Myocardial deformation parameters assessed by CMR feature tracking in chronic heart failure: the influence of an optimal medical therapy on myocardial remodelling

BackgroundMyocardial deformation parameters have been shown to yield early detection of pathological changes in chronic heart failure (CHF). Aim of our study was to evaluate myocardial deformation changes under optimal medical therapy (OMT) in CHF patients.MethodsCHF patients were examined longitudinally with two cardiac magnetic resonance imaging (CMR) examinations at a median time interval of 140 days. Left and right ventricular volumes were quantified, and deformation analysis was performed using feature tracking, respectively.Results57 patients were included into the study. There was a high rate of OMT with a prescription of beta blockers in 98.2% and ACE-inhibitors/Angiotensin receptor blockers in 93.0%. In the total cohort, there were indications of positive remodelling with a significant improvement in left ventricular (LV) ejection fraction (38.9% & PLUSMN; 11.6 vs. 43.0% & PLUSMN; 12.7, p = 0.009), LV enddiastolic volume indexed (92.1 ml/m(2) & PLUSMN; 23.5 vs. 87.2 ml/m(2) & PLUSMN; 21.2, p = 0.007), LV mass (140.3 g & PLUSMN; 35.7 vs. 128.0 g & PLUSMN; 34.4, p = 0.001) and right ventricular global longitudinal strain (RV GLS) (-18.1% & PLUSMN; 5.1 vs. -20.3% & PLUSMN; 4.5, p < 0.001) during follow-up.DiscussionPatients with CHF and OMT show positive reverse remodelling with improvement of LV volumes and function and RV GLS. This has a potential impact on the surveillance of this patient group, which should be further investigated in larger prospective studies.

Automated summary

This study aimed to evaluate myocardial deformation changes in chronic heart failure (CHF) patients under optimal medical therapy (OMT). Longitudinal observations of 57 patients showed significant improvement in left ventricular ejection fraction, left ventricular end-diastolic volume indexed, left ventricular mass, and right ventricular global longitudinal strain under OMT.