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Global Longitudinal Strain Associates with Adverse Outcomes in Nonischemic Dilated Cardiomyopathy without Myocardial Scar1Fuwai Hospital and National Center for Cardiovascular Diseases, Beijing, China
Synopsis
Keywords: Cardiomyopathy, Cardiomyopathy
Despite late gadolinium enhancement (LGE) have already proved a strong association with adverse outcomes in non-ischemic dilated cardiomyopathy (NIDCM) patients, for those who with negative LGE, mortality remains a clinical issue. This study therefore aimed to investigate the prognostic impact of cardiac magnetic resonance (CMR) feature tracking derived strain in NIDCM patients without myocardial scar.
Purpose
Despite late gadolinium enhancement (LGE) have already proved a strong association with adverse outcomes in non-ischemic dilated cardiomyopathy (NIDCM) patients, for those who with negative LGE, mortality remains a clinical issue. This study therefore aimed to investigate the prognostic impact of cardiac magnetic resonance (CMR) feature tracking derived strain in NIDCM patients without myocardial scar.Methods
Consecutive patients with NIDCM who underwent CMR between 2012 and 2014 were retrospectively evaluated, and those with positive LGE were excluded. Ventricular systolic dysfunction was measured as LV and RV global longitudinal strain (GLS) by CMR feature tracking. All patients were followed up for the combined endpoints (CE) including all-cause mortality and heart transplantation.Results
A total of 171 patients with NIDCM were followed up for a median of 5.9 years, and 26 patients reached CE. Both LV and RV GLS were significantly associated with endpoints. Using separate multivariate COX analysis models, LV-GLS offered incremental prognostic value for endpoints beyond NYHA class and NT-proBNP(HR, 1.377; P<0.001). RV-GLS also exhibited an independent prognostic value in addition to NYHA class, NT-proBNP, and anti-arrhythmic medication(HR, 1.142; P=0.002). Furthermore, among patients of LVEF less than 35%, patients with a LVGLS>-12.92% had a higher rate of CE(log-rank, P<0.001).Conclusion
Biventricular GLS associated with adverse outcomes in NIDCM patients without myocardial scar, and provided risk stratification value in the subgroup of reduced EF.Acknowledgements
This study was made possible by the wonderful work of colleagues in department of Magnetic Resonance Imaging, Fuwai hospital, Beijing, China.References
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