Cardiac Magnetic Resonance Imaging for Myocardial Mechanics

Cardiac magnetic resonance (CMR) has emerged as the gold standard for non-invasive assessment of myocardial mechanics, offering unparalleled soft-tissue contrast, high spatial resolution and the ability to characterise tissue without ionising radiation. By encoding myocardial motion over the cardiac cycle, CMR techniques quantify deformation (strain) in circumferential, longitudinal and radial dimensions. Traditional approaches such as myocardial tagging impose grid-like magnetisation patterns that deform with the contracting heart, providing direct maps of regional strain. More recent developments harness feature-tracking algorithms to follow natural tissue landmarks on routine cine images, accelerating analysis and widening accessibility. Advanced sequences including displacement encoding with stimulated echoes (DENSE) and strain-encoding (SENC) extend the dynamic range of deformation readouts, while deep learning models now automate segmentation of long- and short-axis views with high repeatability. Together, these tools enable detailed evaluation of global and segmental function, informing early detection of subclinical dysfunction, risk stratification in cardiomyopathies and monitoring of therapeutic interventions. Emerging consensus guidelines aim to standardise acquisition, post-processing and reporting, laying the foundation for broader clinical translation and multicentre trials.

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Cardiac Magnetic Resonance Imaging for Myocardial Mechanics publication trend

The graph below shows the total number of articles in cardiac magnetic resonance imaging for myocardial mechanics across all publications each year (not limited to Nature Index journals).

Technical terms

Strain: Dimensionless measure of myocardial deformation expressed as percentage change in length, with negative values denoting shortening (longitudinal, circumferential) and positive values indicating thickening (radial).

Myocardial tagging: CMR pulse sequence that labels myocardium with spatial saturation patterns (e.g., SPAMM, CSPAMM) to visualise tissue displacement directly.

Feature tracking (FT): Post-processing technique that follows inherent image features across cine frames to compute strain without specialised acquisitions.

DENSE: Displacement encoding with stimulated echoes; CMR method that encodes tissue displacement into phase images for precise strain quantification.

SENC: Strain-encoding imaging; sequence that directly encodes myocardial strain magnitude into image contrast, enabling rapid assessment of regional mechanics.

Global longitudinal strain (GLS): Average shortening of the left ventricular myocardium along its long axis, a sensitive marker of early systolic dysfunction.

References

1. Myocardial Strain Measured by Cardiac Magnetic Resonance Predicts Cardiovascular Morbidity and Death. Journal of the American College of Cardiology (2024).
2. Automated segmentation of long and short axis DENSE cardiovascular magnetic resonance for myocardial strain analysis using spatio-temporal convolutional neural networks. Journal of Cardiovascular Magnetic Resonance (2023).
3. Principles of cardiovascular magnetic resonance feature tracking and echocardiographic speckle tracking for informed clinical use. Journal of Cardiovascular Magnetic Resonance (2016).
4. Myocardial tagging by Cardiovascular Magnetic Resonance: evolution of techniques–pulse sequences, analysis algorithms, and applications. Journal of Cardiovascular Magnetic Resonance (2011).
5. Society for Cardiovascular Magnetic Resonance (SCMR) expert consensus for CMR imaging endpoints in clinical research: part I - analytical validation and clinical qualification. Journal of Cardiovascular Magnetic Resonance (2018).