OBJECTIVES In some cardiac pathologies, impairment of left ventricular (LV) longitudinal function may precede reduction in LV ejection fraction. This study investigates the effectiveness of a fast method to quantify long-axis LV function compared to conventional feature tracking and manual approaches. METHODS The study consisted of 50 normal controls and 100 heart failure (HF) patients including 40 with reduced ejection fraction (HFrEF), 30 with mid-range ejection fraction (HFmrEF), and 30 with preserved ejection fraction (HFpEF). Parameters including fast long-axis strain (FLAS) at end-systole and peak strain rates during systole (FLASRs), early diastole (FLASRe), and atrial contraction (FLASRa) were derived by a fast semi-automated approach on cine cardiovascular magnetic resonance. RESULTS FLAS exhibited good agreement with strain values obtained using conventional feature tracking (bias - 2.9%, limits of agreement ± 3.0%) and the manual approach (bias 0.6%, limits of agreement ± 2.1%), where FLAS was more reproducible and required shorter measurement time. The mean FLAS (HFrEF < HFmrEF < HFpEF < controls; 6.1 ± 2.4 < 9.9 ± 2.4 < 11.0 ± 2.5 < 16.9 ± 2.3%, all p < 0.0001) was decreased in all the HF patient groups. A FLAS of 12.3% (mean-2SD of controls) predicted the presence of systolic dysfunction in 67% of patients with HFpEF, and 87% with HFmrEF. Strain parameters using the fast approach were superior to those obtained by conventional feature tracking and manual approaches for discriminating HFpEF from controls. Notable examples are area under the curve, sensitivity, and specificity for FLAS (0.94, 93%, and 86%) and FLASRe (0.96, 90%, and 94%). CONCLUSIONS The fast approach-derived LV strain and strain rate parameters facilitate reproducible, reliable, and effective LV longitudinal function analysis. KEY POINTS • Left ventricular long-axis strain can be rapidly derived from cine CMR with shorter measurement time and higher reproducibility compared to conventional feature tracking and the manual approach. • Progressive reductions in left ventricular long-axis strain and strain rate measurements were observed from HFpEF, HFmrEF, to HFrEF group. • Based on long-axis strain, systolic abnormalities were evident in HFmrEF and HFpEF indicating common coexistence of systolic and diastolic dysfunction in the HF phenotypes.

中文翻译：

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快速长轴应变：一种简单的自动方法，用于通过电影心血管磁共振评估左心室纵向功能。

目的在某些心脏疾病中，左心室（LV）纵向功能受损可能先于左室射血分数降低。这项研究调查了定量方法与常规特征跟踪和手动方法相比，快速量化长轴左室功能的有效性。方法该研究由50名正常对照者和100名心力衰竭（HF）患者组成，其中40例射血分数降低（HFrEF），30例中射血分数（HFmrEF）和30例射血分数保留（HFpEF）。通过快速半自动化的电影心血管磁共振方法得出包括收缩末期快速长轴应变（FLAS）和收缩期峰值应变率（FLASR），早期舒张期（FLASRe）和心房收缩（FLASRa）在内的参数。结果FLAS与使用常规特征跟踪（偏差-2.9％，一致性极限±3.0％）和手动方法（偏差0.6％，一致性极限±2.1％）获得的应变值显示出良好的一致性，其中FLAS具有更高的可重复性和要求测量时间短。在所有HF患者组中，平均FLAS（HFrEF <HFmrEF <HFpEF <对照; 6.1±2.4 <9.9±2.4 <11.0±2.5 <16.9±2.3％，所有p <0.0001）均降低。FLAS为12.3％（对照组的平均2SD）预测67％的HFpEF患者和87％的HFmrEF患者存在收缩功能障碍。使用快速方法的应变参数优于通过传统特征跟踪和手动方法将HFpEF与对照区分开的参数。值得注意的例子是FLAS的曲线下面积，敏感性和特异性（0.94，93％和86％）和FLASRe（0.96、90％和94％）。结论快速方法得出的左心室应变和应变率参数有助于可重现，可靠和有效的左心室纵向功能分析。要点•与常规特征跟踪和手动方法相比，电影CMR可以快速获得左心室长轴应变，测量时间更短，重现性更高。•从HFpEF，HFmrEF到HFrEF组，观察到左室长轴应变和应变率测量值逐渐降低。•基于长轴应变，HFmrEF和HFpEF中的收缩异常明显，表明HF表型的收缩功能和舒张功能障碍同时存在。结论快速方法得出的左心室应变和应变率参数有助于可重现，可靠和有效的左心室纵向功能分析。要点•与常规特征跟踪和手动方法相比，电影CMR可以快速获得左室长轴应变，测量时间更短，重现性更高。•从HFpEF，HFmrEF到HFrEF组，观察到左室长轴应变和应变率测量值逐渐降低。•基于长轴应变，HFmrEF和HFpEF中的收缩异常明显，表明HF表型的收缩功能和舒张功能障碍同时存在。结论快速方法得出的左心室应变和应变率参数有助于可重现，可靠和有效的左心室纵向功能分析。要点•与常规特征跟踪和手动方法相比，电影CMR可以快速获得左室长轴应变，测量时间更短，重现性更高。•从HFpEF，HFmrEF到HFrEF组，观察到左室长轴应变和应变率测量值逐渐降低。•基于长轴应变，HFmrEF和HFpEF中的收缩异常明显，表明HF表型的收缩功能和舒张功能障碍共存。要点•与常规特征跟踪和手动方法相比，电影CMR可以快速获得左心室长轴应变，测量时间更短，重现性更高。•从HFpEF，HFmrEF到HFrEF组，观察到左室长轴应变和应变率测量值逐渐降低。•基于长轴应变，HFmrEF和HFpEF中的收缩异常明显，表明HF表型的收缩功能和舒张功能障碍同时存在。要点•与常规特征跟踪和手动方法相比，电影CMR可以快速获得左心室长轴应变，测量时间更短，重现性更高。•从HFpEF，HFmrEF到HFrEF组，观察到左室长轴应变和应变率测量值逐渐降低。•基于长轴应变，HFmrEF和HFpEF中的收缩异常明显，表明HF表型的收缩功能和舒张功能障碍同时存在。