Prognostic value of myocardial strain by magnetic resonance imaging in nonischemic dilated cardiomyopathy: a systematic review and meta-analysis

Aim This study was aimed at performing a systematic review and meta-analysis to investigate the prognostic role of left ventricular (LV) myocardial strain variables as determined by magnetic-resonance imaging in non-ischemic dilated cardiomyopathy. Material and methods A search was performed in PubMed (MEDLINE), Google Scholar, and EMBASE databases for studies on the prognostic role of LV myocardial strain based on MR feature-tracking in non-ischemic dilated cardiomyopathy. Uncorrected odds ratio (OR) values reported by the studies where similar evaluation criteria of myocardial strain were available, were combined for a meta-analysis. Results Nine studies were selected from 351 publications for this systematic review and meta-analysis. The analysis included a totality of 2139 patients (mean age, 52.3 years; mean follow-up duration, 42.5 months). The meta-analysis showed that the worsening of the LV global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) was associated with increased risk of major adverse cardiovascular events (MACE): OR, 1.13 per each % of GLS; 95 % CI: 1.050-1.225; p=0.001; OR, 1.16 per each % of GCS; 95% CI: 1.107-1.213; p<0.0001; OR, 0.95 per each % of GRS; 95 % CI: 0.92-0.97; p<0.0001. Conclusion The LV GLS, GCS, and GRS variables by MR feature-tracking data are powerful predictors for the development of MACE. Evaluation of myocardial strain can be used as an effective instrument for risk stratification in patients with non-ischemic dilated cardiomyopathy.