffness measurements between inter-scans. a) Concordance correlation coefficient rc=0.77 with p<0.0001 and narrow confidence interval (95%: 0.71–0.83) when performed on same day. b) Concordance correlation coefficient rc=0.93 with p<0.0001 and narrow confidence interval (95%: 0.90–0.86) when performed on separate days (day 1 and 3). Solid: regression line; dotted: line of perfect concordance.
Figure 4
Figure 4
Short axis magnitude images of the LV myocardium (a, f), and snapshots of waves traveling in the three orthogonal planes (b–d, g–i), during ED (top) and ES (bottom) respectively. CMRE-derived stiffness maps are shown on the right (e,j). Increased stiffness is visible during ES compared to ED. Colorbar: displacement field in radians; stiffness map in kPa.
Figure 5
Figure 5
Plot of CMRE-derived stiffness values during ES and ED. Mean ES stiffness (6.10±1.38 kPa) in all volunteers was significantly higher than ED stiffness (4.99±1.05 kPa).
Figure 6
Figure 6
Plot shows cyclic variation of CMRE-derived LV stiffness over the cardiac cycle in a 71 year-old female volunteer. ED is marked as an open triangle, ES as a solid circle.
Figure 7
Figure 7
Plot of CMRE-derived ES stiffness (solid circles) and ED stiffness (open triangles) in all volunteers as a function of age (a), and difference in ES/ED stiffness as a function of age (b).
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