Association between right ventricular strain and outcomes in patients with dilated cardiomyopathy

Liu, Tong; Gao, Yifeng; Wang, Hui; Zhou, Zhen; Wang, Rui; Chang, Shuangyu; Liu, Yuanyuan; Sun, Yuqing; Rui, Hongliang; Yang, Guang; Firmin, David; Dong, Jianzeng; Xu, Lei

doi:10.1136/heartjnl-2020-317949

Cited by 37 publications

(47 citation statements)

References 29 publications

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“…The steady-state free precession breath-hold cine images with 25 reconstructed phases were acquired. The detailed scanning parameters of cine images have been described previously ( 15 ).…”

Section: Methodsmentioning

confidence: 99%

“…The LV myocardial volume was calculated as the LV myocardial mass divided by the specific myocardial density (1.05 g/mL). Further details regarding CMR data assessment are described previously ( 15 ).…”

Section: Methodsmentioning

confidence: 99%

“…The selection of covariates is based on our previous studies ( 1 , 9 , 15 ), and those examining the risk factors for HF ( 16 ). Laboratory ( 17 ) and electrocardiogram ( 18 ) examinations provided data on hemoglobin (HgB), white blood cell counts (WBC), ion concentration, renal function, the level of brain natriuretic peptide (BNP), atrial fibrillation (AF) ( 19 ), and LBBB.…”

Section: Methodsmentioning

confidence: 99%

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Association Between Left Ventricular Global Function Index and Outcomes in Patients With Dilated Cardiomyopathy

Liu

Zhou

et al. 2021

Front. Cardiovasc. Med.

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Purpose: Left ventricular global function index (LVGFI) assessed using cardiac magnetic resonance (CMR) seems promising in the prediction of clinical outcomes. However, the role of the LVGFI is uncertain in patients with heart failure (HF) with dilated cardiomyopathy (DCM). To describe the association of LVGFI and outcomes in patients with DCM, it was hypothesized that LVGFI is associated with decreased major adverse cardiac events (MACEs) in patients with DCM.Materials and Methods: This prospective cohort study was conducted from January 2015 to April 2020 in consecutive patients with DCM who underwent CMR. The association between outcomes and LVGFI was assessed using a multivariable model adjusted with confounders. LVGFI was the primary exposure variable. The long-term outcome was a composite endpoint, including death or heart transplantation.Results: A total of 334 patients (mean age: 55 years) were included in this study. The average of CMR-LVGFI was 16.53%. Over a median follow-up of 565 days, 43 patients reached the composite endpoint. Kaplan–Meier analysis revealed that patients with LVGFI lower than the cutoff values (15.73%) had a higher estimated cumulative incidence of the endpoint compared to those with LVGFI higher than the cutoff values (P = 0.0021). The hazard of MACEs decreased by 38% for each 1 SD increase in LVGFI (hazard ratio 0.62[95%CI 0.43–0.91]) and after adjustment by 46% (HR 0.54 [95%CI 0.32–0.89]). The association was consistent across subgroup analyses.Conclusion: In this study, an increase in CMR-LVGFI was associated with decreasing the long-term risk of MACEs with DCM after adjustment for traditional confounders.

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“…The steady-state free precession breath-hold cine images with 25 reconstructed phases were acquired. The detailed scanning parameters of cine images have been described previously ( 15 ).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Association Between Left Ventricular Global Function Index and Outcomes in Patients With Dilated Cardiomyopathy

Liu

Zhou

et al. 2021

Front. Cardiovasc. Med.

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“…Furthermore, CMR strain assessment by measuring low LV contractile reverses under dobutamine stress enabled prediction of biventricular fibrosis [61] and myocardial remodelling in patients with DCM, which was associated with a lower probability of functional recovery [62]. Importantly, biventricular dysfunction and a significant prognostic impact of RV GLS in patients with advanced staged DCM have been demonstrated beyond LV performance quantification [63].…”

Section: Cmr-ft In Non-ischemic Cardiomyopathiesmentioning

confidence: 99%

Quantification of Myocardial Deformation Applying CMR-Feature-Tracking—All About the Left Ventricle?

Lange

Schuster

2021

Curr Heart Fail Rep

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Purpose of Review Cardiac magnetic resonance-feature-tracking (CMR-FT)-based deformation analyses are key tools of cardiovascular imaging and applications in heart failure (HF) diagnostics are expanding. In this review, we outline the current range of application with diagnostic and prognostic implications and provide perspectives on future trends of this technique. Recent Findings By applying CMR-FT in different cardiovascular diseases, increasing evidence proves CMR-FT-derived parameters as powerful diagnostic and prognostic imaging biomarkers within the HF continuum partly outperforming traditional clinical values like left ventricular ejection fraction. Importantly, HF diagnostics and deformation analyses by CMR-FT are feasible far beyond sole left ventricular performance evaluation underlining the holistic nature and accuracy of this imaging approach. Summary As an established and continuously evolving technique with strong prognostic implications, CMR-FT deformation analyses enable comprehensive cardiac performance quantification of all cardiac chambers.

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“…FT-derived LV global longitudinal strain (GLS) assessment has been associated with prognosis in both NICM and ischemic cardiopathy, showing additional prognostic power when combined with the above-mentioned classical parameters ( 5 , 6 ). However, to date, only few studies have evaluated the prognostic impact of RV-GLS, calculated by CMR-FT analysis, in the setting of NICM ( 7 ), despite RVEF is a known prognostic tool in this setting ( 2 ). Therefore, the aim of this study was to test the possible prognostic role of RV-GLS measured by FT when added to standard, comprehensive CMR evaluation in a large cohort of Caucasian NICM patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy

Cittar

Cipriani

Merlo

et al. 2021

Front. Cardiovasc. Med.

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Aims: Left ventricular global longitudinal strain (GLS) by cardiac magnetic resonance feature tracking (CMR-FT) analysis has shown an incremental prognostic value compared to classical parameters in non-ischemic dilated cardiomyopathy (NICM). However, less is known about the role of right ventricular (RV) GLS. Our objective was to evaluate the prognostic impact of RV-GLS by CMR-FT analysis in a population of NICM patients.Methods: In this multicenter study, we examined NICM patients evaluated with a comprehensive CMR-FT study. Major cardiac events (MACEs) were considered as the study primary outcome measure and were defined as a composite of (a) cardiovascular death, (b) cardiac transplant or destination therapy ventricular assist device, (c) hospitalization for life-threatening ventricular arrhythmias or implantable cardiac defibrillator appropriate intervention. Heart failure (HF) related events, including hospitalizations and life-threatening arrhythmia-related events were considered as secondary end-points. Receiver operating time-dependent analysis were used to calculate the possible additional effect of RV-GLS to standard evaluation.Results: We consecutively enrolled 273 patients. During a median follow-up of 39 months, 41 patients (15%) experienced MACEs. RV-GLS and LV late gadolinium emerged as the strongest prognostic CMR-FT variables: their association provided an estimated 3-year MACEs rate of 29%. The addition of RV-GLS significantly improved the prognostic accuracy in predicting MACEs with respect to the standard evaluation including LGE (areas under the curve from 0.71 [0.66–0.82] to 0.76 [0.66–0.86], p = 0.03). On competing risk analysis, RV-GLS showed a significant ability to reclassify overall both HF-related and life-threatening arrhythmia-related events, regardless of LV and RV ejection fraction.Conclusions: In NICM patients, RV-GLS showed a significant prognostic role in reclassifying the risk of MACEs, incremental with respect to standard evaluation with standard prognostic parameters.

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Association between right ventricular strain and outcomes in patients with dilated cardiomyopathy

Cited by 37 publications

References 29 publications

Association Between Left Ventricular Global Function Index and Outcomes in Patients With Dilated Cardiomyopathy

Association Between Left Ventricular Global Function Index and Outcomes in Patients With Dilated Cardiomyopathy

Quantification of Myocardial Deformation Applying CMR-Feature-Tracking—All About the Left Ventricle?

Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy

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