Key result
Each 1% decrease in the absolute value of right ventricular global longitudinal strain measured by cardiac magnetic resonance was associated with a 7% increased risk of major adverse cardiovascular events (HR 1.07).
Why the study?
Existing studies evaluating the prognostic value of right ventricular strain determined using cardiac magnetic resonance were limited by small sample size and low event number.
Does right ventricular strain measured with CMR predict major adverse cardiac events in adults with cardiovascular disease?
Systematic Review (n=3,239)
Does right ventricular strain measured with CMR predict major adverse cardiac events in adults with cardiovascular disease?
Hazard Ratio: 1.07 (95% CI 1.05–1.08)
p-value: p=0.013
Right ventricular global longitudinal strain assessed by cardiac magnetic resonance is a significant independent predictor of major adverse cardiovascular events across various cardiovascular diseases.
Supports CMR RV GLS for MACE risk stratification in practice; extends prognostic evidence across cardiovascular diseases.
Objective: To evaluate the prognostic value of cardiac magnetic resonance (CMR) imaging in assessing right ventricular strain via meta-analysis of current literature. Background: Right ventricular strain recorded with CMR serves as a novel indicator to quantify myocardial deformation. Although several studies have reported the predictive value of right ventricular strain determined using CMR, their validity is limited by small sample size and low event number. Methods: Embase, Medline and Web of Science were searched for studies assessing the prognostic value of myocardial strain. The primary endpoint was a composite of all-cause mortality, cardiovascular death, aborted sudden cardiac death, heart transplantation and heart failure admissions. Results: A total of 14 studies met the selection criteria and were included in the analysis (n = 3239 adults). The random-effects model showed the association of parameters of right ventricular strain with major adverse cardiac events. Absolute value of right ventricular global longitudinal strain was negatively correlated with right ventricular ejection fraction (hazard ratio: 1.07, 95% confidence interval: 1.05–1.08; p = 0.013). Despite the small number of studies, right ventricular radial strain, right ventricular circumferential strain and right ventricular long-axis strain displayed potential prognostic value. Conclusions: Right ventricular strain measured with CMR is an effective prognostic indicator for cardiovascular disease.
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Bo et al. (2022) conducted a systematic review in Cardiovascular disease (n=3,239). Right ventricular global longitudinal strain (RVGLS) measured by CMR vs. Per 1% decrease in absolute RVGLS was evaluated on Composite of all-cause mortality, cardiovascular death, aborted sudden cardiac death, heart transplantation and heart failure admissions (HR 1.07, 95% CI 1.05-1.08, p=0.013). Each 1% decrease in the absolute value of right ventricular global longitudinal strain measured by cardiac magnetic resonance was associated with a 7% increased risk of major adverse cardiovascular events (HR 1.07).
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