CMR feature tracking in patients with dilated cardiomyopathy: patterns of myocardial strain and focal fibrosis
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CMR feature tracking in patients with dilated cardiomyopathy: patterns of myocardial strain and focal fibrosis. / Chevalier, Céleste; Kremer, Katja; Cavus, Ersin; Schneider, Jan; Jahnke, Charlotte; Schön, Gerhard; Radunski, Ulf K; Tahir, Enver; Adam, Gerhard; Lund, Gunnar; Kirchhof, Paulus; Blankenberg, Stefan; Muellerleile, Kai.
in: OPEN HEART, Jahrgang 9, Nr. 2, e002013, 12.2022.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - CMR feature tracking in patients with dilated cardiomyopathy: patterns of myocardial strain and focal fibrosis
AU - Chevalier, Céleste
AU - Kremer, Katja
AU - Cavus, Ersin
AU - Schneider, Jan
AU - Jahnke, Charlotte
AU - Schön, Gerhard
AU - Radunski, Ulf K
AU - Tahir, Enver
AU - Adam, Gerhard
AU - Lund, Gunnar
AU - Kirchhof, Paulus
AU - Blankenberg, Stefan
AU - Muellerleile, Kai
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/12
Y1 - 2022/12
N2 - BACKGROUND: There is a paucity of data on cardiovascular magnetic resonance feature tracking (CMR-FT) in patients with dilated cardiomyopathy (DCM). We aimed at describing global and segmental myocardial strain patterns and a potential association with the presence of focal myocardial scarring in DCM patients by CMR-FT.METHODS: Thirty-nine patients with DCM and reduced left ventricular (LV) ejection fraction (mean 21±8%) underwent CMR including standard cine steady-state free precession (SSFP) sequences and late gadolinium enhancement (LGE). We measured global LV longitudinal as well as global and segmental circumferential and radial strain. The presence of focal myocardial fibrosis was assessed on LGE images.RESULTS: Nineteen patients had focal myocardial fibrosis on LGE images with the highest prevalence in the basal septal segments II and III, which were affected in 12 (63%) and 13 (68%) patients. Furthermore, there was a significantly lower average short-axis LV radial strain (LVSAX-RS) in these segments (4.89 (-1.55 to 11.34) %) compared with the average of the other myocardial segments (21.20 (17.36 to 25.05)%; p<0.001) after adjusting for LGE and left-bundle branch block (LBBB). In general, LV segments with LGE had lower model-based mean LVSAX-RS values (17.65 (10.37 to 24.93) %) compared with those without LGE (19.40 (15.43 to 23.37) %), but this effect was not significant after adjusting for the presence of LBBB (p=0.630).CONCLUSION: Our findings revealed a coincidence of impaired radial strain and focal myocardial fibrosis in the basal septal LV myocardial segments of patients with DCM. Regardless of this pattern, we did not find a general, significant effect of myocardial fibrosis on strain in our cohort. Future studies are required to assess the potential prognostic implications of myocardial strain patterns in addition to the assessment of myocardial fibrosis in patients with DCM.
AB - BACKGROUND: There is a paucity of data on cardiovascular magnetic resonance feature tracking (CMR-FT) in patients with dilated cardiomyopathy (DCM). We aimed at describing global and segmental myocardial strain patterns and a potential association with the presence of focal myocardial scarring in DCM patients by CMR-FT.METHODS: Thirty-nine patients with DCM and reduced left ventricular (LV) ejection fraction (mean 21±8%) underwent CMR including standard cine steady-state free precession (SSFP) sequences and late gadolinium enhancement (LGE). We measured global LV longitudinal as well as global and segmental circumferential and radial strain. The presence of focal myocardial fibrosis was assessed on LGE images.RESULTS: Nineteen patients had focal myocardial fibrosis on LGE images with the highest prevalence in the basal septal segments II and III, which were affected in 12 (63%) and 13 (68%) patients. Furthermore, there was a significantly lower average short-axis LV radial strain (LVSAX-RS) in these segments (4.89 (-1.55 to 11.34) %) compared with the average of the other myocardial segments (21.20 (17.36 to 25.05)%; p<0.001) after adjusting for LGE and left-bundle branch block (LBBB). In general, LV segments with LGE had lower model-based mean LVSAX-RS values (17.65 (10.37 to 24.93) %) compared with those without LGE (19.40 (15.43 to 23.37) %), but this effect was not significant after adjusting for the presence of LBBB (p=0.630).CONCLUSION: Our findings revealed a coincidence of impaired radial strain and focal myocardial fibrosis in the basal septal LV myocardial segments of patients with DCM. Regardless of this pattern, we did not find a general, significant effect of myocardial fibrosis on strain in our cohort. Future studies are required to assess the potential prognostic implications of myocardial strain patterns in addition to the assessment of myocardial fibrosis in patients with DCM.
KW - Humans
KW - Cardiomyopathy, Dilated/diagnostic imaging
KW - Magnetic Resonance Imaging, Cine/methods
KW - Contrast Media
KW - Gadolinium
KW - Fibrosis
KW - Cardiomyopathies/diagnostic imaging
U2 - 10.1136/openhrt-2022-002013
DO - 10.1136/openhrt-2022-002013
M3 - SCORING: Journal article
C2 - 36522125
VL - 9
JO - OPEN HEART
JF - OPEN HEART
SN - 2053-3624
IS - 2
M1 - e002013
ER -