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Journal of Cardiovascular Magnetic Resonance

, 18:15

First Online: 10 April 2016Received: 16 December 2015Accepted: 15 March 2016


BackgroundThe purpose of this work is to analyze differences in left ventricular torsion between volunteers and patients with non-ischemic cardiomyopathy based on tissue phase mapping TPM cardiovascular magnetic resonance CMR.

MethodsTPM was performed on 27 patients with non-ischemic cardiomyopathy and 14 normal volunteers. Patients underwent a standard CMR including late gadolinium enhancement LGE for the assessment of myocardial scar and ECG-gated cine CMR for global cardiac function. TPM was acquired in short-axis orientation at base, mid, and apex for all subjects. After evaluation by experienced observers, the patients were divided in subgroups according to the presence or absence of LGE LGE+-LGE-, local wall motion abnormalities WM+-WM-, and having a preserved ≥50 % or reduced <50 % ejection fraction EF+-EF-. TPM data was semi-automatically segmented and global LV torsion was computed for each cardiac time frame for endocardial and epicardial layers, and for the entire myocardium.

ResultsMaximum myocardial torsion was significantly lower for patients with reduced EF compared to controls 0.21 ± 0.15°-mm vs. 0.36 ± 0.11°-mm, p = 0.018, but also for patients with wall motion abnormalities 0.21 ± 0.13°-mm vs. 0.36 ± 0.11°-mm, p = 0.004. Global myocardial torsion showed a positive correlation r = 0.54, p < 0.001 with EF. Moreover, endocardial torsion was significantly higher than epicardial torsion for EF+ subjects 0.56 ± 0.33°-mm vs. 0.34 ± 0.18°-mm, p = 0.039 and for volunteers 0.46 ± 0.16°-mm vs. 0.30 ± 0.09°-mm, p = 0.004. The difference in maximum torsion between endo- and epicardial layers was positively correlated with EF r = 0.47, p = 0.002 and age r = 0.37, p = 0.016 for all subjects.

ConclusionsTPM can be used to detect significant differences in LV torsion in patients with reduced EF and in the presence of local wall motion abnormalities. We were able to quantify torsion differences between the endocardium and epicardium, which vary between patient subgroups and are correlated to age and EF.

KeywordsNon-ischemic cardiomyopathy Myocardial velocities Torsion Cardiovascular magnetic resonanace Tissue phase mapping AbbreviationsCMRcardiovascular magnetic resonance imaging

CMRcardiovascular magnetic resonance


EFejection fraction

EFpatient subgroup with reduced ejection fraction

EF+patient subgroup with preserved ejection fraction

LGElate gadolinium enhancement

LGEpatient subgroup without late gadolinium enhancement present

LGE+patient subgroup with late gadolinium enhancement present

LVleft ventricle

SDstandard deviation


TPMtissue phase mapping

WMpatient subgroup without wall motion abnormalities

WM+patient subgroup with wall motion abnormalities

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Author: Teodora Chitiboi - Susanne Schnell - Jeremy Collins - James Carr - Varun Chowdhary - Amir Reza Honarmand - Anja Hennemuth


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