Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndrome

ABSTRACT: Background: Evidence to support risk stratification in Eisenmenger syndrome (ES) is still very limited. We hypothesized that biventricular longitudinal strain analysis could have potential prognostic value in ES. Methods: We prospectively enrolled 57 consecutive ES patients with post-tric...

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Main Authors: Chao Gong, Chen Chen, Xuhan Liu, Ke Wan, Jiajun Guo, Juan He, Lidan Yin, Bi Wen, Shoufang Pu, Yucheng Chen
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Journal of Cardiovascular Magnetic Resonance
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Online Access:http://www.sciencedirect.com/science/article/pii/S1097664724011438
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author Chao Gong
Chen Chen
Xuhan Liu
Ke Wan
Jiajun Guo
Juan He
Lidan Yin
Bi Wen
Shoufang Pu
Yucheng Chen
author_facet Chao Gong
Chen Chen
Xuhan Liu
Ke Wan
Jiajun Guo
Juan He
Lidan Yin
Bi Wen
Shoufang Pu
Yucheng Chen
author_sort Chao Gong
collection DOAJ
description ABSTRACT: Background: Evidence to support risk stratification in Eisenmenger syndrome (ES) is still very limited. We hypothesized that biventricular longitudinal strain analysis could have potential prognostic value in ES. Methods: We prospectively enrolled 57 consecutive ES patients with post-tricuspid shunt who underwent both cardiovascular magnetic resonance (CMR) and right heart catheterization between June 2013 and March 2022. Biventricular longitudinal strains were evaluated by CMR feature-tracking analysis. The composite endpoint included all-cause mortality and re-admission for heart failure or hemoptysis. Cox regression analysis, Kaplan–Meier curves, and C-index were employed to assess the relationship between biventricular longitudinal strain and prognosis. Results: During a median follow-up of 33 months (interquartile range: 12–50), 35.1% (20/57) patients reached the composite endpoint. Patients with composite endpoints had significantly lower absolute values of left ventricular global longitudinal strain (LV GLS) and right ventricular free wall longitudinal strain (RV FWLS) than patients without composite endpoints (p < .05). Multivariate Cox regression analysis demonstrated that LV GLS and RV FWLS were independent predictors for composite endpoints (hazard ratio [HR]: 1.37, 95% confidence interval [CI]: 1.08–1.75, p = 0.010 and HR: 1.19, 95% CI: 1.01–1.41, p = 0.042). Kaplan–Meier analysis indicated that patients with both lower absolute values of LV GLS and RV FWLS were more likely to be at an even higher risk of composite endpoints (p <0.001). Furthermore, the combined addition of LV GLS and RV FWLS provided incremental value for the prognostic model including clinical parameters and biventricular ejection fraction (C-index increased from 0.75 to 0.86, p = 0.004). Conclusion: Impaired biventricular longitudinal strains improved prognostic prediction of ES patients with post-tricuspid shunt.
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series Journal of Cardiovascular Magnetic Resonance
spelling doaj-art-9c94169938eb4d649c0654b8aa2d6fe62024-12-16T05:34:56ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472024-01-01262101116Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndromeChao Gong0Chen Chen1Xuhan Liu2Ke Wan3Jiajun Guo4Juan He5Lidan Yin6Bi Wen7Shoufang Pu8Yucheng Chen9Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR ChinaDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Corresponding author. Cardiology Division, West China Hospital, Sichuan University, Guoxue Xiang No. 37, Chengdu, Sichuan Province 610041, China.ABSTRACT: Background: Evidence to support risk stratification in Eisenmenger syndrome (ES) is still very limited. We hypothesized that biventricular longitudinal strain analysis could have potential prognostic value in ES. Methods: We prospectively enrolled 57 consecutive ES patients with post-tricuspid shunt who underwent both cardiovascular magnetic resonance (CMR) and right heart catheterization between June 2013 and March 2022. Biventricular longitudinal strains were evaluated by CMR feature-tracking analysis. The composite endpoint included all-cause mortality and re-admission for heart failure or hemoptysis. Cox regression analysis, Kaplan–Meier curves, and C-index were employed to assess the relationship between biventricular longitudinal strain and prognosis. Results: During a median follow-up of 33 months (interquartile range: 12–50), 35.1% (20/57) patients reached the composite endpoint. Patients with composite endpoints had significantly lower absolute values of left ventricular global longitudinal strain (LV GLS) and right ventricular free wall longitudinal strain (RV FWLS) than patients without composite endpoints (p < .05). Multivariate Cox regression analysis demonstrated that LV GLS and RV FWLS were independent predictors for composite endpoints (hazard ratio [HR]: 1.37, 95% confidence interval [CI]: 1.08–1.75, p = 0.010 and HR: 1.19, 95% CI: 1.01–1.41, p = 0.042). Kaplan–Meier analysis indicated that patients with both lower absolute values of LV GLS and RV FWLS were more likely to be at an even higher risk of composite endpoints (p <0.001). Furthermore, the combined addition of LV GLS and RV FWLS provided incremental value for the prognostic model including clinical parameters and biventricular ejection fraction (C-index increased from 0.75 to 0.86, p = 0.004). Conclusion: Impaired biventricular longitudinal strains improved prognostic prediction of ES patients with post-tricuspid shunt.http://www.sciencedirect.com/science/article/pii/S1097664724011438Cardiovascular magnetic resonanceEisenmenger syndromeFeature-trackingStrainPrognosis
spellingShingle Chao Gong
Chen Chen
Xuhan Liu
Ke Wan
Jiajun Guo
Juan He
Lidan Yin
Bi Wen
Shoufang Pu
Yucheng Chen
Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndrome
Journal of Cardiovascular Magnetic Resonance
Cardiovascular magnetic resonance
Eisenmenger syndrome
Feature-tracking
Strain
Prognosis
title Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndrome
title_full Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndrome
title_fullStr Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndrome
title_full_unstemmed Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndrome
title_short Biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature-tracking: Prognostic value in Eisenmenger syndrome
title_sort biventricular longitudinal strain analysis using cardiovascular magnetic resonance feature tracking prognostic value in eisenmenger syndrome
topic Cardiovascular magnetic resonance
Eisenmenger syndrome
Feature-tracking
Strain
Prognosis
url http://www.sciencedirect.com/science/article/pii/S1097664724011438
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