scholarly journals Abnormal left ventricular global longitudinal strain by speckle tracking echocardiography in COVID-19 patients

2020 ◽  
Author(s):  
Lori B Croft ◽  
Parasuram Krishnamoorthy ◽  
Richard Ro ◽  
Malcolm Anastasius ◽  
Wenli Zhao ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Healthy Population ◽  
Significant Difference ◽  
The Mean ◽  
Lv Ejection Fraction ◽  
Prognostic Implications

COVID-19 infection can affect the cardiovascular system. We sought to determine if left ventricular global longitudinal strain (LVGLS) is affected by COVID-19 and if this has prognostic implications. Materials & methods: Retrospective study, with LVGLS was measured in 58 COVID-19 patients. Patients discharged were compared with those who died. Results: The mean LV ejection fraction (LVEF) and LVGLS for the cohort was 52.1 and -12.9 ± 4.0%, respectively. Among 30 patients with preserved LVEF(>50%), LVGLS was -15.7 ± 2.8%, which is lower than the reference mean LVGLS for a normal, healthy population. There was no significant difference in LVGLS or LVEF when comparing patients who survived to discharge or died. Conclusion: LVGLS was reduced in COVID-19 patients, although not significantly lower in those who died compared with survivors.

scholarly journals Early detection with speckle tracking echocardiography of biventricular systolic dysfunction, and its relationship with fatigue, in patients with multiple sclerosis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
E Michelotto ◽  
MC Oliva ◽  
MT Amoruso ◽  
G Giovannetti ◽  
C Battista ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Lv Function ◽  
Healthy Population ◽  
The Mean

Abstract Funding Acknowledgements Type of funding sources: None. Background Fatigue is a frequent and debilitating symptom of multiple sclerosis (MS), affecting 90% of patients. Symptoms seems multifactorial, but little is known about the contribution of cardiovascular morpho-functional alterations linked to comorbidities, to lifestyle, to MS itself or to drugs (i.e. mitoxantrone). Aim to investigate the presence of cardiac alterations in MS patients, and to evaluate their impact on fatigue. Methods  24 patients with relapsing-remitting MS (RR-MS) underwent an electrocardiogram (ECG), a transthoracic echocardiographic (TTE), a six minutes walking test (6MWT) with Borg scale (BS), and two fatigue self-assessment scales, the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale (MFIS). The patients were divided into 2 groups: group 1, without traditional cardiovascular risk factors (CVRF: smoke, hypertension, diabetes, hypercholesterolemia; n = 12, 11 females), and group 2, with at least one CVRF (n = 12, 5 females). None of the patients had ever been on mitoxantrone therapy. No new control group was studied due to the SARS-CoV-2 pandemic restrictions , so the comparison was performed with general healthy population in internationally validated previous studies. Results No arrhythmias were found. In both MS groups all the TTE left ventricular (LV) systolic function parameters were depressed compared to the healthy population, but only the mean global longitudinal strain (GLS), the mean longitudinal strain rate (LSR) of LV and estimated pulmonary artery systolic pressure (PAPs) were statistically significant depressed compared to the healthy general population (p < 0.005): see table. This reduction was observed in both MS groups, while there were non significant differences among the two groups. TTE LV function depression significantly correlated to variation of parameters of fatigue , especially considering LV GLS in relation to BS values. Conclusions Subclinical biventricular systolic dysfunction is present in MS patients, and it seems to be linked to the disease itself without being influenced by CVRF. This dysfunction, detected by speckle tracking echocardiographic techniques, seems to contribute to the symptom of fatigue in patients with MS. It is important to include TTE in the workup and follow-up of MS patients, in order to promptly treat cardiac dysfunction and relieve fatigue. Echocardiography and LV strain MS total MS no CVRF MS + CVRF Healthy population LV GLS 17.7 ± 2.2* 18.0 ± 2.1* 17.4 ± 2.4* 22.6 ± 1.7 LV LSR 1.0 ± 0.1* 1.0 ± 0.1* 1.0 ± 0.2* 1.2 ± 0.1 PAPs 25.0 ± 2.6* 24.8 ± 2.9* 25.2 ± 2.5* 14.0 ± 6.0 * p < 0.05 vs healthy population

scholarly journals Evaluation of Cardiac Functions By Speckle Tracking Echocardiography in Type 2 Diabetes Mellitus With Hyperlipidemia

2021 ◽  
Author(s):  
Zhizhi Dong ◽  
Jun Zhou ◽  
Yue Chen ◽  
Zulin Liu ◽  
Douzi Shi ◽  
...  
Keyword(s):  
Normal Control ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Normal Control Group ◽  
Control Group ◽  
Cardiac Functions ◽  
Significant Difference

Abstract Background To investigate the value of two-dimensional speckle tracking echocardiography (2D-STE) in evaluating cardiac functions in type 2 diabetes mellitus (T2DM) with hyperlipidemia. Methods Sixty T2DM patients with normal left ventricular ejection fraction (LVEF) and poorly-controlled blood glucose were selected. Among these, thirty had hyperlipidemia. Thirty age- and gender-matched healthy individuals were recruited as the normal control group. Longitudinal strain of left ventricular segments, left ventricular global longitudinal strain (LV GLS), left atrial global longitudinal strain (LA GLS), right ventricular global longitudinal strain (RV GLS) and right atrial global longitudinal strain (RA GLS) were measured by 2D-STE. Results (1) Compared with the normal control group, LV GLS in T2DM group and T2DM with hyperlipidemia group decreased (P < 0.05), but there was no significant difference of LV GLS between T2DM group and T2DM with hyperlipidemia group (P > 0.05). Compared with the normal control group and T2DM group, longitudinal strain of middle segment of LV in T2DM with hyperlipidemia group decreased (P < 0.05). (2) There was a significant difference in LA GLS among the three groups. LA GLS of T2DM with hyperlipidemia group was lower compared with the normal control and T2DM group (P < 0.05). (3) Compared with the normal control group, RV GLS in T2DM group and T2DM with hyperlipidemia group was lower (P < 0.05), but there was no significant difference of RV GLS between T2DM group and T2DM with hyperlipidemia group (P > 0.05). RA GLS in T2DM with hyperlipidemia group decreased (P < 0.05) compared to the normal control group and T2DM group. Conclusion Speckle tracking echocardiography can effectively evaluate cardiac dysfunction in patients with T2DM. LA GLS and RA GLS can be used as potential markers of cardiac dysfunction in T2DM with hyperlipidemia, and provide the basis for early clinical diagnosis and treatment.

scholarly journals Direct comparison of multilayer left ventricular global longitudinal strain using CMR feature tracking and speckle tracking echocardiography

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saikrishna Ananthapadmanabhan ◽  
Giau Vo ◽  
Tuan Nguyen ◽  
Hany Dimitri ◽  
James Otton
Keyword(s):  
Feature Tracking ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Imaging Modality ◽  
Global Longitudinal Strain ◽  
Intraclass Correlation ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Multilayer Strain

Abstract Background Cardiac magnetic resonance feature tracking (CMR-FT) and speckle tracking echocardiography (STE) are well-established strain imaging modalities. Multilayer strain measurement permits independent assessment of endocardial and epicardial strain. This novel and layer specific approach to evaluating myocardial deformation parameters may provide greater insight into cardiac contractility when compared to whole-layer strain analysis. The aim of this study is to validate CMR-FT as a tool for multilayer strain analysis by providing a direct comparison between multilayer global longitudinal strain (GLS) values between CMR-FT and STE. Methods We studied 100 patients who had an acute myocardial infarction (AMI), who underwent CMR imaging and echocardiogram at baseline and follow-up (48 ± 13 days). Dedicated tissue tracking software was used to analyse single- and multi-layer GLS values for CMR-FT and STE. Results Correlation coefficients for CMR-FT and STE were 0.685, 0.687, and 0.660 for endocardial, epicardial, and whole-layer GLS respectively (all p < 0.001). Bland Altman analysis showed good inter-modality agreement with minimal bias. The absolute limits of agreement in our study were 6.4, 5.9, and 5.5 for endocardial, whole-layer, and epicardial GLS respectively. Absolute biases were 1.79, 0.80, and 0.98 respectively. Intraclass correlation coefficient (ICC) values showed moderate agreement with values of 0.626, 0.632, and 0.671 respectively (all p < 0.001). Conclusion There is good inter-modality agreement between CMR-FT and STE for whole-layer, endocardial, and epicardial GLS, and although values should not be used interchangeably our study demonstrates that CMR-FT is a viable imaging modality for multilayer strain

Speckle tracking echocardiography in patients with stroke

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Trush ◽  
S.V Ivanova ◽  
E.N Yushchuk ◽  
A.A Savin ◽  
I.V Melehina
Keyword(s):  
Ischemic Stroke ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Ct Scanning ◽  
Left Ventricular ◽  
Stroke Severity ◽  
Large Artery ◽  
Stroke Subtypes ◽  
Significant Difference

Abstract Introduction Global longitudinal strain (GLS) via speckle tracking echocardiography (STE) has emerged as a quantitative technique to estimate myocardial function and has been shown to have clinical utility in a variety of settings. The use of this technique in patients with a stroke is limited. Purpose Comparative analysis of myocardial deformation indicators in patients with a stroke, depending on the severity and subtype. Results 230 patients with an acute cerebrovascular accident (132 men and 98 women) were included in our study, with the mean age of 64,9±10,8. Transient ischemic attack (TIA) was diagnosed in 39 (17%), acute ischemic stroke (AIS) in 191 (83%) patients. The type of an ischemic stroke in each patient was classified as one of the following traditional stroke subtypes: large-artery atherosclerosis (LAA) was diagnosed in 85 (44,5%), cardioembolic infarcts were diagnosed in 58 (30,4%), lacunar infarcts were diagnosed in 32 (16,8%) and in 16 (8,4%) the stroke was of another determined or undetermined etiology. There was no significant difference in left ventricular (LV) ejection fraction (EF) between the subgroups of TIA and AIS - 63.0% [60.0; 65.0] and 62.0% [58.0; 65.0], respectively. The LV GLS was within normal limits and amounted to 19.9±2.6 in the TIA group where as in the group of patients with stroke there was a significant (p&lt;0.01) decrease in GLS below standard values - 17.1±3.8. The LV EF showed no significant difference between the groups of stroke subtypes. However, a decrease in GLS was found in the series from cardioembolic infarct &gt; lacunar infarct &gt; LAA - 17.5±3.7 &gt; 16.5±6.5 &gt; 16.2±3.2 (p=0,7). A decrease in GLS was significantly more often observed in male patients. A decrease in the level of GLS in patients with a stroke is associated with duration of type 2 diabetes, stroke severity by the National Institutes of Health Stroke Scale (NIHSS) score, ECG voltage criteria for LVH, increase in heart rate, LV mass/BSA, relative wall thickness (RWT) according to echocardiography. Significant differences in GLS from the size of the stroke focus according to CT scanning/ magnetic resonance imaging were not detected. Conclusion GLS via STE in patients with a stroke correlates with the severity of a stroke, the severity of LV remodeling, risk factors for cardiovascular events and requires a further study to assess the long-term prognosis Funding Acknowledgement Type of funding source: None

scholarly journals Atrial and Ventricular Structural and Functional Alterations in Obese Children

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 562
Author(s):  
Rima Šileikienė ◽  
Karolina Adamonytė ◽  
Aristida Ziutelienė ◽  
Eglė Ramanauskienė ◽  
Jolanta Justina Vaškelytė
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Myocardial Dysfunction ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Z Score ◽  
Obese Children ◽  
2D Speckle Tracking

Background and objectives: Childhood obesity has reached epidemic levels in the world. Obesity in children is defined as a body mass index (BMI) equal to or above the 95th percentile for age and sex. The aim of this study was to determine early changes in cardiac structure and function in obese children by comparing them with their nonobese peers, using echocardiography methods. Materials and methods: The study enrolled 35 obese and 37 age-matched nonobese children. Standardized 2-dimensional (2D), pulsed wave tissue Doppler, and 2D speckle tracking echocardiography were performed. The z-score BMI and lipid metabolism were assessed in all children. Results: Obese children (aged 13.51 ± 2.15 years; 20 boys; BMI z-score of 0.88 ± 0.63) were characterized by enlarged ventricular and atrial volumes, a thicker left ventricular posterior wall, and increased left ventricular mass. Decreased LV and RV systolic and diastolic function was found in obese children. Atrial peak negative (contraction) strain (−2.05% ± 2.17% vs. −4.87% ± 2.97%, p < 0.001), LV and RV global longitudinal strain (−13.3% ± 2.88% vs. −16.87% ± 3.39%; −12.51% ± 10.09% vs. −21.51% ± 7.42%, p < 0.001), and LV global circumferential strain (−17.0 ± 2.7% vs. −19.5 ± 2.9%, p < 0.001) were reduced in obese children. LV torsion (17.94° ± 2.07° vs. 12.45° ± 3.94°, p < 0.001) and normalized torsion (2.49 ± 0.4°/cm vs. 1.86 ± 0.61°/cm, p = 0.001) were greater in obese than nonobese children. A significant inverse correlation was found between LV and RV global longitudinal strain and BMI (r = −0.526, p < 0.01; r = −0.434, p < 0.01) and total cholesterol (r = −0.417, p < 0.01). Multivariate analysis revealed that the BMI z-score was independently related to LV and RV global longitudinal strain as well as LV circumferential and radial strain. Conclusion: 2D speckle tracking echocardiography is beneficial in the early detection of regional LV systolic and diastolic dysfunctions, with preserved ejection fraction as well as additional RV and atrial involvement, in obese children. Obesity may negatively influence atrial and ventricular function, as measured by 2D speckle tracking echocardiography. Obese children, though they are apparently healthy, may have subclinical myocardial dysfunction.

Myocardial work in Stage 1 and 2 hypertensive patients

2021 ◽  
Author(s):  
Akshar Jaglan ◽  
Sarah Roemer ◽  
Ana Cristina Perez Moreno ◽  
Bijoy K Khandheria
Keyword(s):  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Hypertensive Patients ◽  
Non Invasive ◽  
Significant Difference ◽  
Lv Ejection Fraction ◽  
Global Work ◽  
Stage 1

Abstract Aims Myocardial work (MW) is a novel parameter that can be used in a clinical setting to assess left ventricular (LV) pressures and deformation. We sought to distinguish patterns of global MW index in hypertensive vs. non-hypertensive patients and to look at differences between categories of hypertension. Methods and results Sixty-five hypertensive patients (mean age 65 ± 13 years; 30 male) and 15 controls (mean age 38 ± 12 years; 7 male) underwent transthoracic echocardiography at rest. Hypertensive patients were subdivided into Stage 1 (n = 32) and Stage 2 (n = 33) hypertension based on 2017 American College of Cardiology guidelines. Exclusion criteria were suboptimal image quality for myocardial deformation analysis, reduced ejection fraction, valvular heart disease, intracardiac shunt, and arrhythmia. Global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency were estimated from LV pressure–strain loops utilizing proprietary software from speckle-tracking echocardiography. LV systolic and diastolic pressures were estimated using non-invasive brachial artery cuff pressure. Global longitudinal strain and LV ejection fraction were preserved between the groups with no statistically significant difference, whereas there was a statically significant difference between the control and two hypertension groups in GWI (P = 0.01), GCW (P &lt; 0.001), and GWW (P &lt; 0.001). Conclusion Non-invasive MW analysis allows better understanding of LV response under conditions of increased afterload. MW is an advanced assessment of LV systolic function in hypertension patients, giving a closer look at the relationship between LV pressure and contractility in settings of increased load dependency than LV ejection fraction and global longitudinal strain.

scholarly journals Left Ventricular Myocardial Deformations in Hemodialysis Children by Speckle Tracking Echocardiography

2020 ◽  
Vol 14 ◽  
pp. 117954682093001
Author(s):  
Manal F Elshamaa ◽  
Fatma A Mostafa ◽  
Inas AES Sad ◽  
Ahmed M Badr ◽  
Yomna AEM Abd Elrahim
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Radial Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Myocardial Mechanics

Background: Cardiac systolic dysfunction was potentially found in adult patients with end-stage renal disease (ESRD) who have preserved left ventricular ejection fraction (EF%). In children with ESRD, little data are available on early changes in myocardial function. This study aimed to detect the early changes in myocardial mechanics in pediatric patients with ESRD using speckle tracking echocardiography (STE). Methods: Thirty ESRD children receiving hemodialysis (HD) and30 age-matched controls were prospectively studied. Patients underwent echocardiographic studies before and after HD. Left ventricular longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) myocardial deformation parameters (strain, strain rate) were evaluated by STE. Results: The LS was significantly reduced in pre-HD and post-HD patients compared with controls ( P = .000). Controls showed the highest global longitudinal strain. The RS measurements did not differ significantly among the studied groups except for the inferior segment that is significantly reduced after HD compared with controls ( P < .05). The CS was significantly reduced in pre-HD and post-HD patients compared with controls at the lateral and posterior segments ( P = .035 and P = .013, respectively). Conclusion: Speckle-tracking echocardiography might detect early changes in myocardial mechanics in children with ESRD with preserved EF%.

scholarly journals 1187 Evaluation of left and right ventricular functions with 3D speckle tracking in patients with mitral stenosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O Seckin ◽  
S Unlu ◽  
G Tacoy
Keyword(s):  
Right Ventricular ◽  
Mitral Stenosis ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Control Group ◽  
Free Wall ◽  
Significant Difference

Abstract Background The function of both ventricles have been suggested to be affected in patients with mitral stenosis. In this study, it was aimed to investigate deformation properties of right (RV) and left ventricles (LV) in mild and moderate rheumatic mitral stenosis (MS) patients with three-dimensional speckle tracking echocardiography (3D-STE). Methods A total of 60 patients were included in the study (20 patients with mild MS diagnosis, 20 patients with moderate MS diagnosis and 20 healthy volunteers). Three-dimensional echocardiography datasets were obtained for both ventricles in all patients. An example for RV assessment is shown in Figure 1. LV global longitudinal strain (GLS), LV torsion, RV free wall (FW) LS and interventricular septal (IVS) LS measurements were analyzed. Results The LV ejection fraction (EF), RV fractional area change and tricuspid annular plane systolic excursion values were statistically similar and in the normal range. The LV GLS measurements were significantly different among the groups by being highest in the control group and least in the moderate stenosis group (ANOVA,p &lt; 0.001) (Table 1). Patients with MS showed higher torsional values, correlated with MS severity (ANOVA,p &lt; 0.001) (Table 1). IVS LS, RVFW LS values obtained by RV analysis also differed significantly among groups. The FW-GLS values only showed significant difference between the control group and moderate MS group (Table 1). Conclusion Patients with mitral stenosis showed lower LV-GLS and higher LV torsion values. Although the LV GLS is affected; the LV EF was detected to be normal due to increase in LV torsion. RV deformation indices showed signıficant decrease in correlation with the severity of the mitral stenosis. In conclusion, our data suggest that subclinical LV and RV systolic dysfunction is present in mild-moderate MS patients and this dysfunction can be detected by 3D-STE. Table 1 Parameters Control group Mild MS Moderate MS P LV GLS (%) 23.3 ± 2.08 18.9 ± 1.3 17.5 ± 1.8 &lt;0.001 LV torsion 1.5 ± 0.6 2.1 ± 0.6 2.6 ± 0.5 &lt;0.001 IVS LS (%) 23 ± 3.0% 20 ± 2.6 17.1 ± 2.9 &lt;0.001 RV FW LS (%) 25.4 ± 5 22.7 ± 3.2 21.1 ± 4.8 &lt;0.001 FW; free-wall, GLS; global longitudinal strain, IVS; interventricular septum, LV; left ventricular, RV; right ventricular Abstract 1187 Figure 1

scholarly journals Early impairment of myocardial deformation assessed by regional speckle-tracking echocardiography in the indeterminate form of Chagas disease without fibrosis detected by cardiac magnetic resonance

2020 ◽  
Vol 14 (11) ◽  
pp. e0008795
Author(s):  
Minna Moreira Dias Romano ◽  
Henrique Turin Moreira ◽  
José Antônio Marin-Neto ◽  
Priscila Elias Baccelli ◽  
Fawaz Alenezi ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Myocardial Fibrosis ◽  
Chagas Disease ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Indeterminate Form

Chagas disease (CD) will account for 200,000 cardiovascular deaths worldwide over the next 5 years. Early detection of chronic Chagas cardiomyopathy (CCC) is a challenge. We aimed to test if speckle-tracking echocardiography (STE) can detect incipient myocardial damage in CD. METHODS: Among 325 individuals with positive serological tests, 25 (age 55±12yrs) were selected to compose the group with indeterminate form of Chagas disease (IFCD), based on stringent criteria of being asymptomatic and with normal EKG/X-ray studies. This group was compared with a group of 20 patients with CCC (55±11yrs) and a group of 20 non-infected matched control (NC) subjects (48±10yrs). CD patients and NC were submitted to STE and CD patients were submitted to cardiac magnetic resonance (CMR) with late gadolinium administration to detect cardiac fibrosis by the late enhancement technique. Global longitudinal strain (GLS), circumferential (GCS) and radial strain (GRS) were defined as the average of segments measured from three apical view (GLS) and short axis views (GRS and GCS). Regional left ventricular (LV) longitudinal strain (Reg LS) was measured from each of the 17 segments. Twist was measured as systolic peak difference between basal and apical rotation and indexed to LV length to express torsion. RESULTS: STE global indices (GLS, GCS, twist and torsion) were reduced in CCC vs NC (GLS: -14±6.3% vs -19.3±1.6%, p = 0.001; GCS: -13.6±5.2% vs -17.3 ±2.8%; p = 0.008; twist: 8±7° vs 14±7°, p = 0.01 and torsion: 0.96±1°/cm vs 1.9±1°/cm, p = 0.005), but showed no differences in IFCD vs NC. RegLS was reduced in IFCD vs NC in four LV segments: basal-inferior (-16.3±3.3% vs -18.6±2.2%, p = 0.013), basal inferoseptal (-13.1±3.4 vs -15.2±2.7, p = 0.019), mid-inferoseptal (-17.7±3.2 vs -19.4±2, p = 0.032) and mid-inferolateral (-15.2±3.5 vs -17.8±2.8, p = 0.014). These abnormalities in RegLS occurred in the absence of myocardial fibrosis detectable with CMR in nearly 92% of subjects with IFCD, while myocardial fibrosis was present in 65% with CCC. CONCLUSION: RegLS detects early regional impairment of myocardial strain that is independent from fibrosis in IFCD subjects.

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