Endocardial center motion for quantification of left ventricular discoordination in heart failure using cine MRI

Salvatore Saporito, Patrick Houthuizen, Jean Paul M.M. Aben, Jos J.M. Westenberg, Harrie C.M. Van Den Bosch, Hans C. van Assen, Massimo Mischi

Research output: Contribution to journalArticleAcademicpeer-review


Objective: To compare a novel cardiovascular magnetic resonance technique for the assessment of left ventricular (LV) mechanical discoordination by characterizing the endocardial center motion (ECM) in short-axis cine MRI in healthy volunteers and heart failure patients with left bundle branch block (HF-LBBB). Approach: To evaluate ECM analysis as mechanical discoordination measure, we retrospectively compared spatial and temporal features of the ECM between a group of healthy volunteers (n = 14) and conduction defect patients (HF-LBBB, n = 31). We tracked the center of the endocardial borders on short-axis view MRI cine loops during the cardiac cycle. From the ECM trajectory we calculated the overall traveled distance, the enclosed area, the eccentricity of the trajectory, and the maximum traveled distance. The ECM can be visualized in spatial coordinates as well as by its temporal behavior. We evaluated the classification performance of these measures for LBBB detection. We also quantified the coherence of the ECM on the longitudinal direction by considering the variability of the ECM measures between different short-axis slices. Main results: Patients with LBBB showed significantly higher traveled distance (p < 0.0001), enclosed area (p < 0.002), eccentricity (p < 0.02), and peak displacement (p < 0.02) of the endocardial center. Patients with positive late gadolinium enhancement showed a higher variability of ECM measures across different slices (p < 0.05). Significance: ECM analysis is feasible and it allows the assessment of left ventricular mechanical discoordination. Differences in ECM measures permit one to distinguish between LBBB and healthy volunteers.

Original languageEnglish
Article number025009
Pages (from-to)1-9
JournalPhysiological Measurement
Issue number2
Publication statusPublished - 28 Feb 2018


  • cine MRI
  • conduction disorders
  • heart failure
  • left bundle branch block
  • left ventricle
  • Endocardium/physiopathology
  • Movement
  • Humans
  • Heart Failure/complications
  • Ventricular Dysfunction, Left/complications
  • Male
  • Magnetic Resonance Imaging, Cine
  • Case-Control Studies
  • Image Processing, Computer-Assisted
  • Adult
  • Female
  • Aged
  • Bundle-Branch Block/complications


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