Incremental prognostic value of left atrial and biventricular feature tracking in dilated cardiomyopathy: a long-term study

作者：Xiaorui Xiang, Yanyan Song, Kankan Zhao, Shiqin Yu, Shujuan Yang, Jing Xu, Jiaxin Wang, Zhixiang Dong, Xuan Ma, Zhuxin Wei, Yun Tang, Minjie Lu, Shihua Zhao, Xiuyu Chen · 发表于：Journal of Cardiovascular Magnetic Resonance · 年份：2023 · DOI：10.1186/s12968-023-00967-4 · 被引用次数：8 · 研究领域：Cardiovascular Function and Risk Factors、Cardiac Imaging and Diagnostics、Cardiomyopathy and Myosin Studies

Despite the use of cardiovascular magnetic resonance (CMR) feature tracking (FT) imaging to detect myocardial deformation, the optimal strain index in dilated cardiomyopathy (DCM) is unclear. This study aimed to determine whether atrial and biventricular strains can provide the greatest or joint incremental prognostic value in patients with DCM over a long follow-up period. Four hundred-twelve DCM patients were included retrospectively. Comprehensive clinical evaluation and imaging investigations were obtained, including measurements of CMR-FT derived left atrial (LA) reservoir, conduit, booster strain (εs, εe, εa); left ventricular (LV) and right ventricular (RV) global longitudinal, radial, circumferential strain (GLS, GRS, GCS). All patients were followed up for major adverse cardiac events (MACE) including all-cause mortality, heart transplantation, and implantable cardioverter defibrillator discharge. The predictors of MACE were examined with univariable and multivariable Cox regression analysis. Subsequently, nested Cox regression models were built to evaluate the incremental prognostic value of strain parameters. The incremental predictive power of strain parameters was assessed by Omnibus tests, and the model performance and discrimination were evaluated by Harrell C-index and integrated discrimination improvement (IDI) analysis. Patient survival was illustrated by Kaplan–Meier curves and differences were evaluated by log-rank test. During a median follow-up of 5.0 ye...