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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
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Layer-Specific Strain Analysis in Patients with Dilated Cardiomyopathy.

Despina-Manuela Toader1, Alina Paraschiv2, Georgică Târtea3,4

  • 1EuroEchoLab, Craiova Cardiology Center, Emergency Hospital Craiova, 200642 Craiova, Romania.

Biomedicines
|January 25, 2025
PubMed
Summary
This summary is machine-generated.

Layer-specific strain analysis in dilated cardiomyopathy can predict cardiac mortality. Circumferential strain at the endocardium (CSPMend) is a key indicator for identifying patients at higher risk of death within two years.

Keywords:
dilated cardiomyopathylayer-specific strain analysisoutcome

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Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Imaging

Background:

  • Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
  • Etiology of DCM (ischemic vs. non-ischemic) influences disease presentation.
  • Predicting cardiac mortality in DCM patients with heart failure decompensation is crucial.

Purpose of the Study:

  • To evaluate layer-specific strain in DCM based on etiology.
  • To determine if longitudinal and circumferential layer strain predict cardiac mortality in DCM patients.
  • To assess the prognostic value of strain parameters in a two-year follow-up.

Main Methods:

  • Recruited 97 DCM patients (LVEF ≤ 40%), divided by ischemic (n=51) and non-ischemic (n=46) etiologies.
  • Performed conventional and 2D speckle-tracking echocardiography (2D-STE) during compensated heart failure.
  • Assessed layer-specific longitudinal and circumferential strain (endocardium, mid-myocardium, epicardium) and calculated gradients.

Main Results:

  • Non-ischemic DCM patients showed lower global and layer strain than ischemic patients.
  • Decreased GLS, GLSend, GLSend-GLSepi, CSPMend, CSPMend-CSPMepi, CSAP, CSAPend, and CSAPend-CSAPepi were observed in non-survivors.
  • Multivariate analysis identified CSPMend as an independent predictor of two-year mortality; a cut-off of -10.8% showed 80% sensitivity and 61.05% specificity.

Conclusions:

  • Layer-specific strain analysis revealed reduced values in non-ischemic DCM and in non-survivors.
  • Circumferential strain at the endocardium (CSPMend) emerged as the most sensitive parameter for predicting mortality risk in DCM patients.