Layer-specific strain in patients with heart failure using cardiovascular magnetic resonance: not all layers are the same

• Published in: Journal of cardiovascular magnetic resonance 2020-12, Vol.22 (1), p.81-81, Article 81
• Main Authors: Xu, Lingyu, Pagano, Joseph J, Haykowksy, Mark J, Ezekowitz, Justin A, Oudit, Gavin Y, Mikami, Yoko, Howarth, Andrew, White, James A, Dyck, Jason R B, Anderson, Todd, Paterson, D Ian, Thompson, Richard B
• Format: Article
• Language: English
• Subjects: Aged; Alberta; Biomechanical Phenomena; Brain natriuretic peptide; Cardiac arrhythmia; Cardiac patients; Cardiovascular disease; Cardiovascular magnetic resonance imaging; Care and treatment; Case-Control Studies; Concentricity; Congestive heart failure; Coronary vessels; Creatinine; Diagnostic systems; Ejection fraction; Epicardium; Feature tracking; Female; Heart; Heart Disease Risk Factors; Heart failure; Heart Failure - diagnostic imaging; Heart Failure - mortality; Heart Failure - physiopathology; Humans; Hypertension; Layer-specific global longitudinal strain; Likelihood ratio; Magnetic resonance imaging; Magnetic Resonance Imaging, Cine; Male; Medical imaging; Middle Aged; Mortality; Natriuretic peptides; Parameters; Performance prediction; Predictions; Predictive Value of Tests; Prognosis; Resonance; Risk Assessment; Risk management; Stroke Volume; Ventricle; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - mortality; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left; Wall thickness
• ISSN: 1097-6647; 1532-429X
• DOI: 10.1186/s12968-020-00680-6

Global longitudinal strain (GLS), most commonly measured at the endocardium, has been shown to be superior to left ventricular (LV) ejection fraction (LVEF) for the identification of systolic dysfunction and prediction of outcomes in heart failure (HF). We hypothesized that strains measured at different myocardial layers (endocardium = ENDO, epicardium = EPI, average = AVE) will have distinct diagnostic and predictive performance for patients with HF. Layer-specific GLS, layer-specific global circumferential strain (GCS) and global radial strain (GRS) were evaluated by cardiovascular magnetic resonance imaging (CMR) feature tracking in the Alberta HEART study. A total of 453 subjects consisted of healthy controls (controls, n = 77), at-risk for HF (at-risk, n = 143), HF with preserved ejection fraction (HFpEF, n = 87), HF with mid-range ejection fraction (HFmrEF, n = 88) and HF with reduced ejection fraction (HFrEF, n = 58). For outcomes analysis, CMR-derived imaging parameters were adjusted with a base model that included age and N-terminal prohormone of b-type natriuretic peptide (NT-proBNP) to test their independent association with 5-year all-cause mortality. GLS_EPI distinguished all groups with preserved LVEF (controls - 16.5 ± 2.4% vs. at-risk - 15.5 ± 2.7% vs. HFpEF - 14.1 ± 3.0%, p