Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy

Robin J. Taylor; Fraz Umar; Erica L S Lin; Amar Ahmed; William E. Moody; Wojciech Mazur; Berthold Stegemann; Jonathan N. Townend; Richard P. Steeds; Francisco Leyva

doi:10.1186/s12968-015-0221-2

Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy

Robin J. Taylor, Fraz Umar, Erica L S Lin, Amar Ahmed, William E. Moody, Wojciech Mazur, Berthold Stegemann, Jonathan N. Townend, Richard P. Steeds, Francisco Leyva^*

^*Corresponding author for this work

Aston Medical School

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Left ventricular (LV) mid-wall fibrosis (MWF), which occurs in about a quarter of patients with non-ischemic cardiomyopathy (NICM), is associated with high risk of pump failure. The mid LV wall is the site of circumferential myocardial fibers. We sought to determine the effect of MWF on LV myocardial mechanics. Methods: Patients with NICM (n = 116; age: 62.8 ± 13.2 years; 67 % male) underwent late gadolinium enhancement cardiovascular magnetic resonance (CMR) and were categorized according to the presence (+) or absence (-) of MWF. Feature tracking (FT) CMR was used to assess myocardial deformation. Results: Despite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (ε_cc: -6.6 % vs -9.4 %, P = 0.004), but similar longitudinal (ε_ll: -7.6 % vs. -9.4 %, p = 0.053) and radial (ε_rr: 14.6 % vs. 17.8 % p = 0.18) strain. Compared with - MWF, + MWF was associated with reduced LV systolic, circumferential strain rate (-0.38 ± 0.1 vs -0.56 ± 0.3 s^-1, p = 0.005) and peak LV twist (4.65 vs. 6.31°, p = 0.004), as well as rigid LV body rotation (64 % vs 28 %, P cc: 0.34 vs. 0.46 s^-1; DSR_ll: 0.38 vs. 0.50s^-1; DSR_rr: -0.55 vs. -0.75 s^-1; all p

Original language	English
Article number	221
Journal	Journal of Cardiovascular Magnetic Resonance
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s12968-015-0221-2
Publication status	Published - 5 Jan 2016

Bibliographical note

Copyright: 2016 Taylor et al. Open Access - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Funding: Medtronic Inc.

Keywords

Cardiovascular magnetic resonance
Feature-tracking
Heart failure
Mid-wall fibrosis
Myocardial deformation
Non ischemic dilated cardiomyopathy
Torsion

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10.1186/s12968-015-0221-2Licence: CC BY 3.0

Mechanical effects of left ventricular
Copyright: 2016 Taylor et al. Open Access - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Final published version, 1.2 MBLicence: CC BY 3.0

Cite this

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title = "Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy",

abstract = "Background: Left ventricular (LV) mid-wall fibrosis (MWF), which occurs in about a quarter of patients with non-ischemic cardiomyopathy (NICM), is associated with high risk of pump failure. The mid LV wall is the site of circumferential myocardial fibers. We sought to determine the effect of MWF on LV myocardial mechanics. Methods: Patients with NICM (n = 116; age: 62.8 ± 13.2 years; 67 % male) underwent late gadolinium enhancement cardiovascular magnetic resonance (CMR) and were categorized according to the presence (+) or absence (-) of MWF. Feature tracking (FT) CMR was used to assess myocardial deformation. Results: Despite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (εcc: -6.6 % vs -9.4 %, P = 0.004), but similar longitudinal (εll: -7.6 % vs. -9.4 %, p = 0.053) and radial (εrr: 14.6 % vs. 17.8 % p = 0.18) strain. Compared with - MWF, + MWF was associated with reduced LV systolic, circumferential strain rate (-0.38 ± 0.1 vs -0.56 ± 0.3 s-1, p = 0.005) and peak LV twist (4.65 vs. 6.31°, p = 0.004), as well as rigid LV body rotation (64 % vs 28 %, P cc: 0.34 vs. 0.46 s-1; DSRll: 0.38 vs. 0.50s-1; DSRrr: -0.55 vs. -0.75 s-1; all p ",

keywords = "Cardiovascular magnetic resonance, Feature-tracking, Heart failure, Mid-wall fibrosis, Myocardial deformation, Non ischemic dilated cardiomyopathy, Torsion",

author = "Taylor, {Robin J.} and Fraz Umar and Lin, {Erica L S} and Amar Ahmed and Moody, {William E.} and Wojciech Mazur and Berthold Stegemann and Townend, {Jonathan N.} and Steeds, {Richard P.} and Francisco Leyva",

note = "Copyright: 2016 Taylor et al. Open Access - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Funding: Medtronic Inc.",

year = "2016",

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day = "5",

doi = "10.1186/s12968-015-0221-2",

language = "English",

volume = "18",

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TY - JOUR

T1 - Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy

AU - Taylor, Robin J.

AU - Umar, Fraz

AU - Lin, Erica L S

AU - Ahmed, Amar

AU - Moody, William E.

AU - Mazur, Wojciech

AU - Stegemann, Berthold

AU - Townend, Jonathan N.

AU - Steeds, Richard P.

AU - Leyva, Francisco

N1 - Copyright: 2016 Taylor et al. Open Access - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Funding: Medtronic Inc.

PY - 2016/1/5

Y1 - 2016/1/5

N2 - Background: Left ventricular (LV) mid-wall fibrosis (MWF), which occurs in about a quarter of patients with non-ischemic cardiomyopathy (NICM), is associated with high risk of pump failure. The mid LV wall is the site of circumferential myocardial fibers. We sought to determine the effect of MWF on LV myocardial mechanics. Methods: Patients with NICM (n = 116; age: 62.8 ± 13.2 years; 67 % male) underwent late gadolinium enhancement cardiovascular magnetic resonance (CMR) and were categorized according to the presence (+) or absence (-) of MWF. Feature tracking (FT) CMR was used to assess myocardial deformation. Results: Despite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (εcc: -6.6 % vs -9.4 %, P = 0.004), but similar longitudinal (εll: -7.6 % vs. -9.4 %, p = 0.053) and radial (εrr: 14.6 % vs. 17.8 % p = 0.18) strain. Compared with - MWF, + MWF was associated with reduced LV systolic, circumferential strain rate (-0.38 ± 0.1 vs -0.56 ± 0.3 s-1, p = 0.005) and peak LV twist (4.65 vs. 6.31°, p = 0.004), as well as rigid LV body rotation (64 % vs 28 %, P cc: 0.34 vs. 0.46 s-1; DSRll: 0.38 vs. 0.50s-1; DSRrr: -0.55 vs. -0.75 s-1; all p

AB - Background: Left ventricular (LV) mid-wall fibrosis (MWF), which occurs in about a quarter of patients with non-ischemic cardiomyopathy (NICM), is associated with high risk of pump failure. The mid LV wall is the site of circumferential myocardial fibers. We sought to determine the effect of MWF on LV myocardial mechanics. Methods: Patients with NICM (n = 116; age: 62.8 ± 13.2 years; 67 % male) underwent late gadolinium enhancement cardiovascular magnetic resonance (CMR) and were categorized according to the presence (+) or absence (-) of MWF. Feature tracking (FT) CMR was used to assess myocardial deformation. Results: Despite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (εcc: -6.6 % vs -9.4 %, P = 0.004), but similar longitudinal (εll: -7.6 % vs. -9.4 %, p = 0.053) and radial (εrr: 14.6 % vs. 17.8 % p = 0.18) strain. Compared with - MWF, + MWF was associated with reduced LV systolic, circumferential strain rate (-0.38 ± 0.1 vs -0.56 ± 0.3 s-1, p = 0.005) and peak LV twist (4.65 vs. 6.31°, p = 0.004), as well as rigid LV body rotation (64 % vs 28 %, P cc: 0.34 vs. 0.46 s-1; DSRll: 0.38 vs. 0.50s-1; DSRrr: -0.55 vs. -0.75 s-1; all p

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KW - Myocardial deformation

KW - Non ischemic dilated cardiomyopathy

KW - Torsion

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Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy

Abstract

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Keywords

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