Clinical relevance of cardiac magnetic resonance feature tracking derived left ventricular strain in nonischemic dilated cardiomyopathy

Abstract Background Left ventricular (LV) myocardial deformation analysis with echocardiography has shown an additive value for risk stratification in nonischemic dilated cardiomyopathy (NIDCM). However, scarce data is available with the new cardiac magnetic resonance (CMR) technique feature tracking, which allows strain evaluation from conventional cine sequences. Purpose Our aim is to analyze prognostic relevance of FT in NIDCM Methods Consecutive patients with NIDCM diagnosis and CMR at diagnosis were retrospectively included. LV global longitudinal, circumferential and radial strain (GLS, GCS and GRS, respectively) were obtained from standard CMR cine sequences with a dedicated FT software. Their association with a composite endpoint (heart failure admission, implantable cardioverter defibrillator in secondary prevention, and death) was evaluated. Results FT derived strain was obtained in 98 patients (68±13 years, 72% males) with NIDCM, mostly idiopathic (75.5%). The vast majority showed a severely dilated LV (LVEDVi= 133.6±33.4 mL/m2) with severely impaired systolic function (LVEF= 29.5±9.6%), and in 38.8% of the cases fibrosis was demonstrated in late gadolium enhancement (LGE). During a 3.2 [2.2–4] years follow-up 25.5% had an admission due to heart failure, 5.1% received an implantable cardioverter defibrillator in secondary prevention, and 10.2% died. Only a trend towards worse GCS values (−7.1 vs −8.5%; p=0.10) was noted among patients with heart failure hospitalization. Mortality was associated with poorer GCS (−5.9 vs −7.9%; p=0.012) and GLS (−6.9 vs −9.6%; p=0.051) values, whereas GRS was not related with any prognostic variable. Exclusively GCS was associated with the composite endpoint (−6.7 vs −8.2%; p=0.035). Considering other morphological parameters with prognostic relevance (LVEF and LVEDVi), GCS was the only independent predictor (OR 1.15; p=0.038). A cut-off point