Additional predictive role of cardiac magnetic resonance feature-tracking right ventricular global longitudinal strain in patients with reduced ejection fraction: results from the DERIVATE registry

Abstract Background The left ventricular global longitudinal strain (GLS) is recognized as an additional prognostic marker in patients with reduced ejection fraction on top of traditional imaging parameters. However, less is known about the role of right ventricular global longitudinal strain (RV GLS) assessed with cardiac magnetic resonance feature tracking (CMR-FT). Purpose The aim of this study is to assess the prognostic value of CMR-FT derived RV GLS in a cohort of patients with ischemic (ICM) and non-ischemic cardiomyopathy (NICM) and reduced left ventricular ejection fraction (LVEF). Methods Patients from the DERIVATE registry, an international, multicenter, and multivendor study with LVEF - 23.2%, with an area under curve (AUC) of 0.6. After adjustment for clinical (age, diabetes, atrial fibrillation, NYHA class III-IV) and standard CMR parameters (RV dimensions, LVEF and presence of late gadolinium enhancement), RV GLS > - 23.2% remained as an independent predictor of MACE (aHR 1.27, 95% CI 1.00 – 1.61, p < 0.049). Conclusions CMR-FT RV GLS is an independent predictor of ACM or HF on top of standard clinical and imaging parameters in both NICM and ICM. A cut-off of > - 23.2% identifies high-risk patients that may require further clinical evaluation.