Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12968-021-00724-5
Title: Cardiovascular magnetic resonance-assessed fast global longitudinal strain parameters add diagnostic and prognostic insights in right ventricular volume and pressure loading disease conditions
Authors: Leng, Shuang 
Tan, Ru-San
Guo, Jiajun
Chai, Ping 
Zhang, Gangcheng
Teo, Lynette 
Ruan, Wen 
Yeo, Tee Joo 
Zhao, Xiaodan 
Allen, John C 
Tan, Ju Le
Yip, James W
Chen, Yucheng
Zhong, Liang 
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Radiology, Nuclear Medicine & Medical Imaging
Cardiovascular System & Cardiology
Cardiovascular magnetic resonance
Right ventricular function
Strain
Volume overload
Pressure overload
Issue Date: 1-Apr-2021
Publisher: BMC
Citation: Leng, Shuang, Tan, Ru-San, Guo, Jiajun, Chai, Ping, Zhang, Gangcheng, Teo, Lynette, Ruan, Wen, Yeo, Tee Joo, Zhao, Xiaodan, Allen, John C, Tan, Ju Le, Yip, James W, Chen, Yucheng, Zhong, Liang (2021-04-01). Cardiovascular magnetic resonance-assessed fast global longitudinal strain parameters add diagnostic and prognostic insights in right ventricular volume and pressure loading disease conditions. JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE 23 (1). ScholarBank@NUS Repository. https://doi.org/10.1186/s12968-021-00724-5
Abstract: Background: Parameters of myocardial deformation may provide improved insights into right ventricular (RV) dysfunction. We quantified RV longitudinal myocardial function using a fast, semi-automated method and investigated its diagnostic and prognostic values in patients with repaired tetralogy of Fallot (rTOF) and pulmonary arterial hypertension (PAH), who respectively exemplify patients with RV volume and pressure overload conditions. Methods: The study enrolled 150 patients (rTOF, n = 75; PAH, n = 75) and 75 healthy controls. RV parameters of interest were fast global longitudinal strain (GLS) and strain rates during systole (GLSRs), early diastole (GLSRe) and late diastole (GLSRa), obtained by tracking the distance from the medial and lateral tricuspid valve insertions to the RV epicardial apex on cine cardiovascular magnetic resonance (CMR). Results: The RV fast GLS exhibited good agreement with strain values obtained by conventional feature tracking approach (bias − 4.9%, error limits (± 2·standard deviation) ± 4.3%) with fast GLS achieving greater reproducibility and requiring reduced analysis time. Mean RV fast GLS was reduced in PAH and rTOF groups compared to healthy controls (PAH < rTOF < healthy controls: 15.1 ± 4.9 < 19.3 ± 2.4 < 24.4 ± 3.0%, all P < 0.001 in pairwise comparisons). In rTOF patients, RV fast GLS was significantly associated with metabolic equivalents, peak oxygen consumption (PVO2) and percentage of predicted PVO2 achieved during cardiopulmonary exercise testing. Lower RV fast GLS was associated with subnormal exercise capacity in rTOF (area under the curve (AUC) = 0.822, sensitivity = 72%, specificity = 91%, cut-off = 19.3%). In PAH patients, reduced RV fast GLS was associated with RV decompensated hemodynamics (AUC = 0.717, sensitivity = 75%, specificity = 58%, cut-off = 14.6%) and higher risk of clinical worsening (AUC = 0.808, sensitivity = 79%, specificity = 70 %, cut-off = 16.0%). Conclusions: Quantitative RV fast strain and strain rate parameters assessed from CMR identify abnormalities of RV function in rTOF and PAH and are predictive of exercise capacity, RV decompensation and clinical risks in these patients. Trial registry Clinicaltrials.gov: NCT03217240
Source Title: JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
URI: https://scholarbank.nus.edu.sg/handle/10635/208576
ISSN: 10976647
1532429X
DOI: 10.1186/s12968-021-00724-5
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