title: The prognostic value of right ventricular long axis strain in non-ischaemic dilated cardiomyopathies using standard cardiac magnetic resonance imaging.
abstract: OBJECTIVE
  To investigate the association of right ventricular long axis strain (RV-LAS), a parameter of longitudinal function, with outcome in patients with non-ischaemic dilated cardiomyopathy (NIDCM).
  
  
  METHODS
  In 441 patients with NIDCM, RV-LAS was analysed retrospectively by measuring the length between the epicardial border of the left ventricular apex and the middle of a line connecting the origins of the tricuspidal valve leaflets in end-diastole and end-systole on non-contrast standard cine sequences.
  
  
  RESULTS
  The primary endpoint (cardiac death or heart transplantation) occurred in 41 patients, whereas 95 reached the combined endpoint (including cardiac decompensation and sustained ventricular arrhythmias) during a median follow-up of 4.2 years. Kaplan-Meier survival curves showed a poor outcome in patients with RV-LAS values below -10% (log-rank, p < 0.0001). In a risk stratification model RV-LAS improved prediction of outcome in addition to RV ejection fraction (RVEF) and presence of late gadolinium enhancement. Assessment of RV-LAS offered incremental information compared to clinical symptoms, biomarkers and RVEF. Even in the subgroup with normal RVEF (>45%, n = 213) reduced RV-LAS was still associated with poor outcome.
  
  
  CONCLUSIONS
  Assessment of RV-LAS is an independent indicator of outcome in patients with NIDCM and offers incremental information beyond clinical and cardiac MR parameters.
  
  
  CONCLUSIONS
  • Impaired right ventricular longitudinal function (RV-LAS) is associated with poorer cardiac outcomes. • Poor outcome is associated with decreased RV-LAS even in patients with RVEF >45%. • Addition of RV-LAS to known risk factors enhances the power prognostic information.
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.|Department of Cardiology, Solothurner Spitäler AG, Kantonsspital Olten, Baslerstrasse 150, 4600, Olten, Switzerland.
authors.forename: Nisha
authors.initials: N
authors.lastname: Arenja
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Riffel
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Manuel
authors.initials: M
authors.lastname: Halder
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Charly N
authors.initials: CN
authors.lastname: Djiokou
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fritz
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Andre
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Aus dem Siepen
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zelniker
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Meder
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Elham
authors.initials: E
authors.lastname: Kayvanpour
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.
authors.forename: Grigorios
authors.initials: G
authors.lastname: Korosoglou
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany.|DZHK (German Centre for Cardiovascular Research), partner site Heidelberg, Heidelberg, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Im Neuenheimer Feld 410, Heidelberg, 69120, Germany. sbuss@gmx.de.|Das Radiologische Zentrum - Radiology Center, Sinsheim-Eberbach-Erbach-Walldorf-Heidelberg, Germany. sbuss@gmx.de.
authors.forename: Sebastian J
authors.initials: SJ
authors.lastname: Buss
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D005260:Female; D005682:Gadolinium; D016027:Heart Transplantation / Q000401:mortality; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013312:Stress, Physiological / Q000502:physiology; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000401:mortality
chemical_list: D005682:Gadolinium
keywords: Cardiac magnetic resonance imaging; Longitudinal function; Non-ischaemic dilated cardiomyopathy; Prognosis; Right ventricular long axis strain