AUTHOR=Morales Manuel A. , Snel Gert J. H. , van den Boomen Maaike , Borra Ronald J. H. , van Deursen Vincent M. , Slart Riemer H. J. A. , Izquierdo-Garcia David , Prakken Niek H. J. , Catana Ciprian 

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

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.831080

DOI=10.3389/fcvm.2022.831080

ISSN=2297-055X

ABSTRACT=Purpose: The purpose of this study was to evaluate if a fully-automatic deep learning method for myocardial strain analysis based on cine-MRI can detect asymptomatic dysfunction in young adults with cardiac risks factors. 
Methods: An automated strain analysis workflow termed DeepStrain was implemented using U-net models. DeepStrain was trained and tested using cine-MRI images from healthy subjects and patients with cardiac disease. Prospective evaluation was performed in young adults with overweight, hypertension, and type 2 diabetes risk factors. 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 magnetic resonance short-axis cine acquisitions to derived strain measures using DeepStrain. Differences in global circumferential and radial strain and strain rate among groups was evaluated. 
Results: The cohort consisted of 119 participants: 30 controls, 39 in RFG1, 30 in RFG2, and 20 in RFG 3. 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). 
Conclusion 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.