DeepStrain Evidence of Asymptomatic Left Ventricular Diastolic and Systolic Dysfunction in Young Adults With Cardiac Risk Factors

• Main Authors: Morales, Manuel A. (Author), Snel, Gert J. H. (Author), van den Boomen, Maaike (Author), Borra, Ronald J. H. (Author), van Deursen, Vincent M. (Author), Slart, Riemer H. J. A. (Author), Izquierdo-Garcia, David (Author), Prakken, Niek H. J. (Author), Catana, Ciprian (Author)
• Format: Article
• Language: English
• Published: Frontiers Media SA, 2022-06-15T15:58:57Z.
• Subjects: Article
• Online Access: Get fulltext

 <jats:sec><jats:title>Purpose</jats:title><jats:p>To evaluate if a fully-automatic deep learning method for myocardial strain analysis based on magnetic resonance imaging (MRI) cine images can detect asymptomatic dysfunction in young adults with cardiac risk factors.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>An automated workflow termed DeepStrain was implemented using two U-Net models for segmentation and motion tracking. DeepStrain was trained and tested using short-axis cine-MRI images from healthy subjects and patients with cardiac disease. Subsequently, subjects aged 18-45 years were prospectively recruited and classified among age- and gender-matched groups: risk factor group (RFG) 1 including overweight without hypertension or type 2 diabetes; RFG2 including hypertension without type 2 diabetes, regardless of overweight; RFG3 including type 2 diabetes, regardless of overweight or hypertension. Subjects underwent cardiac short-axis cine-MRI image acquisition. Differences in DeepStrain-based left ventricular global circumferential and radial strain and strain rate among groups were evaluated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The cohort consisted of 119 participants: 30 controls, 39 in RFG1, 30 in RFG2, and 20 in RFG3. Despite comparable (>0.05) left-ventricular mass, volumes, and ejection fraction, all groups (RFG1, RFG2, RFG3) showed signs of asymptomatic left ventricular diastolic and systolic dysfunction, evidenced by lower circumferential early-diastolic strain rate (<0.05, <0.001, <0.01), and lower septal circumferential end-systolic strain (<0.001, <0.05, <0.001) compared with controls. Multivariate linear regression showed that body surface area correlated negatively with all strain measures (<0.01), and mean arterial pressure correlated negatively with early-diastolic strain rate (<0.01).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>DeepStrain fully-automatically provided evidence of asymptomatic left ventricular diastolic and systolic dysfunction in asymptomatic young adults with overweight, hypertension, and type 2 diabetes risk factors.</jats:p></jats:sec>