Cardiac magnetic resonance feature tracking derived left atrial strain in the diagnosis of patients with constrictive pericarditis and restrictive cardiomyopathy

Kairui Bo; Yichen Zhao; Xuelian Gao; Yanchun Chen; Yue Ren; Yifeng Gao; Zhen Zhou; Hui Wang; Lei Xu

doi:10.1016/j.heliyon.2024.e28768

Cardiac magnetic resonance feature tracking derived left atrial strain in the diagnosis of patients with constrictive pericarditis and restrictive cardiomyopathy

Heliyon. 2024 Mar 28;10(7):e28768. doi: 10.1016/j.heliyon.2024.e28768. eCollection 2024 Apr 15.

Authors

Kairui Bo¹, Yichen Zhao², Xuelian Gao¹, Yanchun Chen¹, Yue Ren¹, Yifeng Gao¹, Zhen Zhou¹, Hui Wang¹, Lei Xu¹

Affiliations

¹ Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
² Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.

Abstract

Objective: To explore the diagnostic value of cardiac magnetic resonance feature tracking (CMR-FT) divided left atrial (LA) strain in differentiating constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM).

Methods: Patients with CP (n = 40) and RCM (n = 40), and another 40 normal control group were retrospectively enrolled over a period of 8 years at a tertiary cardiac centre. Left ventricular (LV) and biatrial strain and strain rate (SR) were measured. Atrial strain was used to differentiate between patients with CP and RCM. Then, patients were grouped according to their left ventricular ejection fraction (LVEF), either ≥50% or < 50%. A deeper analysis was done to evaluate the diagnostic value of atrial strain in these subgroups. Receiver operating characteristic curves (ROC) were used to assess the accuracy of myocardial strain based on CMR FT for the differential diagnosis of CP and RCM.

Results: LV and LA strain and SR were significantly lower in patients with CP and RCM than those in the normal controls (P < 0.05). LA strain and SR were significantly lower in the RCM group than in the CP group (P < 0.05). In patients with either LVEF≥50% or＜50%, LA strain were lower in the RCM group than in the CP group (P < 0.05). ROC analysis showed that LA stored strain (LA-εs) had a good differential diagnostic value for CP and RCM, with an area under the curve (AUC) of 0.811 and an optimal cutoff value of 6.98%, above this value it tends to develop CP. Further, an excellent differential diagnostic value was found in patients with LVEF＜50%, with an AUC of 0.955.

Conclusion: LA strain analysis obtained by CMR-FT provides good differential diagnostic value for distinguishing CP from RCM, especially in patients with LVEF＜50%.

Keywords: Constrictive pericarditis; Left atrium; Myocardial strain; Restrictive cardiomyopathy.