Mechanical effects of left ventricular midwall fibrosis in non-ischemic cardiomyopathy


Background: Left ventricular (LV) mid-wall fibrosis (MWF), which occurs in about a quarter of patients with non-ischemic cardiomyopathy (NICM), is associated with high risk of pump failure. The mid LV wall is the site of circumferential myocardial fibers. We sought to determine the effect of MWF on LV myocardial mechanics. Methods: Patients with NICM (n = 116; age: 62.8 ± 13.2 years; 67 % male) underwent late gadolinium enhancement cardiovascular magnetic resonance (CMR) and were categorized according to the presence (+) or absence (-) of MWF. Feature tracking (FT) CMR was used to assess myocardial deformation. Results: Despite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (εcc: -6.6 % vs -9.4 %, P = 0.004), but similar longitudinal (εll: -7.6 % vs. -9.4 %, p = 0.053) and radial (εrr: 14.6 % vs. 17.8 % p = 0.18) strain. Compared with - MWF, + MWF was associated with reduced LV systolic, circumferential strain rate (-0.38 ± 0.1 vs -0.56 ± 0.3 s-1, p = 0.005) and peak LV twist (4.65 vs. 6.31°, p = 0.004), as well as rigid LV body rotation (64 % vs 28 %, P cc: 0.34 vs. 0.46 s-1; DSRll: 0.38 vs. 0.50s-1; DSRrr: -0.55 vs. -0.75 s-1; all p

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Divisions: College of Health & Life Sciences > Aston Medical School
Additional Information: Copyright: 2016 Taylor et al. Open Access - This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated. Funding: Medtronic Inc.
Uncontrolled Keywords: Cardiovascular magnetic resonance,Feature-tracking,Heart failure,Mid-wall fibrosis,Myocardial deformation,Non ischemic dilated cardiomyopathy,Torsion,Cardiology and Cardiovascular Medicine,Radiology Nuclear Medicine and imaging,Radiological and Ultrasound Technology,Family Practice
Publication ISSN: 1532-429X
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://jcmr-on ... 2968-015-0221-2 (Publisher URL)
PURE Output Type: Article
Published Date: 2016-01-05
Accepted Date: 2015-12-22
Authors: Taylor, Robin J.
Umar, Fraz
Lin, Erica L S
Ahmed, Amar
Moody, William E.
Mazur, Wojciech
Stegemann, Berthold (ORCID Profile 0000-0003-2841-8022)
Townend, Jonathan N.
Steeds, Richard P.
Leyva, Francisco



Version: Published Version

License: Creative Commons Attribution

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