Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy

Journal of Cardiovascular Magnetic Resonance

Research

Berthold Stegemann¹  Erica L. S. Lin²  Amar Ahmed²  William E. Moody³  Jonathan N. Townend³  Richard P. Steeds³  Robin J. Taylor³  Fraz Umar³  Francisco Leyva⁴  Wojciech Mazur⁵ 

[1] Bakken Research Centre, Medtronic Inc, Maastricht, The Netherlands;Centre for Cardiovascular Sciences, University of Birmingham, Birmingham, UK;Centre for Cardiovascular Sciences, University of Birmingham, Birmingham, UK;Department of Cardiology, The Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, B15 2WB, Birmingham, UK;Department of Cardiology, The Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, B15 2WB, Birmingham, UK;Aston Medical Research Institute, Aston Medical School, University of Aston, Birmingham, UK;The Christ Hospital Heart and Vascular Center, Cincinnati, OH, USA;

关键词: Heart failure;    Non ischemic dilated cardiomyopathy;    Mid-wall fibrosis;    Feature-tracking;    Cardiovascular magnetic resonance;    Torsion;    Myocardial deformation;   

DOI  :  10.1186/s12968-015-0221-2

 received in 2015-08-06, accepted in 2015-12-22,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundLeft ventricular (LV) mid-wall fibrosis (MWF), which occurs in about a quarter of patients with non-ischemic cardiomyopathy (NICM), is associated with high risk of pump failure. The mid LV wall is the site of circumferential myocardial fibers. We sought to determine the effect of MWF on LV myocardial mechanics.MethodsPatients with NICM (n = 116; age: 62.8 ± 13.2 years; 67 % male) underwent late gadolinium enhancement cardiovascular magnetic resonance (CMR) and were categorized according to the presence (+) or absence (−) of MWF. Feature tracking (FT) CMR was used to assess myocardial deformation.ResultsDespite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (Ɛcc: −6.6 % vs −9.4 %, P = 0.004), but similar longitudinal (Ɛll: −7.6 % vs. −9.4 %, p = 0.053) and radial (Ɛrr: 14.6 % vs. 17.8 % p = 0.18) strain. Compared with − MWF, + MWF was associated with reduced LV systolic, circumferential strain rate (−0.38 ± 0.1 vs −0.56 ± 0.3 s−1, p = 0.005) and peak LV twist (4.65 vs. 6.31°, p = 0.004), as well as rigid LV body rotation (64 % vs 28 %, P <0.001). In addition, +MWF was associated with reduced LV diastolic strain rates (DSRcc: 0.34 vs. 0.46 s−1; DSRll: 0.38 vs. 0.50s−1; DSRrr: −0.55 vs. −0.75 s−1; all p <0.05).ConclusionsMWF is associated with reduced LV global circumferential strain, strain rate and torsion. In addition, MWF is associated with rigid LV body rotation and reduced diastolic strain rates. These systolic and diastolic disturbances may be related to the increased risk of pump failure observed in patients with NICM and MWF.

【 授权许可】

CC BY   
© Taylor et al. 2016