Mapping propagation of mechanical activation in the paced heart with MRI tagging

The temporal evolution of three-dimensional (3-D) strain maps derived from magnetic resonance imaging (MRI) tagging were used to noninvasively evaluat e mechanical activation in the left ventricle (LV) while seven canine heart s were paced in situ from three different sites: the base of the LV free wa ll (LVb), the right ventricular apex (RVa), and the right atrium (RA). Stra in maps plotted against time showed the evolution of shortening over the en tire LV midwall and were used to generate mechanical activation maps showin g the onset of circumferential shortening. RA pacing showed rapid synchrono us shortening; LVb pacing showed a wave front of mechanical activation prop agating slowly and steadily from the pacing site, whereas RVa pacing showed regions of rapid and slower propagation. The mechanical (M) activation tim es correlated linearly with the electrical (E) activation (M = 1.06E + 8.4 ms, R = 0.95). The time for 90% activation of the LV was 63.1 +/- 24.3 ms f or RA pacing, 130.2 +/- 9.8 ms for LVb pacing, and 121.3 +/- 17.9 ms for RV a pacing. The velocity of mechanical activation was calculated for LVb and RVa pacing and was similar to values reported for electrical conduction in myocardium. The propagation of mechanical activation for RVa pacing showed regional variations, whereas LVb pacing did not.