Evaluation of cardiac dyssynchrony with longitudinal strain analysisin 4-chamber cine MR imaging

Purpose: We investigated the clinical performance of evaluation of cardiac mechanical dyssynchrony withlongitudinal strain analysis using four-chamber (4CH) cine magnetic resonance imaging (MRI).Materials and methods: We retrospectively enrolled 73 chronic heart failure patients (41 men, 32 women;mean age, 57 years, NYHA 2, 3, and 4) who underwent a cardiac MRI in the present study. The left ventricu-lar dyssynchrony (LVD) and interventricular dyssynchrony (IVD) indices were calculated by longitudinalstrain analysis using 4CH cine MRI. The LVD and IVD indices were compared by the Wilcoxon rank-sumtest between the patients with indication for cardiac resynchronization therapy (CRT) (n = 13) and with-out indication for CRT (n = 60), with LGE (n = 40) and without LGE (n = 27), the CRT responders (n = 8) andnon-responders (n = 6), respectively.Results: LVD in the patients with indication for CRT were significantly longer than those without indicationfor CRT (LVD: 92 ± 65 vs. 28 ± 40 ms, P 〈 .01). LVD and IVD were significantly longer in the patients withLGE than those without LGE (LVD: 54 ± 58 vs. 21 ± 30 ms, P 〈 .01 and IVD: 51 ± 39 vs. 23 ± 34 ms, P 〈 .01).LVD and IVD in the CRT responders were significantly longer than the CRT non-responders (LVD: 126 ± 55vs. 62 ± 55 ms, P 〈 .01 and IVD: 96 ± 39 vs. 52 ± 40 ms, P 〈 .05).Conclusion: Longitudinal strain analysis with 4CH cine MRI could be useful for clinical examination in theevaluation of cardiac mechanical dyssynchrony.