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KMID : 1146220210290040331
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Journal of Cardiovascular Imaging
2021 Volume.29 No. 4 p.331 ~ p.344
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Magnetic Resonance Myocardial Feature Tracking in Transfusion-Dependent Myelodysplastic Syndrome
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Alonso-Fernandez-Gatta Marta
Martin-Garcia Ana
Diez-Campelo Maria
Martin-Garcia Agustin C.
Barreiro-Perez Manuel
Lopez-Cadenas Felix
Diaz-Pelaez Elena
Sanchez Pedro L.
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Abstract
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BACKGROUND: Myocardial deformation with echocardiography allows early detection of systolic dysfunction and is related to myocardial iron overload (MIO) determined by T2* in hereditary anemias under transfusion support. Our aim was to analyze the diagnostic and prognostic usefulness of magnetic resonance feature tracking (MR-FT) myocardial strain in low-risk myelodysplastic syndromes (LR-MDS) patients.
METHODS: Prospective study in transfusion-dependent LR-MDS patients and healthy controls who underwent a cardiac MR-FT. We analyzed the relationships between strain MR-FT and iron overload parameters and its prognostic impact in cardiovascular events and/or death.
RESULTS: Thirty-one patients and thirteen controls were included. MIO (T2* < 20 ms) was detected in 9.7% of patients. Left ventricular global longitudinal strain (LV-GLS) by MR-FT was pathological (> ?19.3%) in 32.3% of patients. Less negative strain values correlated with lower T2* (R = ?0.37, p = 0.033) and native myocardial T1 (R = ?0.39, p = 0.031) times. LV-GLS by MR-FT was significantly associated with higher incidence of the combined cardiovascular events and/or all-cause death (p = 0.047), with a cut-off value of ?17.7% for predicting them (63% sensitivity and 81% specificity, area under the curve = 0.69). After adjusting analysis including demographic, biomarkers and imaging variables, a higher LV-GLS value by MR-FT remained as predictor of combined event in transfusion-dependent LR-MDS patients (hazard ratio, 0.4; confidence interval, 0.15?0.98; p = 0.045).
CONCLUSIONS: Longitudinal myocardial strain by MR-FT in LR-MDS patients is associated to MIO and correlates with adverse events in the follow-up, what could serve as a prognostic tool.
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KEYWORD
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Myelodysplastic syndrome, Iron overload, Cardiac magnetic resonance, Feature tracking, Myocardial deformation
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