Right ventricular long axis strain—validation of a novel parameter in non-ischemic dilated cardiomyopathy using standard cardiac magnetic resonance imaging

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• 作者：Nisha Arenja^a ; Johannes H. Riffel^a ; Charly Noel Djiokou^a ; Florian Andre^a ; Thomas Fritz^a ; Manuel Halder^a ; Thomas Zelniker^a ; Arnt V. Kristen^a ; Grigorios Korosoglou^a ; Hugo A. Katus^a ; ^b ; Sebastian J. Buss^a ; ^{sebastian.buss@med.uni-heidelberg.de" class="auth_mail" title="E-mail the corresponding author}
• 关键词：ARVC ; arrhythmogenic right ventricular cardiomyopathy ; AUC ; area under curve ; CMR ; cardiac magnetic resonance ; ECG ; electrocardiogram ; EDV ; end-diastolic volume ; EF ; ejection Fraction ; ESV ; end-systolic volume ; FTI ; feature tracking analysis ; FOV ; field of view ; GLS ; global longitudinal strain ; LAS ; long axis strian ; LV ; left ventricle ; NIDCM ; non-ischemic dilated cardiomyopathy ; NYHA ; New York heart association-classification ; ROC ; receiver operating characteristic ; RV ; right ventricle ; RV-GLS
• 刊名：European Journal of Radiology
• 出版年：2016
• 出版时间：July 2016
• 年：2016
• 卷：85
• 期：7
• 页码：1322-1328
• 全文大小：964 K

文摘

Right ventricular longitudinal axis strain (RV-LAS) is a simple measure of RV longitudinal function. The purpose of this study was the evaluation of its diagnostic performance in non-ischemic dilated cardiomyopathy (NIDCM) and the determination of reference values in controls.

Methods

217 NIDCM patients and 200 healthy controls were analysed retrospectively regarding the diagnostic performance of RV-LAS using receiver operating characteristic curves in comparison with RV ejection fraction (RVEF), tricuspid annular plane systolic excursion (TAPSE) and global longitudinal strain (RV-GLS). Hereby, four different approaches were evaluated to assess RV-LAS based on different reference points. RV-LAS LVapex/mid was defined as the change in distance between the LV apex and the middle of a line connecting the origins of the tricuspidal valve leaflets in systole and diastole. The ethical approval was obtained in all participants.

Results

NIDCM and controls were 48 years in mean. Controls were equally gender distributed, while the proportion of men with NIDCM was higher with 77%. Among the four approaches RV-LAS LVapex/mid provided the highest diagnostic performance for discrimination between NIDCM and controls (AUC = 0.94). Of all RV functional parameters RV-LAS LVapex/mid preformed significantly better than RVEF (delta AUC = 0.05; p = 0.003), TAPSE (delta AUC = 0.23; p < 0.0001) and RV-GLS (delta AUC = 0.31; p < 0.0001). A significant correlation was found between RV-LAS LVapex/mid and RVEF (r = −0.65; p < 0.0001). The reference mean values for RV-LAS LVapex/mid were −17.4 ± 3.5 for men and −18.5 ± 3.7 for women.

Conclusion

RV-LAS showed better diagnostic accuracy for RV dysfunction than RVEF, TAPSE and RV-GLS. Furthermore, it has a rapid accessibility and low intra- and interobserver variability.