Change search
ReferencesLink to record
Permanent link

Direct link
RV Longitudinal Deformation Correlates With Myocardial Fibrosis in Patients With End-Stage Heart Failure
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology. Department of Cardiovascular Disease, University of Siena, Siena, Italy. (Heart Centre)
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
Show others and affiliations
2015 (English)In: JACC Cardiovascular Imaging, ISSN 1936-878X, E-ISSN 1876-7591, Vol. 8, no 5, 514-522 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: This study was performed to determine the accuracy of right ventricular (RV) longitudinal strain (LS) in predicting myocardial fibrosis in patients with severe heart failure (HF) undergoing heart transplantation. Background: RVLS plays a key role in the evaluation of its systolic performance and clinical outcome in patients with refractory HF. Methods: We studied 27 patients with severe systolic HF (ejection fraction ≤25% and New York Heart Association functional class III to IV, despite full medical therapy and cardiac resynchronization therapy) using echocardiography before heart transplantation. RV free wall LS, right atrial LS, sphericity index (SI), and tricuspid annular plane systolic excursion (TAPSE) were all measured. Upon removal of the heart, from the myocardial histologic analysis, the ratio of the fibrotic to the total sample area determined the extent of fibrosis (%). Results: RV myocardial fibrosis correlated with RV free wall LS (r = 0.80; p < 0.0001), SI (r = 0.42; p = 0.01) and VO2 max (r = –0.41; p = 0.03), with a poor correlation with TAPSE (r = –0.34; p = 0.05) and right atrial LS (r = –0.37; p = 0.03). Stepwise multivariate analysis showed that RV free wall LS (β = 0.701, p < 0.0001) was independently associated with RV fibrosis (overall model R2 = 0.64, p < 0.0001). RV free wall LS was the main determinant of myocardial fibrosis. In the subgroup of patients with severe RV fibrosis, RV free wall LS had the highest diagnostic accuracy for detecting severe myocardial fibrosis (area under the curve = 0.87; 95% confidence interval: 0.80 to 0.94). Conclusions: In late-stage HF patients, the right ventricle is enlarged, with reduced systolic function due to significant myocardial fibrosis. RV free wall myocardial deformation is the most accurate functional measure that correlates with the extent of RV myocardial fibrosis and functional capacity.

Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 8, no 5, 514-522 p.
Keyword [en]
heart failure, myocardial fibrosis, right ventricle
National Category
Cardiac and Cardiovascular Systems Radiology, Nuclear Medicine and Medical Imaging
URN: urn:nbn:se:umu:diva-105267DOI: 10.1016/j.jcmg.2014.12.026ISI: 000355068500003PubMedID: 25890585OAI: diva2:824582
Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2015-07-02Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Lisi, MatteoCameli, MatteoHenein, Michael Y
By organisation
In the same journal
JACC Cardiovascular Imaging
Cardiac and Cardiovascular SystemsRadiology, Nuclear Medicine and Medical Imaging

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 34 hits
ReferencesLink to record
Permanent link

Direct link