Association of Feature-Tracking Cardiac Magnetic Resonance Imaging Left Ventricular Global Longitudinal Strain with All-Cause Mortality in Patients with Reduced Left Ventricular Ejection Fraction

Direct assessment of myocardial fiber deformation with echocardiographic global longitudinal strain (GLS) has shown promise in providing prognostic information that is incremental to ejection fraction (EF) in patients with left ventricular dysfunction.1 Cardiac magnetic resonance (CMR) imaging has now evolved into a major tool for evaluation of patients with left ventricular dysfunction, providing precise measurements of EF and viability assessment with late gadolinium enhancement (LGE). Recent development of CMR feature-tracking techniques now allow assessment of GLS from standard cine CMR images without the need for specialized pulse sequences or additional scanning time.2 We therefore hypothesized that CMR feature-tracking derived GLS may provide incremental prognostic information in these patients. Consecutive patients (n=470) undergoing CMR with both cine and LGE imaging for evaluation of ischemic or nonischemic dilated cardiomyopathy with EF <50% were included in this retrospective study. Comprehensive phenotyping, including clinical history, imaging, and cardiac catheterization, classified 330 individuals with ischemic and 140 with nonischemic cardiomyopathy. Institutional review board approval was obtained. Steady-state free-precession cine images were acquired in multiple short-axis and 3 long-axis views. LGE imaging was performed 10 to 15 minutes after Gadolinium contrast (0.15 mmol/kg) administration using a 2D-segmented gradient echo inversion recovery sequence in …