Key result
CMR reveals ~77% lower radial strain in basal septal versus other segments in DCM patients.
Why the study?
Data on cardiovascular magnetic resonance feature tracking (CMR-FT) in dilated cardiomyopathy (DCM) were limited, and patterns of myocardial strain and their association with focal myocardial scarring remained unclear.
Does cardiovascular magnetic resonance feature tracking identify an association between myocardial strain patterns and focal myocardial scarring in patients with dilated cardiomyopathy?
Cross-Sectional (n=39)
Does cardiovascular magnetic resonance feature tracking identify an association between myocardial strain patterns and focal myocardial scarring in patients with dilated cardiomyopathy?
Absolute Event Rate: 4.89% vs 21.2%
p-value: p=<0.001
CMR feature tracking reveals impaired radial strain coinciding with focal myocardial fibrosis in basal septal LV segments of DCM patients, though a general effect of fibrosis on strain was not significant.
Impaired basal septal radial strain may mark focal fibrosis in DCM; leaves open broader strain-scarring associations.
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 (LV SAX -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 LV SAX -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.
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Chevalier et al. (2022) conducted a cross-sectional in Dilated cardiomyopathy (n=39). Cardiovascular magnetic resonance feature tracking (CMR-FT) vs. Other myocardial segments was evaluated on Average short-axis LV radial strain (LV SAX-RS) in basal septal segments II and III vs other segments (p=<0.001). Cardiovascular magnetic resonance feature tracking revealed significantly lower radial strain in basal septal segments compared to other segments in DCM patients (4.89% vs 21.20%; p<0.001).
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