Automated assessments of circumferential strain from cine CMR correlate with LVEF declines in cancer patients early after receipt of cardio-toxic chemotherapy

Background: in patients with cancer receiving potentially cardio-toxic chemotherapy,measurements of left ventricular (lv) circumferential or longitudinal strain are often used clinically to identify myocardial dysfunction. using a new software algorithm,we sought to determine in individuals receiving treatment for cancer the association between automated assessments of lv mean mid-wall circumferential strain and conventional measures of lv ejection fraction (ef) both obtained from cardiovascular magnetic resonance (cmr) cine balanced steady-state free-precession (bssfp) white-blood acquisitions. methods: before and 3 months after initiating treatment with potentially cardio-toxic chemotherapy,72 individuals (aged 54 ± 14 years with breast cancer [39%],lymphoma [49%],or sarcoma [12%]) underwent serial cmr cine bssfp assessments of lv volumes and ef,and mean mid-wall circumferential strain determined from these same cine images as well as from additional tagged cmr images. on the cine images,assessments of strain were obtained using the newly developed deformation-based segmentation algorithm. assessments of lv volumes/ef from the cine images and strain from tagged cmr were accomplished using commercially available software. all measures were analyzed in a blinded fashion independent of one another. results: acceptable measures for the automated assessments of mean mid-wall circumferential strain from the cine images were obtained in 142 of 144 visits (98.6%) with an overall analysis time averaging 6:47 ± 1:06 min. the results from these automated measures averaged -18.8 ± 2.9 at baseline and -17.6 ± 3.1 at 3 months (p = 0.001). left ventricular ef declined slightly from 65 ± 7% at baseline to 62 ± 7% at 3 months (p = 0.0002). the correlation between strain from cine imaging and lvef was r = -0.61 (p < 0.0001). in addition,the 3-month changes in lv strain and lvef were correlated (r = -0.49; p < 0.0001). the correlation between cine and tagged derived assessments of strain was r = 0.23; p = 0.01. conclusions: automated measures of lv mean mid-wall circumferential strain can be obtained in 6-34; minutes from cine bssfp lv short-axis images (used concurrently to assess lv volumes and ef) in 98.6% of patients receiving treatment for cancer with potentially cardio-toxic chemotherapy. these cine derived measures of circumferential strain correlate with early subclinical declines in lvef. © 2017 the author(s).