Related Experiment Video
Updated: May 5, 2026
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Diverse distribution patterns of segmental longitudinal strain are associated with different clinical features and
Kaoruko Sengoku1, Tomohito Ohtani2, Yasuharu Takeda1
1Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan.
Insights
Dilated cardiomyopathy patients with distinct patterns of impaired longitudinal strain (LS) experience different cardiac event rates and reverse remodeling. Apical LS patterns predict outcomes better than ejection fraction alone.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Heart Failure Research
Background:
- Dilated cardiomyopathy (DCM) prognosis is complex and not fully predicted by left ventricular ejection fraction (LVEF).
- Longitudinal strain (LS) provides additional prognostic information beyond LVEF.
- LS distribution patterns may offer further clinical insights in DCM.
Purpose of the Study:
- To investigate the clinical significance of LS distribution patterns in patients with DCM.
- To correlate LS patterns with cardiac events and left ventricular reverse remodeling (LVRR).
Main Methods:
- 139 DCM patients with LVEF ≤ 35% were analyzed.
- LS distribution was assessed using bull's eye mapping and the relative apical LS index (RapLSI).
- Associations between LS patterns, cardiac events, and LVRR were evaluated.
Main Results:
- Distinct LS patterns (apical impaired/preserved vs. scattered/homogeneous) were identified.
- Patients with relatively impaired apical LS showed higher cardiac event rates and lower LVRR incidence.
- RapLSI independently predicted cardiac event rates.
Conclusions:
- LS distribution patterns in DCM are associated with differential clinical outcomes.
- Apical LS patterns are significant predictors of cardiac events and LVRR in DCM patients.
Background:
Dilated cardiomyopathy (DCM) presents with diverse clinical courses, hardly predictable solely by the left ventricular (LV) ejection fraction (EF). Longitudinal strain (LS) offers distinct information from LVEF and exhibits various distribution patterns. This study aimed to evaluate the clinical significance of LS distribution patterns in DCM.
Methods:
We studied 139 patients with DCM (LVEF ≤ 35%) who were admitted for heart failure (HF). LS distribution was assessed using a bull's eye map and the relative apical LS index (RapLSI), calculated by dividing apical LS by the sum of basal and mid-LS values. We evaluated the associations of LS distribution with cardiac events (cardiac death, LV assist device implantation, or HF hospitalization) and LV reverse remodeling (LVRR), as indicated by subsequent LVEF changes.
Results:
Twenty six (19%) and 29 (21%) patients exhibited a pattern of relatively apical impaired or preserved LS (defined by RapLSI < 0.25 or > 0.75, signifying a 50% decrease or increase in apical LS compared to other segments), and the remaining patients exhibited a scattered/homogeneously impaired LS pattern. The proportion of new-onset heart failure and LVEF differed between the three groups. During the median 595-day follow-up, patients with relatively-impaired apical LS had a higher rate of cardiac events (both log-rank p < 0.05) and a lower incidence of LVRR (both p < 0.01) compared to patients with other patterns. RapLSI was significantly associated with cardiac event rates after adjusting for age, sex, and new-onset HF or global LS.
Conclusion:
DCM patients with reduced EF and distinct distribution patterns of impaired LS experienced different outcomes.
Related Concept Videos
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:25Cardiomyopathy I: Introduction and Classification
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
01:29Cardiomyopathy V: Interprofessional Care