Header

UZH-Logo

Maintenance Infos

Myocardial Scar Delineation Using Diffusion Tensor Magnetic Resonance Tractography


Mekkaoui, Choukri; Jackowski, Marcel P; Kostis, William J; Stoeck, Christian T; Thiagalingam, Aravinda; Reese, Timothy G; Reddy, Vivek Y; Ruskin, Jeremy N; Kozerke, Sebastian; Sosnovik, David E (2018). Myocardial Scar Delineation Using Diffusion Tensor Magnetic Resonance Tractography. Journal of the American Heart Association, 7(3):e007834.

Abstract

BACKGROUND:
Late gadolinium enhancement (LGE) is the current standard for myocardial scar delineation. In this study, we introduce the tractographic propagation angle (PA), a metric of myofiber curvature (degrees/unit distance) derived from diffusion tensor imaging (DTI), and compare its use to LGE and invasive scar assessment by endocardial voltage mapping.
METHODS AND RESULTS:
DTI was performed on 7 healthy human volunteers, 5 patients with myocardial infarction, 6 normal mice, and 7 mice with myocardial infarction. LGE to delineate the infarct and border zones was performed with a 2-dimensional inversion recovery gradient-echo sequence. Ex vivo DTI was performed on 5 normal human and 5 normal sheep hearts. Endocardial electroanatomic mapping and subsequent ex vivo DTI was performed on 5 infarcted sheep hearts. PA in the normal human hearts varied smoothly and was generally <4. The mean PA in the infarct zone was significantly elevated (10.34±1.02 versus 4.05±0.45, P<0.05). Regions with a PA ≤4 consistently had a bipolar voltage ≥1.5 mV, whereas those with PA values between 4 and 10 had voltages between 0.5 and 1.5 mV. A PA threshold >4 was the most accurate DTI-derived measure of infarct size and demonstrated the greatest correlation with LGE (r=0.95).
CONCLUSIONS:
We found a strong correlation between infarct size by PA and LGE in both mice and humans. There was also an inverse relationship between PA values and endocardial voltage. The use of PA may enable myocardial scar delineation and characterization of arrhythmogenic substrate without the need for exogenous contrast agents.

Abstract

BACKGROUND:
Late gadolinium enhancement (LGE) is the current standard for myocardial scar delineation. In this study, we introduce the tractographic propagation angle (PA), a metric of myofiber curvature (degrees/unit distance) derived from diffusion tensor imaging (DTI), and compare its use to LGE and invasive scar assessment by endocardial voltage mapping.
METHODS AND RESULTS:
DTI was performed on 7 healthy human volunteers, 5 patients with myocardial infarction, 6 normal mice, and 7 mice with myocardial infarction. LGE to delineate the infarct and border zones was performed with a 2-dimensional inversion recovery gradient-echo sequence. Ex vivo DTI was performed on 5 normal human and 5 normal sheep hearts. Endocardial electroanatomic mapping and subsequent ex vivo DTI was performed on 5 infarcted sheep hearts. PA in the normal human hearts varied smoothly and was generally <4. The mean PA in the infarct zone was significantly elevated (10.34±1.02 versus 4.05±0.45, P<0.05). Regions with a PA ≤4 consistently had a bipolar voltage ≥1.5 mV, whereas those with PA values between 4 and 10 had voltages between 0.5 and 1.5 mV. A PA threshold >4 was the most accurate DTI-derived measure of infarct size and demonstrated the greatest correlation with LGE (r=0.95).
CONCLUSIONS:
We found a strong correlation between infarct size by PA and LGE in both mice and humans. There was also an inverse relationship between PA values and endocardial voltage. The use of PA may enable myocardial scar delineation and characterization of arrhythmogenic substrate without the need for exogenous contrast agents.

Statistics

Citations

Dimensions.ai Metrics
23 citations in Web of Science®
22 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

24 downloads since deposited on 06 Mar 2019
8 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Biomedical Engineering
Dewey Decimal Classification:170 Ethics
610 Medicine & health
Scopus Subject Areas:Health Sciences > Cardiology and Cardiovascular Medicine
Uncontrolled Keywords:Cardiology and Cardiovascular Medicine
Language:English
Date:6 February 2018
Deposited On:06 Mar 2019 08:17
Last Modified:11 May 2020 18:41
Publisher:Wiley Open Access
ISSN:2047-9980
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1161/jaha.117.007834
PubMed ID:29420216

Download

Gold Open Access

Download PDF  'Myocardial Scar Delineation Using Diffusion Tensor Magnetic Resonance Tractography'.
Preview
Content: Published Version
Filetype: PDF
Size: 2MB
View at publisher
Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)