Diffusion Tensor Imaging and Evaluation of Cardiac Ischemic Disorders: A Systematic Review

Abstract

BACKGROUND: A suitable diagnostic method can be beneficial owing to the high prevalence of myocardial infarction (MI) and structural changes that affect systolic and diastolic performance. In this systematic review, we focused on the possibility of using DTI instead of current methods such as cardiac biopsy, an invasive procedure. METHODS: Articles published in PubMed, Scopus, Embase, and Scholar electronic databases from 2010 to 2023 were reviewed using the determined keywords. The articles included evaluating DTI in patients with MI, compared to standard myocardial structure. Studies that did not examine the association between DTI and cardiac ischemic disorders only considered original articles. Methodological risk was evaluated using QUADAS-2 tool. RESULTS: Sixteen articles were selected from 16855 searched articles and divided into two subgroups: human-based (six studies) and animal-based (ten studies). Among the results obtained from both animal and human-based evaluations: (a) the values of the FA, RD (lambda perpendicular), and AD (lambda parallel) indices in the infarcted region were lower than those in the remote or adjacent areas, and the value of the MD index increased. (b) This trend was also present in both acute and chronic conditions and in the follow-up of patients for the assessment of microstructure remodeling. (c) Confirming the process of change evaluated in preclinical human studies. More studies should be conducted on the effects of factors such as the B-value index and environmental conditions. CONCLUSION: Clarifying the trend of changes in DTI indices for AMI and CMI makes them suitable diagnostic tools in this regard. Meanwhile, the study faced limitations such as low sample size and the risk of bias about "patient selection" index.