PMID- 29361479 OWN - NLM STAT- MEDLINE DCOM- 20191120 LR - 20191120 IS - 1876-7591 (Electronic) IS - 1936-878X (Print) IS - 1876-7591 (Linking) VI - 11 IP - 10 DP - 2018 Oct TI - Feature-Tracking Global Longitudinal Strain Predicts Death in a Multicenter Population of Patients With Ischemic and Nonischemic Dilated Cardiomyopathy Incremental to Ejection Fraction and Late Gadolinium Enhancement. PG - 1419-1429 LID - S1936-878X(17)31147-6 [pii] LID - 10.1016/j.jcmg.2017.10.024 [doi] AB - OBJECTIVES: The aim of this study was to evaluate the prognostic value of cardiac magnetic resonance (CMR) feature-tracking-derived global longitudinal strain (GLS) in a large multicenter population of patients with ischemic and nonischemic dilated cardiomyopathy. BACKGROUND: Direct assessment of myocardial fiber deformation with GLS using echocardiography or CMR feature tracking has shown promise in providing prognostic information incremental to ejection fraction (EF) in single-center studies. Given the growing use of CMR for assessing persons with left ventricular (LV) dysfunction, we hypothesized that feature-tracking-derived GLS may provide independent prognostic information in a multicenter population of patients with ischemic and nonischemic dilated cardiomyopathy. METHODS: Consecutive patients at 4 U.S. medical centers undergoing CMR with EF <50% and ischemic or nonischemic dilated cardiomyopathy were included in this study. Feature-tracking GLS was calculated from 3 long-axis cine-views. The primary endpoint was all-cause death. Cox proportional hazards regression modeling was used to examine the association between GLS and death. Incremental prognostic value of GLS was assessed in nested models. RESULTS: Of the 1,012 patients in this study, 133 died during median follow-up of 4.4 years. By Kaplan-Meier analysis, the risk of death increased significantly with worsening GLS tertiles (log-rank p < 0.0001). Each 1% worsening in GLS was associated with an 89.1% increased risk of death after adjustment for clinical and imaging risk factors including EF and late gadolinium enhancement (LGE) (hazard ratio [HR]:1.891 per %; p < 0.001). Addition of GLS in this model resulted in significant improvement in the C-statistic (0.628 to 0.867; p < 0.0001). Continuous net reclassification improvement (NRI) was 1.148 (95% confidence interval: 0.996 to 1.318). GLS was independently associated with death after adjustment for clinical and imaging risk factors (including EF and late gadolinium enhancement) in both ischemic (HR: 1.942 per %; p < 0.001) and nonischemic dilated cardiomyopathy subgroups (HR: 2.101 per %; p < 0.001). CONCLUSIONS: CMR feature-tracking-derived GLS is a powerful independent predictor of mortality in a multicenter population of patients with ischemic or nonischemic dilated cardiomyopathy, incremental to common clinical and CMR risk factors including EF and LGE. CI - Copyright (c) 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Romano, Simone AU - Romano S AD - Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; Department of Medicine, University of Verona, Verona, Italy. FAU - Judd, Robert M AU - Judd RM AD - Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina. FAU - Kim, Raymond J AU - Kim RJ AD - Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina. FAU - Kim, Han W AU - Kim HW AD - Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina. FAU - Klem, Igor AU - Klem I AD - Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina. FAU - Heitner, John F AU - Heitner JF AD - Department of Cardiology, New York Methodist Hospital, New York, New York. FAU - Shah, Dipan J AU - Shah DJ AD - Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas. FAU - Jue, Jennifer AU - Jue J AD - Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois. FAU - White, Brent E AU - White BE AD - Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois. FAU - Indorkar, Raksha AU - Indorkar R AD - Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois. FAU - Shenoy, Chetan AU - Shenoy C AD - Division of Cardiology, Department of Medicine, Duke University, Durham, North Carolina. FAU - Farzaneh-Far, Afshin AU - Farzaneh-Far A AD - Division of Cardiology, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois. Electronic address: afshin@uic.edu. LA - eng GR - K23 HL132011/HL/NHLBI NIH HHS/United States GR - R01 HL064726/HL/NHLBI NIH HHS/United States PT - Comparative Study PT - Journal Article PT - Multicenter Study PT - Research Support, N.I.H., Extramural DEP - 20180117 PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM CIN - JACC Cardiovasc Imaging. 2018 Oct;11(10):1430-1432. PMID: 30286906 CIN - JACC Cardiovasc Imaging. 2018 Oct;11(10):1554-1555. PMID: 30286916 MH - Adult MH - Aged MH - Cardiomyopathy, Dilated/*diagnostic imaging/*mortality/physiopathology MH - Contrast Media/*administration & dosage MH - Gadolinium/*administration & dosage MH - Humans MH - *Magnetic Resonance Imaging, Cine MH - Middle Aged MH - Myocardial Infarction/mortality/physiopathology MH - Observer Variation MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - *Stroke Volume MH - Time Factors MH - United States MH - Ventricular Dysfunction, Left/*diagnostic imaging/*mortality/physiopathology MH - *Ventricular Function, Left PMC - PMC6043421 MID - NIHMS926513 OTO - NOTNLM OT - cardiac magnetic resonance imaging OT - cardiomyopathy OT - feature tracking OT - global longitudinal strain OT - left ventricular function OT - mortality OT - prognosis EDAT- 2018/01/24 06:00 MHDA- 2019/11/21 06:00 PMCR- 2019/10/01 CRDT- 2018/01/24 06:00 PHST- 2017/07/14 00:00 [received] PHST- 2017/10/06 00:00 [revised] PHST- 2017/10/12 00:00 [accepted] PHST- 2018/01/24 06:00 [pubmed] PHST- 2019/11/21 06:00 [medline] PHST- 2018/01/24 06:00 [entrez] PHST- 2019/10/01 00:00 [pmc-release] AID - S1936-878X(17)31147-6 [pii] AID - 10.1016/j.jcmg.2017.10.024 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2018 Oct;11(10):1419-1429. doi: 10.1016/j.jcmg.2017.10.024. Epub 2018 Jan 17.