title: Geometrical characteristics of left ventricular dyssynchrony in advanced heart failure. Myocardial strain analysis by tagged MRI.
abstract: The aims of this study were to quantify the geometrical differences in left ventricular (LV) dyssynchrony in patients with heart failure (HF) using cine-tagged MRI, and to investigate the relationship between dyssynchrony and major adverse cardiac events (MACE) in HF.In 67 patients with HF [mean LV ejection fraction (LVEF), 34%], cardiac MRI using a 3-Tesla scanner was performed. The dyssynchrony time between septal and lateral segments (SL-DT) and between basal and apical segments (BA-DT) was computed by cross-correlation analysis of the strain time-curves from the cine-tagged MRI. After receiving optimal medical treatment, all patients were followed-up for a mean period of 27 months. The primary endpoint was MACE that consisted of cardiac death or HF hospitalization or a left ventricular assist device due to refractory pump failure. Multivariate logistic regression analysis was performed to determine the ability of SL-DT, BA-DT, and HF biomarkers to predict MACE.Multivariate logistic regression analysis showed that the odds ratio to predict MACE was 0.935 for LVEF (P = 0.021), 1.016 for BA-DT (P = 0.026), and 0.971 for systolic blood pressure (P = 0.126).The results show that basal-apical dyssynchrony is an independent predictor of MACE in HF patients.
authors.affiliation: Department of Molecular Imaging and Diagnosis, Graduate School of Medical Sciences, Kyushu University.
authors.forename: Michinobu
authors.initials: M
authors.lastname: Nagao
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Masato
authors.initials: M
authors.lastname: Yonezawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kamitani
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kawanami
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mukai
authors.forename: Taiki
authors.initials: T
authors.lastname: Higo
authors.forename: Hidetake
authors.initials: H
authors.lastname: Yabuuchi
authors.forename: Kenji
authors.initials: K
authors.lastname: Sunagawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D009206:Myocardium; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left