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

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 ventricula...

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Autores principales:	Marco Cittar, Alberto Cipriani, Marco Merlo, Giancarlo Vitrella, Marco Masè, Anna Carrer, Giulia Barbati, Manuel Belgrano, Lorenzo Pagnan, Manuel De Lazzari, Benedetta Giorgi, Maria A. Cova, Sabino Iliceto, Cristina Basso, Davide Stolfo, Gianfranco Sinagra, Martina Perazzolo Marra
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	non-ischemic cardiomyopathy cardiac magnetic resonance feature-tracking analysis right ventricle global longitudinal strain prognosis heart failure Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/acceeda14be848f58a75bc4e552202f7
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spelling	oai:doaj.org-article:acceeda14be848f58a75bc4e552202f72021-12-01T16:21:00ZPrognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy2297-055X10.3389/fcvm.2021.765274https://doaj.org/article/acceeda14be848f58a75bc4e552202f72021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.765274/fullhttps://doaj.org/toc/2297-055XAims: 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.Marco CittarAlberto CiprianiMarco MerloGiancarlo VitrellaMarco MasèAnna CarrerGiulia BarbatiManuel BelgranoLorenzo PagnanManuel De LazzariBenedetta GiorgiMaria A. CovaSabino IlicetoCristina BassoDavide StolfoGianfranco SinagraMartina Perazzolo MarraFrontiers Media S.A.articlenon-ischemic cardiomyopathycardiac magnetic resonance feature-tracking analysisright ventricle global longitudinal strainprognosisheart failureDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	non-ischemic cardiomyopathy cardiac magnetic resonance feature-tracking analysis right ventricle global longitudinal strain prognosis heart failure Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	non-ischemic cardiomyopathy cardiac magnetic resonance feature-tracking analysis right ventricle global longitudinal strain prognosis heart failure Diseases of the circulatory (Cardiovascular) system RC666-701 Marco Cittar Alberto Cipriani Marco Merlo Giancarlo Vitrella Marco Masè Anna Carrer Giulia Barbati Manuel Belgrano Lorenzo Pagnan Manuel De Lazzari Benedetta Giorgi Maria A. Cova Sabino Iliceto Cristina Basso Davide Stolfo Gianfranco Sinagra Martina Perazzolo Marra Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy
description	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.
format	article
author	Marco Cittar Alberto Cipriani Marco Merlo Giancarlo Vitrella Marco Masè Anna Carrer Giulia Barbati Manuel Belgrano Lorenzo Pagnan Manuel De Lazzari Benedetta Giorgi Maria A. Cova Sabino Iliceto Cristina Basso Davide Stolfo Gianfranco Sinagra Martina Perazzolo Marra
author_facet	Marco Cittar Alberto Cipriani Marco Merlo Giancarlo Vitrella Marco Masè Anna Carrer Giulia Barbati Manuel Belgrano Lorenzo Pagnan Manuel De Lazzari Benedetta Giorgi Maria A. Cova Sabino Iliceto Cristina Basso Davide Stolfo Gianfranco Sinagra Martina Perazzolo Marra
author_sort	Marco Cittar
title	Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy
title_short	Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy
title_full	Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy
title_fullStr	Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy
title_full_unstemmed	Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy
title_sort	prognostic significance of feature-tracking right ventricular global longitudinal strain in non-ischemic dilated cardiomyopathy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/acceeda14be848f58a75bc4e552202f7
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Prognostic Significance of Feature-Tracking Right Ventricular Global Longitudinal Strain in Non-ischemic Dilated Cardiomyopathy

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