Pulmonary hypertension (PH) is an increase of blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms. Pulmonary hypertension can be a severe disease with a markedly decreased exercise tolerance and heart failure. The right ventricle is one of four chambers (two atria and two ventricles) in the human heart. It receives deoxygenated blood from the right atrium via the tricuspid valve, and pumps it into the pulmonary artery via the semilunar pulmonary valve and pulmonary artery.

Because of its function, the right ventricle is the most impacted by the increase of after load due to pulmonary hypertension (more resistance to the flow of blood inside the lungs).  Eventually, patients with such disease would suffer from right heart failure which leads to heart failure.  This would require heart transplants to avoid death. Myocardial Solutions’ technology utilized the MRI scanner to help diagnosing the right ventricle, especially by measuring deterioration in its function using strain measurements.

Relevant Papers

Garot J, Bluemke DA, Osman NF, Rochitte CE, Zerhouni EA, Prince JL and Lima JA. Transmural contractile reserve after reperfused myocardial infarction in dogsJ Am Coll Cardiol. 2000;36:2339-46.

Ix JH, Shlipak MG, Chertow GM, Whooley MA, Nasir K, Tsai M, Rosen BD, Fernandes V, Bluemke DA and Folsom AR. Health Services and Outcomes ResearchCirculation. 2007;115:158–160.

Rosen BD, Lima JA, Nasir K, Edvardsen T, Folsom AR, Lai S, Bluemke DA and Jerosch-Herold M. Lower myocardial perfusion reserve is associated with decreased regional left ventricular function in asymptomatic participants of the multi-ethnic study of atherosclerosisCirculation. 2006;114:289–297.

Toro-Salazar OH, Gillan E, O’Loughlin MT, Burke GS, Ferranti J, Stainsby J, Liang B, Mazur W, Raman SV and Hor KN. Occult Cardiotoxicity in Childhood Cancer Survivors Exposed to Anthracycline Therapy. Circulation: Cardiovascular Imaging. 2013;6:873–880.

Pettersen E, Helle-Valle T, Edvardsen T, Lindberg H, Smith HJ, Smevik B, Smiseth OA and Andersen K. Contraction pattern of the systemic right ventricle shift from longitudinal to circumferential shortening and absent global ventricular torsionJ Am Coll Cardiol. 2007;49:2450-6.

Shehata ML, Harouni AA, Skrok J, Basha TA, Boyce D, Lechtzin N, Mathai SC, Girgis R, Osman NF and Lima JA. Regional and global biventricular function in pulmonary arterial hypertension: A cardiac MR imaging study. Radiology. 2013;266:114.

Sasano T, Abraham MR, Chang K-C, Dannals R, Daniel H, Hilton J, Lardo A, Osman N, Marban E and Bengel F. Myocardial sympathetic innervation and regional strain in a porcine model of chronic myocardial infarction. 2007;48:2P.

Castillo E, Osman NF, Rosen BD, El-Shehaby I, Pan L, Jerosch-Herold M, Lai S, Bluemke DA and Lima JA. Quantitative assessment of regional myocardial function with MR-tagging in a multi-center study: interobserver and intraobserver agreement of fast strain analysis with Harmonic Phase (HARP) MRIJ Cardiovasc Magn Reson. 2005;7:783-91.

Ibrahim E-SH, Weiss RG, Stuber M, Spooner AE and Osman NF. Identification of different heart tissues from MRI C-SENC images using an unsupervised multi-stage fuzzy clustering techniqueJournal of Magnetic Resonance Imaging. 2008;28:519–526.

Korosoglou G, Humpert PM, Ahrens J, Oikonomou D, Osman NF, Gitsioudis G, Buss SJ, Steen H, Schnackenburg B and Bierhaus A. Left ventricular diastolic function in type 2 diabetes mellitus is associated with myocardial triglyceride content but not with impaired myocardial perfusion reserve. Journal of Magnetic Resonance Imaging. 2012;35:804–811.

Lu JC, Connelly JA, Zhao L, Agarwal PP and Dorfman AL. Strain measurement by cardiovascular magnetic resonance in pediatric cancer survivors: validation of feature tracking against harmonic phase imagingPediatric Radiology. 2014:1–7.

Murtagh G, Addetia K, Patel AV, Laffin L, Beshai J, Moss J, Mor-Avi V, Lang R and Patel A. Risk stratification of cardiac sarcoidosis with preserved left ventricular ejection fraction using cardiovascular magnetic resonanceJournal of the American College of Cardiology. 2014;63.

Shehata ML, Basha TA, Tantawy WH, Lima JA, Vogel-Claussen J, Bluemke DA, Hassoun PM and Osman NF. Real-time single-heartbeat fast strain-encoded imaging of right ventricular regional function: normal versus chronic pulmonary hypertension. Magn Reson Med. 2010;64:98-106.

Shehata ML, Lossnitzer D, Skrok J, Boyce D, Lechtzin N, Mathai SC, Girgis RE, Osman N, Lima JA and Bluemke DA. Myocardial delayed enhancement in pulmonary hypertension: pulmonary hemodynamics, right ventricular function, and remodelingAJR American journal of roentgenology. 2011;196:87.

Oyama-Manabe N, Sato T, Tsujino I, Kudo K, Manabe O, Kato F, Osman NF and Terae S. The strain-encoded (SENC) MR imaging for detection of global right ventricular dysfunction in pulmonary hypertensionThe international journal of cardiovascular imaging. 2013;29:371–378.

Dibble CT, Lima JA, Bluemke DA, Chirinos JA, Chahal H, Bristow MR, Kronmal RA, Barr RG, Ferrari VA and Propert KJ. Regional Left Ventricular Systolic Function and the Right Ventricle The MESA Right Ventricle StudyThe Multi-Ethnic Study of Atherosclerosis Right Ventricle Study. CHEST Journal. 2011;140:310–316.

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Myocardial Solutions' technology has been used globally in over 70 major medical research centers and is established as the gold standard for strain measurement. The research has yielded over 250 articles in peer-reviewed journals (50 articles from Circulation and JACC alone) that validate CMR strain testing. MyoStrain’s predecessor software (HARP & VIRTUE) have 510(k) clearance and CE Mark certification.
MyoStrain has CE mark certification, and Myocardial Solutions is actively pursuing FDA 510(k) clearance for MyoStrain.