Prognostic value of myocardial strain on cardiac magnetic resonance imaging in patients with non-ischemic cardiomyopathy

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Myocardial strain measurements using feature tracking imaging (FTI) on cardiac magnetic resonance (CMR) has emerged as a reliable method for evaluating myocardial function. However, the prognostic value of left ventricular strain measurements on CMR remains unclear in patients with nonischemic cardiomyopathy (NICM). Purpose The purpose of this meta-analysis is to evaluate the association of myocardial strain measurements with adverse outcomes in patients with NICM. Methods A literature search was conducted for studies reporting on the association of left ventricular global longitudinal strain (LVGLS), left ventricular global circumferential strain (LVGCS), and left ventricular global radial strain (LVGRS) using FTI on CMR with cardiovascular outcomes on long term follow-up in patients with NICM. The primary endpoint was major adverse cardiac events (MACE). The search included the following databases: Ovid MEDLINE, EMBASE, Web of Science, and Google Scholar. The search was not restricted to time or publication status. Results A total of 6 studies with 1004 participants (251 with MACE and 753 without MACE) met inclusion criteria. Mean follow-up duration was 39 months. Mean ejection fraction was 27%. Baseline LVGLS, LVGCS, and LVGRS were significantly lower in NICM patients who subsequently experienced MACE on follow-up compared to patients without MACE (SMD −0.58, 95% CI −1.01, −0.15; p<0.01; SMD −0.58, 95% CI −0.96, −0.21; p<0.01; SMD −0.43, 95% CI −0.81, −0.05; p = 0.03). Conclusions Myocardial strain measurement using FTI on CMR may represent a useful clinical tool for risk stratification of NICM patients at risk for adverse cardiac events.