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Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome

Cardiac magnetic resonance (CMR)-derived left ventricular (LV) global longitudinal strain (GLS) provides incremental prognostic information on various cardiovascular diseases but has not yet been investigated comprehensively in patients with Takotsubo syndrome (TS). This study evaluated the prognost...

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Autores principales: Stiermaier, Thomas, Busch, Kira, Lange, Torben, Pätz, Toni, Meusel, Moritz, Backhaus, Sören J., Frydrychowicz, Alex, Barkhausen, Jörg, Gutberlet, Matthias, Thiele, Holger, Schuster, Andreas, Eitel, Ingo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759874/
https://www.ncbi.nlm.nih.gov/pubmed/33260461
http://dx.doi.org/10.3390/jcm9123882
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author Stiermaier, Thomas
Busch, Kira
Lange, Torben
Pätz, Toni
Meusel, Moritz
Backhaus, Sören J.
Frydrychowicz, Alex
Barkhausen, Jörg
Gutberlet, Matthias
Thiele, Holger
Schuster, Andreas
Eitel, Ingo
author_facet Stiermaier, Thomas
Busch, Kira
Lange, Torben
Pätz, Toni
Meusel, Moritz
Backhaus, Sören J.
Frydrychowicz, Alex
Barkhausen, Jörg
Gutberlet, Matthias
Thiele, Holger
Schuster, Andreas
Eitel, Ingo
author_sort Stiermaier, Thomas
collection PubMed
description Cardiac magnetic resonance (CMR)-derived left ventricular (LV) global longitudinal strain (GLS) provides incremental prognostic information on various cardiovascular diseases but has not yet been investigated comprehensively in patients with Takotsubo syndrome (TS). This study evaluated the prognostic value of feature tracking (FT) GLS, tissue tracking (TT) GLS, and fast manual long axis strain (LAS) in 147 patients with TS, who underwent CMR at a median of 2 days after admission. Long-term mortality was assessed 3 years after the acute event. In contrast to LV ejection fraction and tissue characteristics, impaired FT-GLS, TT-GLS and fast manual LAS were associated with adverse outcome. The best cutoff points for the prediction of long-term mortality were similar with all three approaches: FT-GLS −11.28%, TT-GLS −11.45%, and fast manual LAS −10.86%. Long-term mortality rates were significantly higher in patients with FT-GLS > −11.28% (25.0% versus 9.8%; p = 0.029), TT-GLS > −11.45% (20.0% versus 5.4%; p = 0.016), and LAS > −10.86% (23.3% versus 6.6%; p = 0.014). However, in multivariable analysis, diabetes mellitus (p = 0.001), atrial fibrillation (p = 0.001), malignancy (p = 0.006), and physical triggers (p = 0.006) outperformed measures of myocardial strain and emerged as the strongest, independent predictors of long-term mortality in TS. In conclusion, CMR-based longitudinal strain provides valuable prognostic information in patients with TS, regardless of the utilized technique of assessment. Long-term mortality, however, is mainly determined by comorbidities.
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spelling pubmed-77598742020-12-26 Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome Stiermaier, Thomas Busch, Kira Lange, Torben Pätz, Toni Meusel, Moritz Backhaus, Sören J. Frydrychowicz, Alex Barkhausen, Jörg Gutberlet, Matthias Thiele, Holger Schuster, Andreas Eitel, Ingo J Clin Med Article Cardiac magnetic resonance (CMR)-derived left ventricular (LV) global longitudinal strain (GLS) provides incremental prognostic information on various cardiovascular diseases but has not yet been investigated comprehensively in patients with Takotsubo syndrome (TS). This study evaluated the prognostic value of feature tracking (FT) GLS, tissue tracking (TT) GLS, and fast manual long axis strain (LAS) in 147 patients with TS, who underwent CMR at a median of 2 days after admission. Long-term mortality was assessed 3 years after the acute event. In contrast to LV ejection fraction and tissue characteristics, impaired FT-GLS, TT-GLS and fast manual LAS were associated with adverse outcome. The best cutoff points for the prediction of long-term mortality were similar with all three approaches: FT-GLS −11.28%, TT-GLS −11.45%, and fast manual LAS −10.86%. Long-term mortality rates were significantly higher in patients with FT-GLS > −11.28% (25.0% versus 9.8%; p = 0.029), TT-GLS > −11.45% (20.0% versus 5.4%; p = 0.016), and LAS > −10.86% (23.3% versus 6.6%; p = 0.014). However, in multivariable analysis, diabetes mellitus (p = 0.001), atrial fibrillation (p = 0.001), malignancy (p = 0.006), and physical triggers (p = 0.006) outperformed measures of myocardial strain and emerged as the strongest, independent predictors of long-term mortality in TS. In conclusion, CMR-based longitudinal strain provides valuable prognostic information in patients with TS, regardless of the utilized technique of assessment. Long-term mortality, however, is mainly determined by comorbidities. MDPI 2020-11-29 /pmc/articles/PMC7759874/ /pubmed/33260461 http://dx.doi.org/10.3390/jcm9123882 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Stiermaier, Thomas
Busch, Kira
Lange, Torben
Pätz, Toni
Meusel, Moritz
Backhaus, Sören J.
Frydrychowicz, Alex
Barkhausen, Jörg
Gutberlet, Matthias
Thiele, Holger
Schuster, Andreas
Eitel, Ingo
Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome
title Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome
title_full Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome
title_fullStr Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome
title_full_unstemmed Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome
title_short Prognostic Value of Different CMR-Based Techniques to Assess Left Ventricular Myocardial Strain in Takotsubo Syndrome
title_sort prognostic value of different cmr-based techniques to assess left ventricular myocardial strain in takotsubo syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759874/
https://www.ncbi.nlm.nih.gov/pubmed/33260461
http://dx.doi.org/10.3390/jcm9123882
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