Left ventricular long axis strain: a new prognosticator in non-ischemic dilated cardiomyopathy?

Journal of Cardiovascular Magnetic Resonance

Research

Fabian aus dem Siepen¹  Nisha Arenja¹  Franziska Rost¹  Lutz Frankenstein¹  Johannes H. Riffel¹  Tobias Taeger¹  Marius G. P. Keller¹  Florian Andre¹  Thomas Fritz¹  Philipp Ehlermann¹  Hugo A. Katus²  Benjamin Meder²  Sebastian J. Buss³ 

[1] Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany;Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany;DZHK (German Centre for Cardiovascular Research), partner site, Heidelberg, Germany;Department of Cardiology, University of Heidelberg, INF 410, 69120, Heidelberg, Germany;Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany;

关键词: Dilated cardiomyopathy;    Cardiovascular magnetic resonance;    Prognosis;    Left ventricular function;    Long axis strain;   

DOI  :  10.1186/s12968-016-0255-0

 received in 2016-02-10, accepted in 2016-05-27,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundLong axis strain (LAS) has been shown to be a fast assessable parameter representing global left ventricular (LV) longitudinal function in cardiovascular magnetic resonance (CMR). However, the prognostic value of LAS in cardiomyopathies with reduced left ventricular ejection fraction (LVEF) has not been evaluated yet.Methods and resultsIn 146 subjects with non-ischemic dilated cardiomyopathy (NIDCM, LVEF ≤45 %) LAS was assessed retrospectively from standard non-contrast SSFP cine sequences by measuring the distance between the epicardial border of the left ventricular apex and the midpoint of a line connecting the origins of the mitral valve leaflets in end-systole and end-diastole. The final values were calculated according to the strain formula.The primary endpoint of the study was defined as a combination of cardiac death, heart transplantation or aborted sudden cardiac death and occurred in 24 subjects during follow-up. Patients with LAS values > −5 % showed a significant higher rate of cardiac events independent of the presence of late gadolinium enhancement (LGE). The multivariate Cox regression analysis revealed that LVEDV/BSA (HR: 1.01, p < 0.05), presence of LGE (HR: 2.51, p < 0.05) and LAS (HR: 1.28, p < 0.05) were independent predictors for cardiac events. In a sequential cox regression analysis LAS offered significant incremental information (p < 0.05) for the prediction of outcome in addition to LGE and LVEDV/BSA. Using a dichotomous three point scoring model for risk stratification, including LVEF <35 %, LAS > −10 % and the presence of LGE, patients with 3 points had a significantly higher risk for cardiac events than those with 2 or less points.ConclusionAssessment of long axis function with LAS offers significant incremental information for the prediction of cardiac events in NIDCM and improves risk stratification beyond established CMR parameters.

【 授权许可】

CC BY   
© The Author(s). 2016