What does this research mean for the field?

Cardiac magnetic resonance feature tracking (CMR-FT) strain parameters, specifically global radial, circumferential, and longitudinal strain, have significant diagnostic value in identifying patients with nondilated left-ventricular cardiomyopathy and preserved ejection fraction (NDLVC-pLVEF). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the effectiveness of cardiac magnetic resonance feature tracking in nondilated left-ventricular cardiomyopathy with preserved ejection fraction.

May 26, 2026Open Access

Evaluation of nondilated left-ventricular cardiomyopathy with preserved ejection fraction using cardiac magnetic resonance feature tracking

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Nondilated left ventricular cardiomyopathy with preserved ejection fraction (NDLVC-pLVEF) (n=266). Intervention: Cardiac magnetic resonance feature tracking (CMR-FT) vs. Healthy controls. Primary outcome: Diagnostic performance (AUC) of left ventricular global longitudinal strain (LVGLS) (AUC 0.763, 95% CI 0.700-0.827).

Key Result

Cardiac magnetic resonance feature tracking effectively differentiated patients with nondilated left ventricular cardiomyopathy and preserved ejection fraction from healthy controls, with LVGLS yielding an AUC of 0.763.

Key Points

To evaluate the effectiveness of cardiac magnetic resonance feature tracking in nondilated left-ventricular cardiomyopathy with preserved ejection fraction.
Retrospective study involving 188 patients with nondilated left-ventricular cardiomyopathy and 78 controls.
Performed cardiac magnetic resonance imaging and analyzed strain parameters using CVI42 software.
Conducted ROC curve analysis to assess diagnostic performance of strain parameters.
NDLVC-pLVEF patients showed increased left-ventricular myocardial mass and decreased LVGRS and LVGCS (P < 0.05).
ROC analysis indicated cut-off values for LVGRS, LVGCS, and LVGLS as 36.66%, −18.49%, and −13.90%, respectively, demonstrating sensitivity and specificity metrics for the parameters.

Study Design

Type

Case-Control (n=266)

Blinding

Double-blind

Multicenter

Structured PICO

Does cardiac magnetic resonance feature tracking (CMR-FT) accurately identify subclinical myocardial strain impairment in patients with nondilated left-ventricular cardiomyopathy and preserved ejection fraction compared to healthy controls?

Population

188 patients with nondilated left-ventricular cardiomyopathy and preserved left-ventricular ejection fraction (NDLVC-pLVEF, LVEF ≥ 50%), mean age 43.30, 59.04% male, and 78 age- and sex-matched healthy controls. Excluded: history of valvular heart disease, congenital heart disease, ischemic heart disease, or other cardiac conditions.

Intervention

Cardiac magnetic resonance feature tracking (CMR-FT) to measure left-ventricular global strain parameters including left-ventricular global radial strain (LVGRS), left-ventricular global circumferential strain (LVGCS), and left-ventricular global longitudinal strain (LVGLS).

Comparator

Age- and sex-matched healthy controls undergoing the same cardiac magnetic resonance imaging protocol.

Outcome

Diagnostic performance of left-ventricular global strain parameters (LVGRS, LVGCS, LVGLS) for discriminating NDLVC-pLVEF from healthy controls, evaluated using receiver-operating characteristic (ROC) curve analysis.surrogate

CMR-FT effectively identifies subclinical myocardial strain impairment in patients with nondilated left-ventricular cardiomyopathy and preserved ejection fraction, providing a valuable noninvasive diagnostic tool.

Main Result

Effect estimate: AUC 0.763 (95% CI 0.700-0.827)

Limitations

Relatively small sample size necessitating future studies with larger cohorts
NDLVC cohort was analyzed as a heterogeneous phenotypic group without investigating specific underlying etiologies
Absence of prognostic follow-up data limits assessment of predictive value for MACE and arrhythmia risk
Lack of multiparametric imaging data such as T1 mapping and LGE for myocardial tissue characterization

Abstract

Objective To investigate the value of cardiac magnetic resonance feature tracking (CMR-FT) in evaluating patients with nondilated left-ventricular cardiomyopathy and preserved left-ventricular ejection fraction (NDLVC-pLVEF). Methods This retrospective study included 188 patients with NDLVC and normal left-ventricular ejection fraction (LVEF, ≥ 50%) who underwent cardiac magnetic resonance at Beijing Anzhen Hospital between January 2018 and January 2025, along with 78 age- and sex-matched healthy controls. Using CVI42 postprocessing software, conventional left/right-ventricular function parameters and left-ventricular global strain parameters—including left-ventricular global radial strain (LVGRS), left-ventricular global circumferential strain (LVGCS), and left-ventricular global longitudinal strain (LVGLS)—were obtained. Intergroup differences were analyzed, and the diagnostic performance of strain parameters was evaluated using receiver-operating characteristic (ROC) curve analysis. Results Compared with controls, the NDLVC-pLVEF group exhibited significantly increased absolute values of left-ventricular myocardial mass and LVGLS (P < 0.05), whereas those of LVEF, LVGRS, and LVGCS were significantly decreased (P < 0.05). ROC analysis revealed that the cut-off values of LVGRS, LVGCS, and LVGLS for discriminating the two groups were 36.66%, − 18.49%, and − 13.90%, with sensitivities of 78.70%, 53.20%, and 68.60%; specificities of 64.10%, 74.40%, and 74.40%, and area under the curve values of 0.745, 0.651, and 0.763, respectively. Conclusion CMR-FT demonstrates diagnostic value in identifying patients with NDLVC-pLVEF, with LVGRS, LVGCS, and LVGLS showing considerable diagnostic performance.

Bookmark

View Full Paper