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. 2024 Dec 28:56:101586.
doi: 10.1016/j.ijcha.2024.101586. eCollection 2025 Feb.

Functional myocardial assessment in cine cardiac computerized tomographic angiography using echocardiographic feature-tracking software in patients with and without significant coronary disease

Adi Hertz  1   2 , Michael Jerdev  1   2 , Liza Grosman-Rimon  3 , Itiel Ben-Zakai  4 , Jordan Rimon  5   6 , Offer Amir  7 , Gabby Elbaz Greener  7 , Shemy Carasso  1   2
Affiliations

Functional myocardial assessment in cine cardiac computerized tomographic angiography using echocardiographic feature-tracking software in patients with and without significant coronary disease

Adi Hertz et al. Int J Cardiol Heart Vasc. .

Abstract

Introduction: Cardiac computerized tomographic angiography (CCTA) is perceived as a non-invasive tool for assessment of coronary vessel anatomy. Feature tracking echocardiography has recently emerged as a tool for assessment of regional and global left ventricular function. We aimed to explore the applicability of echocardiographic strain on CCTA cine clips and assess whether global and regional strain parameters are associated with the extent of coronary stenosis.

Methods: CCTA studies of 61 consecutive patients were reconstructed to yield cine images in classic echocardiographic long and short views. Siemens Velocity Vector Imaging (VVI) software was applied to generate strain and displacement results. Volumetric and mechanics parameters were compared among patients with no or non-significant coronary artery disease (CAD) and patients with significant CAD. Finally, a comparison of the degree of coronary stenosis to regional segmental strain was performed.

Results: Myocardial mechanics parameters could be generated in 60 cases. Ejection fraction (EF) and left ventricular end diastolic volume (LVEDV) were within the normal range in both groups. VVI values were lower in the CAD group (VVI LVEF 59 ± 6 vs. 50 ± 11, p = 0.0002). Global longitudinal and global circumferential strain both were significantly lower in this group. Regional segmental strain was lower in segments affected by coronary stenosis in comparison to unaffected segments.

Conclusion: While CT segmentation derived LVEF did not differ among groups, patients with significant coronary stenosis had reduced longitudinal and circumferential contraction. This suggests that application of VVI to CCTA cine clips tracking may help to differentiate significant and non-significant coronary stenosis, adding functional value to anatomic findings in CCTA.

Keywords: Cardiac computerized tomographic angiography (CCTA); Coronary arteries; Global circumferential strains (GCS); Global longitudinal strain (GLS); Velocity Vector Imaging (VVI).

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Typical Strain Output Screen. Taken from a 4-Chamber View of a Normal Subject without CAD, A − Echocardiography and B − CCTA. Left panels show the source image with color coded segmentation, middle panels show segments and peak segmental systolic strain, right panels show cycle (R to next R wave) strain curves for each segment analyzed.
Fig. 2
Fig. 2
Comparisons of LV Volumes Calculated by 3D CT and Biplane VVI.
Fig. 3
Fig. 3
Correlation Between CT LVEF and Global Longitudinal and Circumferential Strain.
Fig. 4
Fig. 4
Segmental Strain According to Coronary Obstruction.
See this image and copyright information in PMC

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