Abstract 18003: Left Ventricular Long Axis Function Assessed During Routine Cine-Cardiac Magnetic Resonance Imaging is an Independent Predictor of Mortality in Patients With Reduced Ejection Fraction: A Multicenter Study
Introduction: Left ventricular contraction involves a complex interplay between myocardial fibers orientated in the longitudinal, oblique and circumferential directions. Long axis function appears to play a fundamental role in cardiac mechanics and there is increasing evidence that it may provide independent prognostic information in a number of disease states. The aim of this study was to evaluate the prognostic value of lateral mitral annular plane systolic excursion (MAPSE) as an index of long axis function, in a large multicenter population of patients with reduced ejection fraction (EF) undergoing CMR.
Hypothesis: Long axis function measured using lateral MAPSE during routine cine-CMR is an independent predictor of mortality in patients with reduced EF.
Methods: Data analysis was performed on 619 consecutive patients with EF<40% undergoing CMR with cine and late gadolinium enhancement (LGE) imaging at 4 US hospitals. Lateral MAPSE was measured in the 4-chamber cine view as the simple displacement of the lateral mitral annulus between end-diastole and end-systole. The primary outcome of death was assessed using the Social Security Death Index. Survival curves were constructed using the Kaplan-Meier method. Cox proportional hazards regression modeling was used to identify factors independently associated with death.
Results: 96 deaths occurred during a median follow-up of 4.4 years. By Kaplan-Meier analysis, the risk of death increased significantly with decreasing tertiles of lateral MAPSE (p < 0.00001) (Figure). After adjustment for established clinical and imaging risk factors, which were univariate predictors (age, EF, presence of LGE), lateral MAPSE remained a significant independent predictor of death (HR =1.84 per 1 mm decrease; p < 0.0001).
Conclusions: Lateral MAPSE measured during cine-CMR is an independent predictor of all-cause mortality in patients with reduced EF.
Author Disclosures: S. Romano: None. J. Jue: None. R. Judd: None. R.J. Kim: None. H.W. Kim: None. I. Klem: None. D.J. Shah: None. J. Heitner: None. V. Rangarajan: None. S.J. Chacko: None. B. White: None. A. Farzaneh-Far: None.
- © 2016 by American Heart Association, Inc.