Asfour Ahmed Shawky, Mohamed Alaa Mohamed Abd Al-Kader, Al-Salam Hesham Yahia Abd, Aboelsoud Heba Mostafa Ahmed, Shaaban Mahmoud, Elramly Mohamed Zaki
Cairo University, Giza, Egypt.
Tanta University, Tanta, Egypt.
Egypt Heart J. 2025 Jun 16;77(1):63. doi: 10.1186/s43044-025-00657-9.
Restrictive cardiomyopathy (RCM) is characterized by increased myocardial stiffness, impaired diastolic filling, and preserved systolic function until advanced stages. Cardiac magnetic resonance imaging (CMR) provides precise strain analysis and tissue characterization, yet its prognostic value in idiopathic RCM remains underexplored. This study aims to evaluate the prognostic significance of CMR parameters, particularly myocardial strain and late gadolinium enhancement (LGE), in predicting outcomes in patients with idiopathic RCM.
Patients demonstrated moderately impaired strain values, with global longitudinal strain (GLS) measured at -10.59 ± 4.64% and global circumferential strain (GCS) at -14.50 ± 4.98%, while maintaining preserved biventricular ejection fractions. LGE was present in 40% of patients. A GLS value greater than -9.5% independently predicted mortality (odds ratio [OR]: 1.195, p = 0.044) and heart failure (HF) hospitalization (OR: 1.152, p = 0.013). Additionally, LGE emerged as a strong independent predictor of both mortality (OR: 6.340, p = 0.004) and HF hospitalization (OR: 4.654, p = 0.001).
CMR is a valuable tool for prognostication in idiopathic RCM. GLS and LGE are independent predictors of adverse outcomes.
限制性心肌病（RCM）的特征是心肌僵硬度增加、舒张期充盈受损，直至疾病晚期收缩功能仍保持正常。心脏磁共振成像（CMR）可提供精确的应变分析和组织特征描述，但其在特发性RCM中的预后价值仍未得到充分探索。本研究旨在评估CMR参数，特别是心肌应变和延迟钆增强（LGE），在预测特发性RCM患者预后方面的意义。
患者表现出中度受损的应变值，整体纵向应变（GLS）为-10.59±4.64%，整体圆周应变（GCS）为-14.50±4.98%，同时双心室射血分数保持正常。40%的患者存在LGE。GLS值大于-9.5%可独立预测死亡率（比值比[OR]：1.195，p=0.044）和心力衰竭（HF）住院率（OR：1.152，p=0.013）。此外，LGE是死亡率（OR：6.340，p=0.004）和HF住院率（OR：4.654，p=0.001）的强有力独立预测因素。
CMR是预测特发性RCM预后的有价值工具。GLS和LGE是不良结局的独立预测因素。
