Stress Testing

Ischemia Detection

As much as 20% of traditional stress test results produce false positives or negatives.[1] MyoStrain performs a rapid and quantitative assessment of heart function to help reduce the number of unnecessary and suboptimal procedures made on false-positive and false-negative CAD patients. 

In a 15-minute stress test, MyoStress™ helps physicians identify ischemic areas of the heart to rule-out healthy patients while ruling-in at-risk patients to determine a treatment plan best suited to the patient’s condition.[2]

Chest Pain Triage

In the ER today, many of the common cardiac diagnostic tools used provide little explanation for chest pain, and physicians must run several lengthy cardiac tests to find the cause of the patient’s discomfort.[3] These challenges can place constraints on the ER system, potentially leading to capacity issues, unnecessary procedures and suboptimal care.

MyoStrain’s rapid, accurate and non-invasive hyperventilation stress test MyoStress™ is designed to help improve detection, enhance workflow efficiency and optimize care in the ER. Physicians may potentially use MyoStress™ to quantitatively detect ischemia in high-risk chest pain patients while identifying heart dysfunction in lower to at-risk patients and directing them towards the most appropriate care decision.[3] Through this approach, MyoStrain and MyoStress may help to improve outcomes in the ER, enabling physicians to effectively triage their patients based on individual cardiac risk and reduce the number of unnecessary procedures performed.

Chest Pain Triage

In the ER today, many of the common cardiac diagnostic tools used provide little explanation for chest pain, and physicians must run several lengthy cardiac tests to find the cause of the patient’s discomfort.[3] These challenges can place constraints on the ER system, potentially leading to capacity issues, unnecessary procedures and suboptimal care.

MyoStrain’s rapid, accurate and non-invasive hyperventilation stress test MyoStress™ is designed to help improve detection, enhance workflow efficiency and optimize care in the ER. Physicians may potentially use MyoStress™ to quantitatively detect ischemia in high-risk chest pain patients while identifying heart dysfunction in lower to at-risk patients and directing them towards the most appropriate care decision.[3] Through this approach, MyoStrain and MyoStress may help to improve outcomes in the ER, enabling physicians to effectively triage their patients based on individual cardiac risk and reduce the number of unnecessary procedures performed.

Chest Pain Triage

In the ER today, many of the common cardiac diagnostic tools used provide little explanation for chest pain, and physicians must run several lengthy cardiac tests to find the cause of the patient’s discomfort.[3] These challenges can place constraints on the ER system, potentially leading to capacity issues, unnecessary procedures and suboptimal care.

MyoStrain’s rapid, accurate and non-invasive hyperventilation stress test MyoStress™ is designed to help improve detection, enhance workflow efficiency and optimize care in the ER. Physicians may potentially use MyoStress™ to quantitatively detect ischemia in high-risk chest pain patients while identifying heart dysfunction in lower to at-risk patients and directing them towards the most appropriate care decision.[3] Through this approach, MyoStrain and MyoStress may help to improve outcomes in the ER, enabling physicians to effectively triage their patients based on individual cardiac risk and reduce the number of unnecessary procedures performed.

Cardio-oncology Publications

The Role of Advanced Cardiovascular Imaging Modalities in Cardio-Oncology: From Early Detection to Unravelling Mechanisms of Cardiotoxicity
Advances in cancer therapies have led to a global improvement in patient survival rates. Nevertheless, the price to pay is a concomitant increase in cardiovascular (CV) morbidity and mortality in this population. Increased inflammation and disturbances of the immune system are shared by both cancer and CV diseases. Immunological effects of anti-cancer treatments occur with both conventional chemotherapy and, to a greater extent, with novel biological therapies such as immunotherapy. For these reasons, there is growing interest in the immune system and its potential role at the molecular level in determining cardiotoxicity. Early recognition of these detrimental effects could help in identifying patients at risk and improve their oncological management. Non-invasive imaging already plays a key role in evaluating baseline CV risk and in detecting even subclinical cardiac dysfunction during surveillance. The aim of this review is to highlight the role of advanced cardiovascular imaging techniques in the detection and management of cardiovascular complications related to cancer treatment.
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August 12, 2023
Journal of Clinical Medicine
Multiparametric Early Detection and Prediction of Cardiotoxicity Using Myocardial Strain, T1 and T2 Mapping, and Biochemical Markers: A Longitudinal Cardiac Resonance Imaging Study During 2 Years of Follow-Up
This publication features key outcome data from the PREFECT study demonstrating MyoStrain's ability to help clinicians detect and predict early cardiotoxicity in patients undergoing cancer therapy. These findings highlight MyoStrain as an accurate and sensitive assessment that may enable cardio-oncologists to implement cardio-protective strategies for cancer patients.
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Cardio-oncology
June 15, 2021
Circulation: Cardiovascular Imaging
CMR fast-SENC intramyocardial LV & RV segmental strain detects cardiotoxicity during oncology treatment and impact of cardioprotection therapy before echocardiography
This abstract utilizes MyoStrain in the early detection of cardiotoxicity for patients undergoing oncology treatment, as compared to echocardiography. The abstract also examines the effectiveness of cardio-protection, utilizing MyoStrain to monitor and manage the effects of cardioprotective therapy on patient heart function.
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Cardio-oncology
August 31, 2019
Abstract at ESC Congress 2019

Chronic Disease Publications

Left and right ventricular strain using fast strain-encoded cardiovascular magnetic resonance for the diagnostic classification of patients with chronic non-ischemic heart failure due to dilated, hypertrophic cardiomyopathy or cardiac amyloidosis
The study compared MyoStrain’s ability to quantify and differentiate asymptomatic patients based on their cardiac risk versus traditional ejection faction, reiterating the technology's potential as a critical cardiac risk stratification tool enabling clinicians to identify at-risk patients early for individualized preventative treatment.
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Heart Failure, Chronic Diseases
April 5, 2021
Journal of Cardiovascular Magnetic Resonance
Fast strain-encoded cardiac magnetic resonance for diagnostic classification and risk stratification of heart failure patients
This article demonstrates MyoStrain's ability to identify patients with subclinical LV dysfunction and those at risk for heart failure-related outcomes compared with LVEF, providing an additional diagnostic window for prevention treatments.
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Heart Failure, Chronic Diseases
January 13, 2021
JACC Cardiovascular Imaging
Echocardiography and cardiovascular magnetic resonance based evaluation of myocardial strain and relationship with late gadolinium enhancement
This paper evaluates and compares MyoStrain's ability to detect fibrosis based on late gadolinium enhancement versus speckle tracking echocardiography.
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Chronic Diseases
August 8, 2019
Journal of Cardiovascular Magnetic Resonance

Stress Testing Publications

Systematic Review and Meta-Analysis for the Value of Cardiac Magnetic Resonance Strain to Predict Cardiac Outcomes
Cardiac magnetic resonance (CMR) is the gold standard for the diagnostic classification and risk stratification in most patients with cardiac disorders. The aim of the present study was to investigate the ability of Strain-encoded MR (SENC) for the prediction of major adverse cardiovascular events (MACE).
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January 11, 2024
Layer-Specific Fast Strain-Encoded Cardiac Magnetic Resonance Imaging Aids in the Identification and Discrimination of Acute Myocardial Injury: A Prospective Proof-of-Concept Study
This study investigated the use of layer-specific fast strain-encoded cardiac magnetic resonance imaging (fSENC) for diagnosing and prognosticating acute myocardial injury in emergency department patients. It found that global longitudinal strain (GLS) and GLSdifference (the difference between epicardial and endocardial GLS) were effective predictors, with GLS showing a high diagnostic accuracy (AUC 91.8%) for myocardial injury. GLSdifference performed well in identifying non-ST-elevation myocardial infarction (NSTEMI) specifically (AUC 83.2%), and combining these measures with assessment of dysfunctional segments improved diagnostic performance further (AUC 87.5%). Incorporating fSENC into standard care enhanced overall diagnostic accuracy significantly (AUC 95.5%) compared to conventional methods alone. The study suggests that layer-specific strain analysis could serve as a valuable diagnostic tool for acute myocardial injuries, offering insights into prognosis and potentially guiding clinical management.
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January 1, 2024
Myocardial Inflammation and Fibrosis Are Associated With Reduced Strain in Collegiate Athletes Recovering From SARS-CoV-2
Several studies show a low (1-3%) but real risk of myocarditis in competitive athletes after SARS-CoV-2 infection.
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November 16, 2023
JACC Cardiovascular Imgaging

Heart Failure Publications

Reduced Functional Capacity is Associated with the Proportion of Impaired Myocardial Deformation Assessed in Heart Failure Patients by CMR.
Heart failure (HF) does not only reduce the life expectancy in patients, but their life is also often limited by HF symptoms leading to a reduced quality of life (QoL) and a diminished exercise capacity. Novel parameters in cardiac imaging, including both global and regional myocardial strain imaging, promise to contribute to better patient characterization and ultimately to better patient management. However, many of these methods are not part of clinical routine yet, their associations with clinical parameters have been poorly studied. An imaging parameters that also indicate the clinical symptom burden of HF patients would make cardiac imaging more robust toward incomplete clinical information and support the clinical decision process.
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February 5, 2023
Frontiers In Cardiovascular Medicine
CMR detects decreased myocardial deformation in asymptomatic patients at risk for heart failure
A recently published article from Berlin highlights the potential of MyoStress in terms of identifying at-risk patients who have reserve and are therefore not symptomatic compared to patients with heart failure who have a preserved ejection fraction. This article shows that asymptomatic subjects with increased CV risk present with HFpEF like impaired myocardial deformation at rest, while they show results like controls under HG stress.
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Stress Testing
January 25, 2023
Frontiers in Cardiovascular Medicine
CMR Detects Decreased Myocardial Deformation in Asymptomatic Patients At Risk for Heart Failure
The main management strategy of heart failure with preserved ejection fraction (HFpEF) is prevention since HFpEF is associated with many cardiovascular (CV) risk factors, especially since HFpEF is linked to a high risk for both mortality and recurrent heart failure (HF) hospitalizations. Therefore, there is a need for new tools to identify patients with a high risk profile early. Regional strain assessment by CMR seems to be superior in describing deformation impairment in HF. The MyoHealth score is a promising tool to identify cardiac changes early.
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January 5, 2023
Frotiners In Cardiovascular Medicine
References

[1] Arbab-Zadeh A. Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm. Heart Int. 2012 Feb 3; 7(1): e2. doi: 10.4081/hi.2012.e2. [2] Riffel JH, Siry D, Salatzki J, Andre F, Ochs M, Weberling LD, et al. (2021) Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain. PLoS ONE 16(5): e0251040. https://doi.org/10.1371/journal.pone.0251040. [3] Ochs, Met al. J Am Coll Cardiol Cardiovasc Imaging.Apr 14, 2021. DOI: 10.1016/j.jcmg.2021.02.022.