Biventricular mechanics in prediction of severe myocardial fibrosis in patients with dilated cardiomyopathy: CMR study. Issue 91 (June 2017)

• Record Type: Journal Article
• Authors: Mazurkiewicz, Łukasz; Petryka, Joanna; Spiewak, Mateusz; Miłosz-Wieczorek, Barbara; Werys, Konrad; Małek, Łukasz A.; Polanska-Skrzypczyk, Magdalena; Ojrzynska, Natalia; Kubik, Agata; Marczak, Magdalena; Misko, Jolanta; Grzybowski, Jacek
• Is Part Of: European journal of radiology. Issue 91(2017)
• Page Start: 71
• Page End: 81
• Publication Date: 2017-06
• Subjects: DCM dilated cardiomyopathy -- LV left ventricle -- RV right ventricle -- LVEDV left ventricular end-diastolic volume -- LVESV left ventricular end-systolic volume -- LVSV left ventricular stroke volume -- LVEF left ventricular ejection fraction -- LVEDVI left ventricular end-diastolic volume index -- LVESVI left ventricular end-systolic volume index -- LVSVI left ventricular stroke volume index -- RVEDV right ventricular end-diastolic volume -- RVESV right ventricular end-systolic volume -- RVSV right ventricular end-diastolic volume -- RVEF right ventricular ejection fraction -- RVEDVI right ventricular end-diastolic volume index -- RVESVI right ventricular end-systolic volume index -- RVSVI right ventricular strike volume index -- LVGLS left ventricular global longitudinal strain -- LVCR left ventricular circumferential strain -- LVR left ventricular radial strain -- RVGLS right ventricular global longitudinal strain -- RVCR right ventricular circumferential strain -- RVR right ventricular radial strain -- ECV extracellular volume -- FT feature tracking -- CMR cardiovascular magnetic resonance -- ROI region of interest -- AUC area under curve -- lge late gadolinium enhancement; Dilated cardiomyopathy -- Feature tracking -- Fibrosis -- T1-mapping -- Cardiac magnetic resonance; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2017.03.019
• Languages: English
• ISSNs: 0720-048X

Abstract

Abstract: Purpose: The purpose of this study was to compare the ability of various parameters of myocardial mechanics to predict large amounts of biventricular fibrosis assessed via T1 mapping in patients with dilated cardiomyopathy (DCM). Material: Cardiovascular magnetic resonance feature tracking analysis and T1 mapping were performed in 26 patients with DCM [mean age: 34.4 ± 9.1 years, 15 (57.6%) males]. The values of various parameters of myocardial mechanics at predicting advanced left-ventricle (LV) and right-ventricle (RV) fibrosis were compared using logistic regression analysis and receiver operating characteristic curve (ROC) analysis. Results: There were 7 (26.9%) patients with a large amount of LV fibrosis and 9 (34.6%) patients with severe RV fibrosis. ROC curve analysis revealed that the model of combined LV strain rates (AUC = 0.902) offered superb ability at predicting large amounts of LV fibrosis. The models including RV strain rates (AUC = 0.974), a combination of RV strains, strain rates and clinical parameters (AUC = 0.993) as well as the RV radial strain rate alone model (AUC = 0.961) yielded outstanding performance in discriminating large and small amounts of RV fibrosis. In multivariate analysis, the LV circumferential strain (LVCR) and RV radial (RVR) strain rate were the only independent predictors of large amounts of LV and RV fibrosis, respectively. Conclusions: Indices of myocardial deformation, especially combined with clinical features, offered a superlative ability to differentiate high from low degrees of fibrosis in DCM patients. Among all analyzed parameters of myocardial mechanics, LVCR and RVR rate alone were the independent predictors of high degrees of LV and RV fibrosis, respectively.