Global constructive work (GCW) and CMRI-derived LVEF independently predicted left ventricular myocardial fibrosis in patients with dilated cardiomyopathy, with GCW showing higher accuracy than global longitudinal strain.
Observational (n=57)
No
Do echocardiographic non-invasive myocardial work indices predict LV myocardial fibrosis in patients with dilated cardiomyopathy?
Non-invasive myocardial work indices, particularly global constructive work, are significant predictors of LV myocardial fibrosis in patients with dilated cardiomyopathy, performing better than global longitudinal strain.
Effect estimate: OR 0.995 (95% CI 0.992-0.999)
p-value: p=0.004
Objectives: To analyze the association between global myocardial work indices evaluated by non-invasive left ventricular (LV) pressure-strain loop (PSL) and LV myocardial fibrosis in patients with dilated cardiomyopathy (DCM). Methods: A total of 57 patients with DCM were included in this prospective study. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE) and global longitudinal strain (GLS) were measured using LVPSL. LV volumes and LV ejection fraction (LVEF) were evaluated using cardiac magnetic resonance imaging (CMRI), LV myocardial fibrosis was estimated at CMRI by qualitative assessment of late gadolinium enhancement (LGE). According to the CMRI, the studied population was divided into two groups, namely: patients without LGE (LGE-) and patients with LGE (LGE+). Results: The LGE+ group presented with increased age, LV end systolic volume (LVESV) index and reduced GWI, GCW, GWE, GLS, CMRI-derived LVEF (LVEF CMRI ), the differences between the two groups were statistically significant ( P 0.05). After correcting for age and LVESV index, LVEF CMRI , GLS, GWI, GCW, and GWE retained independent associations with LV myocardial fibrosis. According to receiver operating characteristics (ROC) analysis, LVEF CMRI , and GCW showed larger AUC and higher accuracy, sensitivity, and specificity than GLS, the accuracy of predicting LV myocardial fibrosis ranged from high to low as: LVEF CMRI , GCW, GWE, GWI, and GLS. Conclusions: LVEF CMRI , GWI, GCW, GWE, and GLS remained significant predictors of LV myocardial fibrosis. LVEF CMRI , and GCW appeared to better predict LV myocardial fibrosis compared with GLS.
Cui et al. (Mon,) conducted a observational in Dilated cardiomyopathy (n=57). Echocardiographic non-invasive myocardial work indices (GCW) was evaluated on Left ventricular myocardial fibrosis (LGE+) (OR 0.995, 95% CI 0.992-0.999, p=0.004). Global constructive work (GCW) and CMRI-derived LVEF independently predicted left ventricular myocardial fibrosis in patients with dilated cardiomyopathy, with GCW showing higher accuracy than global longitudinal strain.
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