Key result
Dilated cardiomyopathy exhibits more impaired global circumferential strain than ischemic cardiomyopathy.
Why the study?
The study aimed to detect differences in left ventricular mechanics between patients with dilated cardiomyopathy and ischemic cardiomyopathy matched using propensity scores.
Does CMR-derived myocardial strain analysis differentiate between ischemic and dilated cardiomyopathy in patients with similar ejection fraction and ventricular geometry?
Observational (n=144)
No
Does CMR-derived myocardial strain analysis differentiate between ischemic and dilated cardiomyopathy in patients with similar ejection fraction and ventricular geometry?
Absolute Event Rate: -10% vs -12.2%
p-value: p=0.002
CMR-derived global circumferential and radial strain are significantly more impaired in dilated cardiomyopathy compared to ischemic cardiomyopathy, suggesting inherently different myocardial mechanics despite similar phenotypes.
May differentiate DCM from ICM via circumferential strain despite matched phenotypes; hypothesis-generating and requires prospective validation before clinical use.
Left ventricular (LV) longitudinal, circumferential, and radial motion can be measured using feature tracking of cardiac magnetic resonance (CMR) images. The aim of our study was to detect differences in LV mechanics between patients with dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM) who were matched using a propensity score-based model. Between April 2017 and October 2019, 1224 patients were included in our CMR registry, among them 141 with ICM and 77 with DCM. Propensity score matching was used to pair patients based on their indexed end-diastolic volume (EDVi), ejection fraction (EF), and septal T1 relaxation time (psmatch2 module L Feature tracking provided six parameters for global longitudinal, circumferential, and radial strain with corresponding strain rates in each group. Strain parameters were compared between matched pairs of ICM and DCM patients using paired t tests. Propensity score matching yielded 72 patients in each group (DCM mean age 58.6 ± 11.6 years, 15 females; ICM mean age 62.6 ± 13.2 years, 11 females, p = 0.084 and 0.44 respectively; LV-EF 32.2 ± 13.5% vs. 33.8 ± 12.1%, p = 0.356; EDVi 127.2 ± 30.7 ml/m 2 vs. 121.1 ± 41.8 ml/m 2 , p = 0.251; native T1 values 1165 ± 58 ms vs. 1167 ± 70 ms, p = 0.862). There was no difference in global longitudinal strain between DCM and ICM patients (− 10.9 ± 5.5% vs. − 11.2 ± 4.7%, p = 0.72), whereas in DCM patients there was a significant reduction in global circumferential strain (− 10.0 ± 4.5% vs. − 12.2 ± 4.7%, p = 0.002) and radial strain (17.1 ± 8.51 vs. 21.2 ± 9.7%, p = 0.039). Our data suggest that ICM and DCM patients have inherently different myocardial mechanics, even if phenotypes are similar. Our data show that GCS is significantly more impaired in DCM patients. This feature may help in more thoroughly characterizing cardiomyopathy patients.
No takes yet. Share an insight, caveat, or question.
Vietheer et al. (2021) conducted an observational in Dilated and Ischemic Cardiomyopathy (n=144). Dilated cardiomyopathy (DCM) vs. Ischemic cardiomyopathy (ICM) was evaluated on Global circumferential strain (GCS) (p=0.002). Patients with dilated cardiomyopathy exhibited significantly more impaired global circumferential strain (-10.0% vs. -12.2%, p=0.002) compared to propensity-matched patients with ischemic cardiomyopathy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: