Comprehensive Cardiovascular Magnetic Resonance-Derived Myocardial Strain Analysis Provides Independent Prognostic

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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
07:21

Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking

Published on: February 12, 2011

14.4K

Jacqueline L Vos1, Anne G Raafs2, Nikki van der Velde3

  • 1Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands.

Journal of the American Heart Association
|September 21, 2022
PubMed

Insights

Cardiovascular magnetic resonance (CMR)-derived left ventricular (LV) strain analysis improves risk prediction for major adverse cardiovascular events in acute myocarditis patients, outperforming traditional markers like ejection fraction and late gadolinium enhancement.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Late gadolinium enhancement and LV ejection fraction (LVEF) on CMR are established prognostic markers in acute myocarditis.
  • However, their predictive value for adverse outcomes like heart failure or arrhythmias is limited.
  • CMR-derived feature tracking offers more sensitive myocardial function analysis for improved risk stratification.

Purpose of the Study:

  • To evaluate the prognostic value of left ventricular (LV), right ventricular (RV), and left atrial (LA) strain in patients with acute myocarditis.
  • To determine if CMR-derived strain parameters improve risk prediction beyond conventional markers.

Main Methods:

  • Multicenter retrospective study including 162 patients with CMR-proven acute myocarditis.
  • Measured parameters included LV global longitudinal, circumferential, and radial strain, RV-global longitudinal strain, and LA strain.
  • Cox proportional hazard regression analysis was used to assess outcomes: all-cause mortality, heart transplantation, heart failure hospitalizations, and life-threatening arrhythmias.

Main Results:

  • Major adverse cardiovascular events occurred in 18% of patients over a median follow-up of 5.5 years.
  • All LV strain parameters (longitudinal, circumferential, radial) independently predicted outcomes, surpassing clinical features, LVEF, and late gadolinium enhancement.
  • RV and LA strain parameters did not show significant predictive value.

Conclusions:

  • CMR-derived LV strain analysis provides significant independent prognostic information in acute myocarditis.
  • LV strain parameters enhance risk stratification beyond traditional CMR markers and clinical factors.
  • RV and LA strain appear less critical for predicting adverse events in this patient cohort.

Keywords:
acute myocarditisfeature trackingmyocardial strainprognosis—CMR

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