Prognostic value of left ventricular strain determined using CMR-feature tracking in patients with alcoholic...

Previous studies have not sufficiently examined alcoholic cardiomyopathy (ACM). Therefore, this research aimed to evaluate the prognostic value of left ventricular strain parameters determined using CMR-feature tracking (CMR-FT) in patients with ACM.

Patients with ACM who underwent CMR from September 2015 to October 2023 were enrolled in this single-center retrospective study. Major adverse cardiovascular events (MACE) included death, heart transplantation, implantable cardioverter-defibrillator (ICD), cardiac resynchronization therapy (CRT), and rehospitalization for worsening heart failure. Multiple linear regression was used to analyze the relationship of the degree of left ventricular strain impairment with daily alcohol intake and drinking duration. The risk factors for MACE were identified using multivariable Cox analysis.

A total of 64 patients with ACM were enrolled. During a median follow-up time of 30 months(IQR: 10.0-55.4), 24 (37.5 %) patients developed MACE, including heart transplantation (2 patients), ICD (4 patients), CRT (3 patients), and rehospitalization owing to heart failure (15 patients). Left ventricular ejection fraction, global circumferential strain, global radial strain and global longitudinal strain (GLS) were significantly worse in patients with MACE than those without MACE (p < 0.05). Regression analysis indicated that daily alcohol intake and drinking duration influence left ventricular strain. Multivariate Cox regression analysis revealed a significant association between GLS and MACE. Kaplan-Meier analysis suggested that patients with GLS <6.5 % showed more favorable clinical outcomes than those with GLS ≥6.5 % (p < 0.05).

GLS exhibits better independent prognostic value than conventional CMR features in patients with ACM.