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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Usefulness of Left Ventricular Strain by Cardiac Magnetic Resonance Feature-Tracking to Predict Cardiovascular Events in Patients With and Without Heart Failure
The American journal of cardiology, v 123(8), pp 1301-1308
15 Apr 2019
PMID: 30717885
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
There is controversy regarding the utility of left ventricular (LV) mechanics assessed by feature-tracking steady-state free-precession (FT-SSFP), a readily implementable technique in clinical practice. In particular, whether LV mechanics assessed by FT-SSFP predicts outcomes in subjects with heart failure (HF) with reduced ejection fraction (HFrEF), with preserved ejection fraction (HFpEF), or without HF is unknown. We aimed to assess whether LV mechanics measured with FT-SSFP cine magnetic resonance imaging (MRI) predicts adverse outcomes. We prospectively enrolled 612 adults without HF (n = 402), with HF with reduced ejection fraction (HFrEF; n = 113), or HFpEF (n = 97) and assessed LV strain using FT-SSFP cine MRI. Over a median follow-up of 39.5 months, 75 participants had an HF admission, and 85 died. In Cox proportional hazards models, lower global longitudinal (Standardized hazard ratio 1.56, 95% confidence interval [CI] 1.22 to 2.00, p = 0.0004), circumferential (Standardized HR 1.46, 95% CI 1.08 to 1.95, p = 0.0123), and radial strain (Standardized HR 0.59, 95% CI 0.43 to 0.83, p = 0.0019) were independently associated with the composite endpoint, after adjustment for HF status, LV ejection fraction (LVEF), age, sex, ethnicity, body mass index, systolic and diastolic blood pressure, hypertension, diabetes, coronary artery disease, and glomerular filtration rate. Furthermore, global longitudinal strain stratified the risk of adverse outcomes across tertiles better than LVEF. In analyses that included only participants with a preserved LVEF, systolic radial, circumferential and longitudinal strain were independently predictive of adverse outcomes. We conclude that LV longitudinal, circumferential and radial strain measured using FT-SSFP cine MRI (a readily implementable technique in clinical practice) predict the risk of adverse events, independently of LVEF.
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Details
- Title
- Usefulness of Left Ventricular Strain by Cardiac Magnetic Resonance Feature-Tracking to Predict Cardiovascular Events in Patients With and Without Heart Failure
- Creators
- Mayank Sardana - University of California San Francisco, San Francisco, CaliforniaPrasad Konda - Drexel University, College of MedicineZeba Hashmath - Perelman Center for Advanced Medicine, Philadelphia, PennsylvaniaGarrett Oldland - Philadelphia VA Medical CenterSwetha Gaddam - Philadelphia VA Medical CenterRachana Miller - Philadelphia VA Medical CenterVaibhav Satija - Perelman Center for Advanced Medicine, Philadelphia, PennsylvaniaBilal Ansari - Perelman Center for Advanced Medicine, Philadelphia, PennsylvaniaJonathan Lee - Allegheny Health NetworkAnique Mustafa - Perelman Center for Advanced Medicine, Philadelphia, PennsylvaniaScott R Akers - Philadelphia VA Medical CenterJulio A Chirinos - Jackson Memorial Hospital
- Publication Details
- The American journal of cardiology, v 123(8), pp 1301-1308
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- R01 HL121510 / NHLBI NIH HHS R21 AG043802 / NIA NIH HHS R56 HL124073 / NHLBI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:000465191100018
- Scopus ID
- 2-s2.0-85060885799
- Other Identifier
- 991021860802704721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems