Assessment of late gadolinium enhancement-negative chronic total occlusion by longitudinal strain analysis using cardiac magnetic resonance imaging

Abstract

Background

Strain analysis has become commonly used in clinical practice in various heart diseases.

Purpose

To explore whether late gadolinium enhancement (LGE)-negative areas with coronary artery chronic total occlusion (CTO) appear normal when analyzed for longitudinal strain using cardiac magnetic resonance (CMR) imaging.

Material and Methods

A total of 16 patients and 31 healthy controls who underwent 1.5-T MR at our hospital between January 2015 and July 2017 were included in the study. The LGE-CMR of patients with CTO was negative. Left ventricular functional parameters, segmental longitudinal strain/strain rate, and perfusion parameters were measured using CVI42 software.

Results

For myocardial segments supplied by CTO vessels, systolic longitudinal strain rate (SLSR)was significantly lower than that of healthy controls, and diastolic longitudinal strain rate (DLSR) was significantly higher (1.19 1/s vs. 1.02 1/s; P = 0.018). Moreover, longitudinal strain (LS), SLSR, and DLSR did not differ between good and poor collateral circulation. Perfusion index of CTO territory segments was lower than non-CTO territory segments (0.20 vs. 0.22; P = 0.027). No correlation was found between longitudinal strain parameters and perfusion parameters.

Conclusion

Although LGE-CMR was negative in patients with CTO, the myocardial SLSR of CTO territory segments was significantly lower than that of healthy controls.