Assessment of left ventricular myocardial deformation by cardiac MRI strain imaging reveals myocardial dysfunction in patients with primary cardiac tumors.

BACKGROUND: To assess left ventricular myocardial deformation in patients with primary cardiac tumors. METHODS: MRI was retrospectively performed in 61 patients, including 31 patients with primary cardiac tumors and 30 matched normal controls. Left ventricular strain and function parameters were then assessed by MRI-tissue tracking. Differences between the tumor group and controls, left and right heart tumor groups, left ventricular wall tumor and non-left ventricular wall tumor groups, and tumors with and without LV enlargement groups were assessed. Finally, the correlations among tumor diameter, myocardial strain, and LV function were analyzed. RESULTS: Left ventricular myocardial strain was milder for tumor group than for normal group. Peak circumferential strain (PCS) and its diastolic strain rate, longitudinal strains (PLS) and its diastolic strain rates, and peak radial systolic and diastolic velocities of the right heart tumor group were lower than those of the left heart tumor group (all p<0.050), but the peak radial systolic strain rate of the former was higher than that of the latter (p=0.017). The corresponding strains were lower in the left ventricular wall tumor groups than in the non-left ventricular wall tumor group (p<0.050). Peak radial systolic velocities were generally higher for tumors with LV enlargement than for tumors without LV enlargement (p<0.050). Peak radial strain, PCS, and PLS showed important correlations with the left ventricular ejection fraction (all p<0.050). CONCLUSION: MRI-tissue tracking is capable of quantitatively assessing left ventricular myocardial strain to reveal sub-clinical abnormalities of myocardial contractile function.

Assessment of pericardial diseases and cardiac masses with cardiovascular magnetic resonance.

Imaging plays an important diagnostic and prognostic role in the assessment of pericardial diseases and cardiac tumors and in differentiating these conditions from other cardiac and noncardiac diseases. A number of imaging modalities are available for this task; each has advantages and limitation. Cardiovascular magnetic resonance (CMR) is a highly versatile imaging modality that provides detailed anatomical information, tissue characterization, cardiac function assessment, and evaluation of the impact of these conditions on hemodynamics. In this review we focus on the current state-of-the-art application of cardiovascular magnetic resonance in assessing pericardial diseases and cardiac tumors.

[Assessment of the left atrial myxoma with gated blood pool SPECT].

A left atrial myxoma with 4 cm diameter was studied with ECG gated Tc-99m blood pool SPECT. The long axial images showed the myxoma to protrude through the mitral valve (MV) during diastole and to come back into the atrium in systole. No significant atrial dilatation due to the MV obstruction was detected. The ejection fraction calculated from the SPECT images was 10% lower than that of the conventional method viewed from LAO 45 degrees. Nuclear medicine gave an additional information for the assessment of the hemodynamics.

Echocardiographic assessment of atrial tumour size and endogeneously generated contrast images. An experimental study.

Experimental models, in vitro and in vivo, were designed to simulate the motion of an atrioventricular valve leaflet and an atrial tumour. Cross-sectional echocardiography was used to investigate any changes in apparent tumour size related to its motion. Both parts of the study suggest that endogenous contrast, due to surfaces of different acoustic densities generated around the rapidly moving tumour, contributes to the echographic pattern of the tumour. Thus, during diastole, the echo-mass cloud is greater than the real size of the tumour. The echocardiographic and actual size of the tumour may be identical only in ventricular systole when the blood flow around the atrial tumour is greatly decreased.