ArticleJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance2023
Localized strain characterization of cardiomyopathy in Duchenne muscular dystrophy using novel 4D kinematic analysis of cine cardiovascular magnetic resonance.
Article in Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 15 citations in OpenAlex.
- Empagliflozin preserves cardiac function and modulates metabolism in a mouse model of Duchenne muscular dystrophy.bioRxiv : the preprint server for biology · 2026Article
- Multiparametric CMR evaluation of myocardial remodeling in dystrophinopathy.Frontiers in cardiovascular medicine · 2026Article
- AAV-microutrophin gene therapy confers durable cardioprotection against pharmacologic and exercise-induced injury in the mdx mouse.Molecular therapy : the journal of the American Society of Gene Therapy · 2025Article
- Deep Learning-based Aligned Strain from Cine Cardiac MRI for Detection of Fibrotic Myocardial Tissue in Patients with Duchenne Muscular Dystrophy.Radiology. Artificial intelligence · 2025Article
- Cardiac Histopathology in Duchenne Muscular Dystrophy Demonstrates Diffuse Fibrofatty Replacement of the Myocardium.Journal of the American Heart Association · 2024Article
- Deep learning enables accurate soft tissue tendon deformation estimation in vivo via ultrasound imaging.Scientific reports · 2024Article
- 4D ultrasound-based strain assessment of cardiac dysfunction in male rats with reperfused and nonreperfused myocardial infarction.Physiological reports · 2024Article
- Artificial Intelligence to derive aligned strain in cine CMR to detect patients with myocardial fibrosis: an open and scrutinizable approach.Research square · 2024Article
- Prognostic Value of Tpeak-Tend Interval in Early Diagnosis of Duchenne Muscular Dystrophy Cardiomyopathy.Diagnostics (Basel, Switzerland) · 2023Article
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundCardiomyopathy (CMP) is the most common cause of mortality in Duchenne muscular dystrophy (DMD), though the age of onset and clinical progression vary. We applied a novel 4D (3D + time) strain analysis method using cine cardiovascular magnetic resonance (CMR) imaging data to determine if localized strain metrics derived from 4D image analysis would be sensitive and specific for characterizing DMD CMP.
methodsWe analyzed short-axis cine CMR image stacks from 43 DMD patients (median age: 12.23 yrs [10.6-16.5]; [interquartile range]) and 25 male healthy controls (median age: 16.2 yrs [13.3-20.7]). A subset of 25 male DMD patients age-matched to the controls (median age: 15.7 yrs [14.0-17.8]) was used for comparative metrics. CMR images were compiled into 4D sequences for feature-tracking strain analysis using custom-built software. Unpaired t-test and receiver operator characteristic area under the curve (AUC) analysis were used to determine statistical significance. Spearman's rho was used to determine correlation.
resultsDMD patients had a range of CMP severity: 15 (35% of total) had left ventricular ejection fraction (LVEF) > 55% with no findings of myocardial late gadolinium enhancement (LGE), 15 (35%) had findings of LGE with LVEF > 55% and 13 (30%) had LGE with LVEF < 55%. The magnitude of the peak basal circumferential strain, basal radial strain, and basal surface area strain were all significantly decreased in DMD patients relative to healthy controls (p < 0.001) with AUC values of 0.80, 0.89, and 0.84 respectively for peak strain and 0.96, 0.91, and 0.98 respectively for systolic strain rate. Peak basal radial strain, basal radial systolic strain rate, and basal circumferential systolic strain rate magnitude values were also significantly decreased in mild CMP (No LGE, LVEF > 55%) compared to a healthy control group (p < 0.001 for all). Surface area strain significantly correlated with LVEF and extracellular volume (ECV) respectively in the basal (rho = - 0.45, 0.40), mid (rho = - 0.46, 0.46), and apical (rho = - 0.42, 0.47) regions.
conclusionStrain analysis of 3D cine CMR images in DMD CMP patients generates localized kinematic parameters that strongly differentiate disease from control and correlate with LVEF and ECV.
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