Role of cardiac magnetic resonance imaging in predicting unfavorable left ventricular remodeling: a retrospective analysis after surgical treatment of ischemic cardiomyopathy

Abstract

Aim . To evaluate the role of cardiac MRI parameters, including strain parameters, in predicting unfavorable left ventricular (LV) remodeling in the midterm after surgery in patients with ischemic cardiomyopathy. Material and methods. The results of paramagnetic contrast-enhanced cardiac magnetic resonance imaging were analyzed in 29 patients with ischemic cardiomyopathy (mean age 59,4±9,4 years) before complex surgical treatment. The anatomical and functional cardiac characteristics, LV global strain indices, and myocardial structural features were assessed, including after contrast agent administration. R e sults . Left ventricular (LV) global longitudinal strain (GLS), LV global radial strain (GRS), LV ejection fraction, and the number of LV segments with pathological delayed enhancement were significant predictors of LV endothelial dysfunction 9-24 months after surgery. According to ROC analysis, the sensitivity of preoperative LV GLS in predicting postoperative LV endothelial dysfunction was 90,9%, and the specificity was 85,7% for a GLS >-3,8. A correlation was found between the left atrial volume index (LAVI) and LV GLS (p<0,005, correlation coefficient ρ=0,55), between LAVI and LV GRS (p<0,005, correlation coefficient ρ= -0,51), between GLS and the number of LV segments with pathological delayed contrast enhancement (p<0,005, correlation coefficient ρ=0,43), and between GRS and the number of LV segments with pathological delayed contrast enhancement (p<0,005, correlation coefficient ρ= -0,38). Conclusion . Changes in quantitative parameters of LV strain in patients with ischemic cardiomyopathy are the most sensitive marker of unfavorable LV remodeling in the postoperative period.