Ischemic and Non-Ischemic Heart Disease: A Patient-Specific Approach to Scar Detection Using Cardiac MRI

Abstract

The purpose of this research was to examine the use of cardiac magnetic resonance (CMR) feature tracking for scar identification in
a population of patients with varying degrees of ischemic and non-ischemic heart disease.
A total of 89 individuals with chronic ischemia and non-ischemic heart disease (IHD+) and 65 patients with ischemic scars
exclusively (IHD) had their cardiac magnetic resonance imaging (CMR) studies retrospectively analyzed. In all cases, original cine
pictures were processed using specialized software (Segment CMR, Medviso) to extract global (GCS) and segmental (SCS)
circumferential strain. Segmental values from GCSmedian percentage plots were associated with corresponding myocardial
segments in late gadolinium enhancement (LGE) after patient-specific median GCS (GCSmedian) was calculated.
Overall, the results showed a range of -3.5% to -19.8% in GCS, with a significantly lower average GCS in IHD+ compared to IHD
(p 0.05). The percentage of infarcted myocardial segments was 19% in IHD and 16% in IHD+. 6.7% of IHD+ segments also showed
evidence of non-ischemic LGE. GCSmedian percentage plots correlated with LGE to reveal that below a cut- off of 39.5%
GCSmedian (87.5% sensitivity, 86.3% specificity, AUC 0.907), the presence of ischemic scar tissue in a myocardial segment was
very probable.95% CI 0.875-0.938, p < 0.05).Ischemic scar tissue in the myocardium may be suspected using patient-specific 
GCSmedian percentage plots computed from native cine pictures, as shown in the conclusion