Professor Ntobeko Ntusi

Cardiovascular Strain Imaging - Impact on Clinical Decision Making

Chair and Head of Medicine at the University of Cape Town and Groote Schuur Hospital

Professor Ntobeko Ntusi is a cardiologist, a Professor of Medicine and is the Chair and Head of Medicine at the University of Cape Town (UCT) and Groote Schuur Hospital (GSH); and is the Clinical Lead for Cardiovascular Magnetic Resonance (CMR) at UCT and GSH. He is a principal investigator based at the Hatter Institute for Cardiovascular Research in Africa and the Cape Universities Body Imaging Centre, UCT. He obtained a BSc(hons) degree in Cellular and Molecular Biology from Haverford College, USA and an MBChB degree from UCT. He served his internship and later worked as a community service medical officer and senior house officer at Frere Hospital in East London, South Africa. He then completed a fellowship in Internal Medicine and a certificate in Cardiology through the Colleges of Medicine of South Africa. He read for a DPhil in Cardiovascular Medicine at the University of Oxford and completed his MD in Cardiology at UCT. He has extensive experience with basic science, translational and clinical research and currently supervises postgraduate students and is conducting several single- and multi-centre mechanistic studies, which are mostly CMR-based. Through his research, Prof. Ntusi has built strong links with colleagues in clinical cardiology, physics and biomedical engineering, HIV medicine, rheumatology, immunology, molecular genetics and biomedical statistics; and he has shown capacity for performance in scientific investigational teams and is suited to being part of multi-disciplinary and multi-centre studies. He has been actively engaged and contributed to improved understanding of cardiomyopathy, inflammatory heart disease and heart failure in South Africa and globally.

Abstract

Cardiovascular Strain Imaging – Impact on Clinical Decision Making

Myocardial strain is a measure of myocardial deformation, a much more sensitive imaging biomarker of myocardial disease than the commonly used ventricular ejection fraction. Myocardial strain is commonly evaluated by using speckle-tracking echocardiography or cardiovascular magnetic resonance (CMR). The commonest CMR technique is feature tracking (FT), which involves postprocessing of routinely acquired cine MR images. Other CMR strain techniques require dedicated sequences, including myocardial tagging, strain-encoded imaging, displacement encoding with stimulated echoes, and tissue phase mapping. The complex systolic motion of the heart can be resolved into longitudinal strain, circumferential strain, radial strain, and torsion. Myocardial strain metrics include strain, strain rate, displacement, velocity, torsion, and torsion rate. CMR myocardial strain is also useful in ischemic heart disease, cardiomyopathies, pulmonary hypertension, myocarditis, anticancer therapy cardiotoxicity, and congenital heart disease. In this talk, I shall review the physics, principles, and clinical applications of CMR strain techniques.

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