Association Between 2D- and 3D-Speckle-Tracking Longitudinal Strain and Cardiovascular Magnetic Resonance Evidence of Diffuse Myocardial Fibrosis in Heart Transplant Recipients,Frontiers in Cardiovascular Medicine

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Association Between 2D- and 3D-Speckle-Tracking Longitudinal Strain and Cardiovascular Magnetic Resonance Evidence of Diffuse Myocardial Fibrosis in Heart Transplant Recipients
Frontiers in Cardiovascular Medicine ( IF 2.8 ) Pub Date : 2021-11-30 , DOI: 10.3389/fcvm.2021.727745
Wei Sun _{1,

2,

3} , Xuehua Shen _{4,

5} , Jing Wang ₄ , Shuangshuang Zhu _{1,

2,

3} , Yanting Zhang _{1,

2,

3} , Chun Wu _{1,

2,

3} , Yuji Xie _{1,

2,

3} , Yun Yang _{1,

2,

3} , Nianguo Dong ₆ , Guohua Wang ₆ , Yuman Li _{1,

2,

3} , Qing Lv _{1,

2,

3} , Bo Liang ₄ , Li Zhang _{1,

2,

3} , Mingxing Xie _{1,

2,

3}

Affiliation

Objective: This study aimed to: (1) evaluate the association between myocardial fibrosis (MF) quantified by extracellular volume fraction (ECV) and myocardial strain measured by two-dimensional (2D)- and three-dimensional speckle-tracking echocardiography (3D-STE) and (2) further investigate which strain parameter measured by 2D- and 3D-STE is the more robust predictor of MF in heart transplant (HT) recipients.

Methods: A total of 40 patients with HT and 20 healthy controls were prospectively enrolled. Left ventricular (LV)-global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were measured by 2D- and 3D-STE. LV diffuse MF was defined by cardiovascular magnetic resonance (CMR)-ECV.

Results: The HT recipients had a significantly higher native T1 and ECV than healthy controls (1043.8 ± 34.0 vs. 999.7 ± 19.7 ms, p < 0.001; 26.6 ± 2.7 vs. 24.3 ± 1.8%, p = 0.02). The 3D- and 2D-STE-LVGLS and LVGCS were lower (p < 0.005) in the HT recipients than in healthy controls. ECV showed a moderate correlation with 2D-LVGLS (r = 0.53, p = 0.002) and 3D-LVGLS (r = 0.60, p < 0.001), but it was not correlated with 2D or 3D-LVGCS, or LVGRS. Furthermore, 3D-LVGLS and 2D-LVGLS had a similar correlation with CMR-ECV (r = 0.60 vs. 0.53, p = 0.670). A separate stepwise multivariate linear analysis showed that both the 2D-LVGLS (β = 0.39, p = 0.019) and 3D-LVGLS (β = 0.54, p < 0.001) were independently associated with CMR-ECV.

Conclusion: CMR marker of diffuse MF was present in asymptomatic patients with HT and appeared to be associated with decreased myocardial strain by echocardiography. Both the 2D- and 3D-LVGLS were independently correlated with diffuse LVMF, which may provide an alternative non-invasive tool for monitoring the development of adverse fibrotic remodeling during the follow-up of HT recipients.

中文翻译：

心脏移植受者弥漫性心肌纤维化的 2D 和 3D 散斑追踪纵向应变与心血管磁共振证据之间的关联

客观的：本研究旨在：(1) 评估通过细胞外体积分数 (ECV) 量化的心肌纤维化 (MF) 与通过二维 (2D) 和三维斑点跟踪超声心动图 (3D-STE) 测量的心肌应变之间的关联(2) 进一步研究通过 2D-和 3D-STE 测量的哪个应变参数是心脏移植 (HT) 受者中 MF 的更可靠预测因子。

方法：共有 40 名 HT 患者和 20 名健康对照者被前瞻性纳入。左心室 (LV)-全局纵向应变 (GLS)、全局圆周应变 (GCS) 和全局径向应变 (GRS) 由 2D-和 3D-STE 测量。LV 弥漫性 MF 由心血管磁共振 (CMR)-ECV 定义。

结果： HT 接受者的天然 T1 和 ECV 显着高于健康对照组（1043.8 ± 34.0 与 999.7 ± 19.7 ms， p< 0.001; 26.6 ± 2.7 与 24.3 ± 1.8%，p= 0.02）。3D- 和 2D-STE-LVGLS 和 LVGCS 较低（p< 0.005) 在 HT 接受者中比在健康对照中。ECV 与 2D-LVGLS 呈中度相关（r = 0.53, p = 0.002) 和 3D-LVGLS (r = 0.60, p< 0.001)，但与 2D 或 3D-LVGCS 或 LVGRS 无关。此外，3D-LVGLS 和 2D-LVGLS 与 CMR-ECV 具有相似的相关性（r = 0.60 对 0.53， p= 0.670）。单独的逐步多元线性分析表明，2D-LVGLS (β = 0.39,p = 0.019) 和 3D-LVGLS (β = 0.54, p < 0.001) 与 CMR-ECV 独立相关。