Publications

Research Highlights

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.
Circulation: Cardiovascular Imaging
June 15, 2021
Hyperventilation/Breath-Hold Maneuver to Detect Myocardial Ischemia by Strain-Encoded CMR: Diagnostic Accuracy of a Needle-Free Stress Protocol
This article demonstrates MyoStrain’s speed and sensitivity to successfully measure cardiac stress during a safe, simple hyperventilation breathing maneuver. Performed without any pharmacological or physical stress protocols, this new technique may provide clinicians with a faster and safer quantitative stress test to help improve the diagnosis and management of coronary artery disease.
JACC: Cardiovascular Imaging
April 15, 2021
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.
Journal of Cardiovascular Magnetic Resonance
April 5, 2021
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.
JACC Cardiovascular Imaging
January 13, 2021
Economic evaluation of cardiac magnetic resonance with fast-SENC in the diagnosis and management of early heart failure
A cost-impact analysis of MyoStrain in the early diagnosis and management of MyoStrain, this manuscript compares the cost-saving potential of MyoStrain versus echocardiography.
BMC Health Economics Review
May 23, 2019
Strain‐encoded magnetic resonance: a method for the assessment of myocardial deformation
This clinical review article describes the history and evolution of the MyoStrain technology. The manuscript itself provides a detailed summary of existing literature about MyoStrain and its predecessor technologies HARP and SENC, totaling 400+ publications representing 70,000+ patient data points to date.
ESC Heart Failure Journal
April 25, 2019
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.
Circulation: Cardiovascular Imaging
June 15, 2021
Hyperventilation/Breath-Hold Maneuver to Detect Myocardial Ischemia by Strain-Encoded CMR: Diagnostic Accuracy of a Needle-Free Stress Protocol
This article demonstrates MyoStrain’s speed and sensitivity to successfully measure cardiac stress during a safe, simple hyperventilation breathing maneuver. Performed without any pharmacological or physical stress protocols, this new technique may provide clinicians with a faster and safer quantitative stress test to help improve the diagnosis and management of coronary artery disease.
JACC: Cardiovascular Imaging
April 15, 2021
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.
Journal of Cardiovascular Magnetic Resonance
April 5, 2021

Select MyoStrain® Publications

The MyoStrain technology is rigorously validated across 500+ peer-reviewed publications (including 50+ in JACC and Circulation) representing more than 80,000 patient data points. The following selection contains the most recent and pivotal articles not highlighted above.

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Multi-Parametric Non-Contrast Cardiac Magnetic Resonance for the Differentiation Between Cardiac Amyloidosis and Hypertrophic Cardiomyopathy
The study aimed to assess fast strain-encoded (SENC) cardiac magnetic resonance (CMR) and native T1 mapping in distinguishing between hypertrophic cardiomyopathy (HCM) and cardiac amyloidosis. Ninety-nine patients (57 with HCM, 42 with amyloidosis) were analyzed for LV parameters, myocardial strain (global and segmental), and T1 values. HCM patients showed evenly distributed strain, while amyloidosis patients exhibited apical sparing with less impaired apical strain. T1 values were significantly higher in amyloidosis. The T1-to-basal segmental strain ratio effectively differentiated between conditions (Sensitivity = 85%, Specificity = 77%, AUC = 0.90), highlighting its potential in non-contrast CMR protocols for accurate diagnosis.
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March 11, 2024
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
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
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
Cardiac Magnetic Resonance Imaging in Appraising Myocardial Strain and Biomechanics: A Current Overview
Subclinical alterations in myocardial structure and function occur early during the natural disease course. In contrast, clinically overt signs and symptoms occur during late phases, being associated with worse outcomes. Identification of such subclinical changes is critical for timely diagnosis and accurate management. Hence, implementing cost-effective imaging techniques with accuracy and reproducibility may improve long-term prognosis. A growing body of evidence supports using cardiac magnetic resonance (CMR) to quantify deformation parameters. Tissue-tagging (TT-CMR) and feature-tracking CMR (FT-CMR) can measure longitudinal, circumferential, and radial strains and recent research emphasize their diagnostic and prognostic roles in ischemic heart disease and primary myocardial illnesses. Additionally, these methods can accurately determine LV wringing and functional dynamic geometry parameters, such as LV torsion, twist/untwist, LV sphericity index, and long-axis strain, and several studies have proved their utility in prognostic prediction in various cardiovascular patients. More recently, few yet important studies have suggested the superiority of fast strain-encoded imaging CMR-derived myocardial strain in terms of accuracy and significantly reduced acquisition time, however, more studies need to be carried out to establish its clinical impact. Herein, the current review aims to provide an overview of currently available data regarding the role of CMR in evaluating myocardial strain and biomechanics.
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January 30, 2023
Publisher Diagnostics
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