Abstract
Background: Myocardial deformation parameters have been shown to yield early detection of pathological changes in chronic heart failure (CHF). Aim of our study was to evaluate myocardial deformation changes under optimal medical therapy (OMT) in CHF patients.Methods: CHF patients were examined longitudinally with two cardiac magnetic resonance imaging (CMR) examinations at a median time interval of 140 days. Left and right ventricular volumes were quantified, and deformation analysis was performed using feature tracking, respectively.Results: 57 patients were included into the study. There was a high rate of OMT with a prescription of beta blockers in 98.2% and ACE-inhibitors/Angiotensin receptor blockers in 93.0%. In the total cohort, there were indications of positive remodeling with a significant improvement in left ventricular (LV) ejection fraction (38.9% ± 11.6 vs. 43.0% ± 12.7, p=0.009), LV enddiastolic volume indexed (92.1ml/m2 ± 23.5 vs. 87.2ml/m2 ± 21.2, p=0.007), LV mass (140.3g ± 35.7 vs. 128.0g ± 34.4, p=0.001) and right ventricular global longitudinal strain (RV GLS) (-18.1% ± 5.1 vs. -20.3% ± 4.5, p<0.001) during follow-up. Discussion: Patients with CHF and OMT show positive reverse remodeling with improvement of LV volumes and function and RV GLS. This has a potential impact on the surveillance of this patient group, which should be further investigated in larger prospective studies.
Should we revise our approach to 'optimal medical therapy'? The case of chronic heart failure
