Myocardial Regional Interstitial Fibrosis is Associated with Left Intra-Ventricular Dyssynchrony in Patients with Heart Failure: A Cardiovascular Magnetic Resonance Study

Lian Yu Lin, Cho Kai Wu, Jyh Ming Jimmy Juang, Yi Chih Wang, Mao Yuan Marine Su, Ling Ping Lai, Juey Jen Hwang, Fu Tien Chiang, Wen Yih Issac Tseng, Jiunn Lee Lin

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Abstract

Left ventricular (LV) dyssynchrony is associated with poor prognosis in patients with heart failure (HF). The mechanisms leading to LV dyssynchrony are not fully elucidated. This study evaluates whether myocardium regional variation in interstitial fibrosis is associated with LV dyssynchrony. Forty-Two patients with systolic heart failure (SHF), 76 patients with heart failure with preserved ejection fraction (HFpEF) and 20 patients without HF received cardiovascular magnetic resonance imaging (MRI) study. LV was divided into 18 segments by short-Axis view. In each segment, regional extracellular volume fraction (ECV) and the time taken to reach minimum regional volume (Tmv) were derived. Intra-LV dyssynchrony were represented by maximum difference (Dysynmax) and standard deviation (Dysynsd) of all Tmv. The results showed that among the covariates, only age (1.87, 95% CI: 0.61-3.13, p = 0.004) and ECV (3.77, 95% CI: 2.72-4.81, p < 0.001) were positively associated with Tmv. The results remained robust in certain subgroups. In conclusion, we demonstrated that LV myocardium regional variation in interstitial fibrosis is closely related to LV intra-ventricular dyssynchrony irrespective of the LV global function. These data might help explain the pathophysiology of LV dyssynchrony and itâ € s underlying mechanisms leading to poor prognosis.

Original languageEnglish
Article number20711
JournalScientific Reports
Volume6
DOIs
Publication statusPublished - Feb 5 2016
Externally publishedYes

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