Range Variability in CMR Feature Tracking Multilayer Strain across Different Stages of Heart Failure

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Heart failure (HF) involves progressive ventricular remodeling and impaired myocardial contraction.
• Distinct regional differences in myocardial function exist across various HF classifications.

Purpose of the Study:

• To comparatively assess myocardial strain at subendocardial, mid, and subepicardial levels using cardiac magnetic resonance (CMR) feature tracking (FT) in patients with different HF types.
• To evaluate the sensitivity of different myocardial layers to contractile impairment detected by CMR-FT.

Main Methods:

• Utilized CMR-FT to analyze systolic longitudinal and circumferential strain and strain-rate in 59 HF patients (HFpEF, HFmrEF, HFrEF) and 17 controls.
• Assessed strain at subendocardial (Endo-), mid (Myo-), and subepicardial (Epi-) myocardial layers.

Main Results:

• Strain values were highest in the subendocardial layer, decreasing progressively towards the subepicardial layer in all groups.
• Global longitudinal strain (GLS) decreased with HF severity (Normal > HFpEF > HFmrEF > HFrEF) across all layers.
• Global circumferential strain (GCS) showed no significant difference between Normal and HFpEF but was markedly lower in HFmrEF and HFrEF groups.

Conclusions:

• CMR-FT multilayer strain assessment highlights significant differences between myocardial regions.
• The subendocardial myocardium plays a critical role in cardiac contraction and is highly sensitive for detecting functional impairment in HF.
• CMR-FT provides a valuable, readily available tool for detailed myocardial evaluation across diverse HF patient groups.