Background

Assessment of subclinical myocardial dysfunction by using feature tracking has shown promise in prognosis evaluation of heart failure with preserved ejection fraction (HFpEF). Global early diastolic longitudinal strain rate (eGLSR) can identify earlier diastolic dysfunction; however, limited data are available on its prognostic value in HFpEF.

Purpose

To evaluate the association between left ventricular (LV) eGLSR and primary composite outcomes (all-cause death or heart failure hospitalization) in patients with HFpEF.

Materials and Methods

In this retrospective study, consecutive patients with HFpEF (included from January 2010 to March 2013) underwent cardiovascular MRI. The correlation between eGLSR and variables was assessed by using linear regression. The association between eGLSR (obtained with use of feature tracking) and outcomes was analyzed by using Cox proportional regression.

Results

A total of 186 patients with HFpEF (mean age ± standard deviation, 59 years ± 12; 77 women) were included. The eGLSR was weakly correlated with LV end-diastole volume index (Pearson correlation coefficient [r] = –0.35; P < .001), heart rate (r = 0.35; P < .001), and LV ejection fraction (r = 0.30; P < .001) and moderately correlated with LV end-systole volume index (r = –0.41; P < .001). At a median follow-up of 9.2 years (interquartile range, 8.7–10.0 years), 72 patients experienced primary composite outcomes. Impaired eGLSR, defined as an eGLSR of less than 0.57 per second, was associated with a greater rate of heart failure hospitalization or all-cause death (hazard ratio, 2.0 [95% CI: 1.1, 3.7]; P = .02) after adjusting for multiple clinical and imaging-based variables.

Conclusion

Left ventricular global early diastolic longitudinal strain rate obtained from cardiovascular MRI feature tracking was independently associated with adverse outcomes in patients with heart failure with preserved ejection fraction.

© RSNA, 2021

Online supplemental material is available for this article.

An earlier incorrect version appeared online. This article was corrected on October 22, 2021.

中文翻译：

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MRI 舒张早期纵向应变率和保留射血分数心力衰竭的结果

背景

通过使用特征跟踪评估亚临床心肌功能障碍在射血分数保留的心力衰竭 (HFpEF) 的预后评估中显示出前景。整体舒张早期纵向应变率 (eGLSR) 可以识别早期舒张功能障碍；然而，关于其在 HFpEF 中的预后价值的可用数据有限。

目的

评估 HFpEF 患者左心室 (LV) eGLSR 与主要复合结局（全因死亡或心力衰竭住院）之间的关联。

材料和方法

在这项回顾性研究中，连续的 HFpEF 患者（包括 2010 年 1 月至 2013 年 3 月）接受了心血管 MRI。eGLSR 与变量之间的相关性通过使用线性回归进行评估。使用 Cox 比例回归分析 eGLSR（通过使用特征跟踪获得）与结果之间的关联。

结果

总共包括 186 名 HFpEF 患者（平均年龄 ± 标准差，59 岁 ± 12；77 名女性）。eGLSR 与 LV 舒张末期容积指数（Pearson 相关系数 [ r ] = –0.35；P < .001）、心率（r = 0.35；P < .001）和 LV 射血分数（r = 0.30 ）弱相关; P < .001) 并与 LV 收缩末期容积指数适度相关 ( r = –0.41; P<.001）。中位随访 9.2 年（四分位数范围，8.7-10.0 年）时，72 名患者经历了主要复合结果。eGLSR 受损（定义为 eGLSR 低于每秒 0.57）与更高的心力衰竭住院率或全因死亡率相关（风险比 2.0 [95% CI: 1.1, 3.7]；P = .02）调整多个临床和基于成像的变量。

结论

从心血管 MRI 特征跟踪获得的左心室整体舒张早期纵向应变率与射血分数保留的心力衰竭患者的不良结局独立相关。

©北美放射学会，2021

本文提供了在线补充材料。

一个较早的错误版本出现在网上。本文已于 2021 年 10 月 22 日更正。