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1 Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205; and 2 Department of Physiology, Cardiovascular Research Institute Maastricht, University of Maastricht, 6200 MD Maastricht, The Netherlands
The temporal
evolution of three-dimensional (3-D) strain maps derived from magnetic
resonance imaging (MRI) tagging were used to noninvasively evaluate
mechanical activation in the left ventricle (LV) while seven canine
hearts were paced in situ from three different sites: the base of the
LV free wall (LVb), the right ventricular apex (RVa), and the right
atrium (RA). Strain maps plotted against time showed the evolution of
shortening over the entire LV midwall and were used to generate
mechanical activation maps showing the onset of circumferential
shortening. RA pacing showed rapid synchronous shortening; LVb pacing
showed a wave front of mechanical activation propagating slowly and
steadily from the pacing site, whereas RVa pacing showed regions of
rapid and slower propagation. The mechanical (M) activation times
correlated linearly with the electrical (E) activation (M = 1.06E + 8.4 ms, R = 0.95). The time
for 90% activation of the LV was 63.1 ± 24.3 ms for RA pacing,
130.2 ± 9.8 ms for LVb pacing, and 121.3 ± 17.9 ms for RVa
pacing. The velocity of mechanical activation was calculated for LVb
and RVa pacing and was similar to values reported for electrical
conduction in myocardium. The propagation of mechanical activation for
RVa pacing showed regional variations, whereas LVb pacing did not.
magnetic resonance imaging; magnetic resonance tagging; pacing; conduction abnormalities
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