Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain

Abstract Background Data on the prognostic value of left ventricular (LV) morphological and functional parameters including LV rotation in patients with dilated cardiomyopathy (DCM) using cardiovascular magnetic resonance (CMR) are currently scarce. In this study, we assessed the prognostic value of...

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Autores principales:	Andreas Ochs, Johannes Riffel, Marco M. Ochs, Nisha Arenja, Thomas Fritz, Christian Galuschky, Andreas Schuster, Oliver Bruder, Heiko Mahrholdt, Evangelos Giannitsis, Norbert Frey, Hugo A. Katus, Sebastian J. Buss, Florian André
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Dilated cardiomyopathy Cardiac magnetic resonance Strain LV torsion Prognosis Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/dadd883bb4834f64a21ed6ace426e901
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spelling	oai:doaj.org-article:dadd883bb4834f64a21ed6ace426e9012021-12-05T12:08:31ZMyocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain10.1186/s12968-021-00829-x1532-429Xhttps://doaj.org/article/dadd883bb4834f64a21ed6ace426e9012021-12-01T00:00:00Zhttps://doi.org/10.1186/s12968-021-00829-xhttps://doaj.org/toc/1532-429XAbstract Background Data on the prognostic value of left ventricular (LV) morphological and functional parameters including LV rotation in patients with dilated cardiomyopathy (DCM) using cardiovascular magnetic resonance (CMR) are currently scarce. In this study, we assessed the prognostic value of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) and LV torsion using CMR feature tracking (FT). Methods CMR was performed in 350 DCM patients and 70 healthy subjects across 5 different European CMR Centers. Myocardial strain parameters were retrospectively assessed from conventional balanced steady-state free precession cine images applying FT. A combined primary endpoint (cardiac death, heart transplantation, aborted sudden cardiac death) was defined for the assessment of clinical outcome. Results GLS, GCS, GRS and LV torsion were significantly lower in DCM patients than in healthy subjects (all p < 0.001). The primary endpoint occurred in 59 (18.7%) patients [median follow-up 4.2 (2.0–5.6) years]. In the univariate analyses all strain parameters showed a significant prognostic value (p < 0.05). In the multivariate model, LV strain parameters, particularly GLS provided an incremental prognostic value compared to established CMR parameters like LV ejection fraction and late gadolinium enhancement. A scoring model including six categorical variables of standard CMR and strain parameters differentiated further risk subgroups. Conclusion LV strain assessed with CMR FT has a high prognostic value in patients with DCM, surpassing routine and dedicated functional parameters. Thus, CMR strain imaging may contribute to the improvement of risk stratification in DCM.Andreas OchsJohannes RiffelMarco M. OchsNisha ArenjaThomas FritzChristian GaluschkyAndreas SchusterOliver BruderHeiko MahrholdtEvangelos GiannitsisNorbert FreyHugo A. KatusSebastian J. BussFlorian AndréBMCarticleDilated cardiomyopathyCardiac magnetic resonanceStrainLV torsionPrognosisDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Dilated cardiomyopathy Cardiac magnetic resonance Strain LV torsion Prognosis Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Dilated cardiomyopathy Cardiac magnetic resonance Strain LV torsion Prognosis Diseases of the circulatory (Cardiovascular) system RC666-701 Andreas Ochs Johannes Riffel Marco M. Ochs Nisha Arenja Thomas Fritz Christian Galuschky Andreas Schuster Oliver Bruder Heiko Mahrholdt Evangelos Giannitsis Norbert Frey Hugo A. Katus Sebastian J. Buss Florian André Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain
description	Abstract Background Data on the prognostic value of left ventricular (LV) morphological and functional parameters including LV rotation in patients with dilated cardiomyopathy (DCM) using cardiovascular magnetic resonance (CMR) are currently scarce. In this study, we assessed the prognostic value of global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS) and LV torsion using CMR feature tracking (FT). Methods CMR was performed in 350 DCM patients and 70 healthy subjects across 5 different European CMR Centers. Myocardial strain parameters were retrospectively assessed from conventional balanced steady-state free precession cine images applying FT. A combined primary endpoint (cardiac death, heart transplantation, aborted sudden cardiac death) was defined for the assessment of clinical outcome. Results GLS, GCS, GRS and LV torsion were significantly lower in DCM patients than in healthy subjects (all p < 0.001). The primary endpoint occurred in 59 (18.7%) patients [median follow-up 4.2 (2.0–5.6) years]. In the univariate analyses all strain parameters showed a significant prognostic value (p < 0.05). In the multivariate model, LV strain parameters, particularly GLS provided an incremental prognostic value compared to established CMR parameters like LV ejection fraction and late gadolinium enhancement. A scoring model including six categorical variables of standard CMR and strain parameters differentiated further risk subgroups. Conclusion LV strain assessed with CMR FT has a high prognostic value in patients with DCM, surpassing routine and dedicated functional parameters. Thus, CMR strain imaging may contribute to the improvement of risk stratification in DCM.
format	article
author	Andreas Ochs Johannes Riffel Marco M. Ochs Nisha Arenja Thomas Fritz Christian Galuschky Andreas Schuster Oliver Bruder Heiko Mahrholdt Evangelos Giannitsis Norbert Frey Hugo A. Katus Sebastian J. Buss Florian André
author_facet	Andreas Ochs Johannes Riffel Marco M. Ochs Nisha Arenja Thomas Fritz Christian Galuschky Andreas Schuster Oliver Bruder Heiko Mahrholdt Evangelos Giannitsis Norbert Frey Hugo A. Katus Sebastian J. Buss Florian André
author_sort	Andreas Ochs
title	Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain
title_short	Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain
title_full	Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain
title_fullStr	Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain
title_full_unstemmed	Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain
title_sort	myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain
publisher	BMC
publishDate	2021
url	https://doaj.org/article/dadd883bb4834f64a21ed6ace426e901
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Myocardial mechanics in dilated cardiomyopathy: prognostic value of left ventricular torsion and strain

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