Semi-automatic analysis of circumferential strain was performed using cvi42® [Release 5.13.5 (2190), Circle Cardiovascular Imaging, Alberta, Canada]. The endocardial and epicardial contours were automatically registered by the software on short-axis CINE images covering the left ventricle. All contours were checked by two experienced readers. Whenever manual correction of the contours was necessary, it was performed by consensus by the readers. The global SDI (SDIglobal), defined as the standard deviation of the segmental time to maximum strain for segments 1–16 normalised to the length of the cardiac cycle and given in time percentage, was used to determine the severity of LV dyssynchrony and to correlate dyssynchrony with the frequency of artefacts identified in LGE imaging (21 (link)).
To further account for LV dyssynchrony due to delayed free wall contraction and associated septal deformation due to stretching in early systole, we investigated two additional new SDI:
The time required for strain analysis was less than 5 min and did not differ between patients and controls.
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