Three-dimensional analysis of regional left ventricular endocardial curvature from cardiac magnetic resonance images

Left ventricular (LV) remodeling is usually assessed using changes in LV volume, while disregarding regional changes that may occur independently of volume. We hypothesized that 3D analysis of regional endocardial curvature could provide useful information on localized remodeling. Cardiac magnetic resonance (CMR) images were acquired in 44 patients: 14 normal controls (NL), 15 with dilated cardiomyopathy (DCM), and 15 ischemic heart disease (IHD). LV endocardial surface was reconstructed throughout the cardiac cycle and used to calculate for each point the curvedness, normalized by instantaneous LV size (C_n). Normalized curvedness was compared between groups of segments: NL (N=401), DCM (N=255) and IHD (N=92). While in NL segments, C_n values were comparable in basal and mid-ventricular segments, they were higher in the apical segments (p<;0.05). Also, % change in C_n was higher in mid and apical compared to basal segments (p<;0.05). At all LV levels, C_n in DCM segments was lower (p<;0.05) than in NL and IHD. In contrast, % change in C_n was lower in both IHD and DCM segments compared to NL (p<;0.05). 3D analysis of regional LV endocardial curvature from CMR images provides quantitative information, which is consistent with the known pathophysiology, and may prove useful in the evaluation of LV remodeling.