Myocardial Strain-Based on Regional Wall Motion Abnormalities Index : A Prognostic Marker of Incident Heart Failure. Cardiovascular MRI study from the Multi-Ethnic Study of Atherosclerosis (MESA)

• Published in: Archives of Cardiovascular Diseases Supplements Vol. 14; no. 1; pp. 35 - 36
• Main Authors: Pezel, T., Bluemke, D.A., Wu, C., Lima, J., Venkatesh, B.A.
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.01.2022
• ISSN: 1878-6480
• DOI: 10.1016/j.acvdsp.2021.09.077

Although several studies have investigated the prognostic value of the LV global circumferential strain for predicting the risk of heart failure (HF), very few studies have assessed the prognostic value of myocardial strain-based Regional Wall Motion Abnormalities (RWMA) index assessed by CMR tagging in asymptomatic individuals without a history of CVD. To assess the long-term prognostic value of myocardial strain and the RWMA index measured by tagged MRI for the prediction of CV events in the Multi-Ethnic Study of Atherosclerosis (MESA). Participants of the MESA who underwent a baseline CMR study including cardiac-tagged MRI using HARP were analysed. The AHA classification with 16-segments was used for strain data. RWMA score was defined by the number of segments with regiona strain>−16% (cut-off defined by survival tree method). Cox proportional hazard models were used to evaluate the association between RWMA index and incident HF. The survival tree method was used to determine the best cut-off to transform the RWMA score into a binary variable. Among the 1506 participants (age 63.3±9.4 years, 54.6% men), 91 incident HFs were observed after a mean follow-up of 15.9±3.1 years. RWMA score was associated with HF (HR 1.58, 95%CI [1.07-2.49], P=0.002). Using an optimal cut-off to predict incident HF, RWMA >66% of total myocardium was also associated with HF (HR 2.43, 95%CI [1.72-3.41], P<0.001). After adjustment for traditional HF risk factors (age, male, ethnicity, BMI, hypertension, diabetes, dyslipidemia, smoking and hypercholesterolemia), higher RWMA score and RWMA >66% were both independently associated with HF (HR 1.57, 95%CI [1.02-2.32], P=0.038 and HR 1.67, 95%CI [1.03-2.94], P=0.002; respectively) (Table 1). In a multi-ethnic population, RWMA index assessed by cardiac-tagged MRI is independently associated with incident HF.