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Longitudinal fiber dysfunction assessed during cine-cardiac magnetic resonance imaging is an independent predictor of adverse cardiac events
Journal of Cardiovascular Magnetic Resonance volume 18, Article number: P135 (2016)
Left ventricular systole involves coordinated contraction of longitudinal, circumferential, and radial myocardial fibers. Longitudinal fiber dysfunction appears to be an early marker for a number of pathological states. We hypothesized that reduced mitral annular plane systolic excursion (MAPSE) measured during cine-Cardiac Magnetic Resonance (CMR) imaging reflects changes in longitudinal fiber function and may be an early marker for adverse cardiovascular outcomes.
400 consecutive patients with known or suspected coronary artery disease undergoing CMR were prospectively enrolled. Lateral MAPSE was measured in the 4-chamber cine view by two independent observers. Patients were prospectively followed for major adverse cardiac events (MACE) - death, non-fatal myocardial infarction, hospitalization for heart failure or chest pain, and late revascularization. Cox proportional hazards regression modeling was used to identify factors independently associated with MACE.
The mean age of the study population was 58(± 15) years, with a mean ejection fraction of 59(± 14%). 31% of the individuals had known coronary artery disease and 33% were diabetic. 72 MACE occurred during a median follow-up of 14.5 months. By Kaplan-Meier analysis, patients with lateral MAPSE ≤1.11 cm (median) experienced significantly higher incidence of MACE than patients with a MAPSE >1.11 cm (p = 0.0270) (Figure 1). After adjustment for established predictors (ejection fraction, age, sex, diabetes, hyperlipidemia, smoking, hypertension, late gadolinium enhancement) lateral MAPSE remained a significant independent predictor of MACE (HR = 2.43 per cm decrease; p = 0.037) (Figure 2).
Longitudinal fiber dysfunction assessed with lateral MAPSE during cine-CMR is an independent predictor of MACE in patients with known or suspected coronary artery disease.
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Chacko, S.J., Rangarajan, V., Jariwala, N. et al. Longitudinal fiber dysfunction assessed during cine-cardiac magnetic resonance imaging is an independent predictor of adverse cardiac events. J Cardiovasc Magn Reson 18, P135 (2016). https://doi.org/10.1186/1532-429X-18-S1-P135
- Ejection Fraction
- Late Gadolinium Enhancement
- Major Adverse Cardiac Event
- Early Marker
- Significant Independent Predictor