Quantification of myocardial segmental function in acute and chronic ischemic heart disease and implications for cardiovascular cell therapy trials: a review from the NHLBI-Cardiovascular Cell Therapy Research Network

JACC Cardiovasc Imaging. 2011 Jun;4(6):671-9. doi: 10.1016/j.jcmg.2011.02.015.


Global left ventricular (LV) ejection fraction (LVEF) has been used as a measure of improvement in LV function following cell therapy. Although the impact of cell therapy on LVEF in short- and long-term follow-up has been generally positive, there is concern that research evaluating regional therapeutics (e.g., cell or gene therapy) may require analysis of regional LV function localized to the site of intervention. Regional LV assessment is traditionally performed with qualitative or quantitative analysis of wall thickening within 16 myocardial segments, but advances in noninvasive imaging permit an increasingly more detailed and accurate evaluation of LV function. Wall-thickness measurements can now include evaluation of over 1,000 myocardial segments. In addition to higher resolution measures of wall thickening, automated assessments of myocardial segment deformation, such as strain imaging, exist. Strain imaging allows for direct evaluation of the mechanical properties that may improve following regional therapeutic intervention. Improvements in regional LV function may also be assessed by determining regional ejection fraction (EF). Regional EF offers the advantage of summarizing the end result of all of the complex deformations in the adjacent myocardial segments. Although regional EF and strain imaging, as compared with wall thickening, enhance detection of improvement in complex measures of regional myocardial function, it remains unclear whether such measures are better able to predict meaningful improvement in clinical outcomes.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Cell Transplantation*
  • Chronic Disease
  • Clinical Trials as Topic* / methods
  • Diagnostic Imaging* / methods
  • Heart Function Tests*
  • Humans
  • Myocardial Contraction
  • Myocardial Ischemia / diagnosis*
  • Myocardial Ischemia / pathology
  • Myocardial Ischemia / physiopathology
  • Myocardial Ischemia / surgery
  • Myocardium / pathology*
  • Predictive Value of Tests
  • Recovery of Function
  • Research Design
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Function, Left*