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Cardiac Magnetic Resonance Feature Tracking Global Longitudinal Strain and Prognosis After Heart Transplantation.

Publication ,  Journal Article
Shenoy, C; Romano, S; Hughes, A; Okasha, O; Nijjar, PS; Velangi, P; Martin, CM; Akçakaya, M; Farzaneh-Far, A
Published in: JACC. Cardiovascular imaging
September 2020

This study determined the long-term prognostic significance of GLS assessed using CMR-FT in a large cohort of heart transplant recipients.In heart transplant recipients, global longitudinal strain (GLS) assessed using echocardiography has shown promise in the prediction of clinical outcomes. We hypothesized that CMR feature tracking (CMR-FT) GLS is independently associated with long-term outcomes in heart transplant recipients.In a cohort of consecutive heart transplant recipients who underwent routine CMR for clinical surveillance, CMR-FT GLS was calculated from 3 long-axis cine CMR images. Associations between GLS and a composite endpoint of death or major adverse cardiac events (MACE), including retransplantation, nonfatal myocardial infarction, coronary revascularization, and heart failure hospitalization, were investigated.A total of 152 heart transplant recipients (age 54 ± 15 years; 29% women; 5.0 ± 5.4 years after heart transplantation) were included. The median GLS was -11.6% (interquartile range: -13.6% to -9.2%). Over a median follow-up of 2.6 years, 59 recipients reached the composite endpoint. On Kaplan-Meier analyses, recipients with GLS worse than the median had a higher estimated cumulative incidence of the composite endpoint compared with recipients with GLS better than the median (log rank p = 0.004). On multivariate Cox proportional hazards regression, GLS was independently associated with the composite endpoint after adjustment for cardiac allograft vasculopathy, history of rejection, left ventricular ejection fraction (LVEF), right ventricular EF, and presence of myocardial fibrosis, with a hazard ratio of 1.15 for every 1% worsening in GLS (95% confidence interval: 1.06 to 1.24; p < 0.001). Similar results were seen in subgroups of recipients with LVEF >50% and with no myocardial fibrosis. GLS provided incremental prognostic value over other variables in the multivariate model as determined by the log-likelihood chi-squared test.In a large cohort of heart transplant recipients, CMR-FT GLS was independently associated with the long-term risk of death or MACE.

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Published In

JACC. Cardiovascular imaging

DOI

EISSN

1876-7591

ISSN

1936-878X

Publication Date

September 2020

Volume

13

Issue

9

Start / End Page

1934 / 1942

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Magnetic Resonance Spectroscopy
  • Magnetic Resonance Imaging, Cine
  • Humans
  • Heart Transplantation
 

Citation

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MLA
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Shenoy, C., Romano, S., Hughes, A., Okasha, O., Nijjar, P. S., Velangi, P., … Farzaneh-Far, A. (2020). Cardiac Magnetic Resonance Feature Tracking Global Longitudinal Strain and Prognosis After Heart Transplantation. JACC. Cardiovascular Imaging, 13(9), 1934–1942. https://doi.org/10.1016/j.jcmg.2020.04.004
Shenoy, Chetan, Simone Romano, Andrew Hughes, Osama Okasha, Prabhjot S. Nijjar, Pratik Velangi, Cindy M. Martin, Mehmet Akçakaya, and Afshin Farzaneh-Far. “Cardiac Magnetic Resonance Feature Tracking Global Longitudinal Strain and Prognosis After Heart Transplantation.JACC. Cardiovascular Imaging 13, no. 9 (September 2020): 1934–42. https://doi.org/10.1016/j.jcmg.2020.04.004.
Shenoy C, Romano S, Hughes A, Okasha O, Nijjar PS, Velangi P, et al. Cardiac Magnetic Resonance Feature Tracking Global Longitudinal Strain and Prognosis After Heart Transplantation. JACC Cardiovascular imaging. 2020 Sep;13(9):1934–42.
Shenoy, Chetan, et al. “Cardiac Magnetic Resonance Feature Tracking Global Longitudinal Strain and Prognosis After Heart Transplantation.JACC. Cardiovascular Imaging, vol. 13, no. 9, Sept. 2020, pp. 1934–42. Epmc, doi:10.1016/j.jcmg.2020.04.004.
Shenoy C, Romano S, Hughes A, Okasha O, Nijjar PS, Velangi P, Martin CM, Akçakaya M, Farzaneh-Far A. Cardiac Magnetic Resonance Feature Tracking Global Longitudinal Strain and Prognosis After Heart Transplantation. JACC Cardiovascular imaging. 2020 Sep;13(9):1934–1942.
Journal cover image

Published In

JACC. Cardiovascular imaging

DOI

EISSN

1876-7591

ISSN

1936-878X

Publication Date

September 2020

Volume

13

Issue

9

Start / End Page

1934 / 1942

Related Subject Headings

  • Ventricular Function, Left
  • Stroke Volume
  • Prognosis
  • Predictive Value of Tests
  • Middle Aged
  • Male
  • Magnetic Resonance Spectroscopy
  • Magnetic Resonance Imaging, Cine
  • Humans
  • Heart Transplantation