Background: While left-bundle-branch-block-related contraction patterns as well as echocardiography-derived strain are variably associated with the volumetric response to cardiac resynchronization therapy (CRT), the role of CMR-derived strain parameters is unexplored. Methods: A total of 50 patients receiving CRT implantation were retrospectively analyzed, all of whom had undergone CMR imaging within one year before, and echocardiography within 6 months before and 6–12 months after CRT implantation. We assessed CMR-derived morphological and functional parameters with regard to the echocardiographic response, defined as a reduction in the left ventricular end-systolic volume of ≥15%. Results: Among the standard CMR parameters, the indexed right ventricular volumes in end-diastole (RVEDVi) (74.5 ± 19.5 vs. 94.8 ± 30.2 mL/m², p = 0.006) and end-systole (RVESVi) (43.2 ± 13.3 vs. 61.6 ± 28.8 mL/m², p = 0.003), as well as the left atrial (LA) area (24.8 ± 3.5 vs. 30.4 ± 9.5 cm², p = 0.020), differed significantly between CRT responders and non-responders. In strain analysis, CRT responders showed a significantly better LA global longitudinal strain (GLS) (25.1 ± 10.4 vs. 15.3 ± 10.5, p = 0.002), LA global circumferential strain (GCS) (27.9 ± 14.7 vs. 17.1 ± 13.1%, p = 0.012), RV GLS (−25.0 ± 6.5 vs. −18.9 ± 7.6%, p = 0.004) and RV free wall strain (−31.1 ± 7.9 vs. −24.9 ± 9.5, p = 0.017). Conclusions: CMR-derived peak septal circumferential strain and RVEDVi correlated with the echocardiographic volumetric response to CRT at 6–12 months.

Heart failure (HF) is a significant public health concern. Early detection, particularly during the asymptomatic stage, is essential for prompt intervention and preventing progression. Conventional measures, such as left ventricular ejection fraction (LVEF) have limited sensitivity. However, left ventricular global longitudinal strain (GLS) can detect subclinical myocardial dysfunction. Preliminary data from the previous HERZCHECK study showed that 23% of participants in rural Germany had GLS-defined subclinical pre-HF (stage B HF) when examined with mobile cardiac MRI units. Yet, the prevalence of asymptomatic HF in urban populations remains unclear. The WE-CARE-HF-CMR trial aims to address this issue. The WE-CARE-HF-CMR trial is a single-center prospective observational study with a cross-sectional baseline assessment and an exploratory longitudinal follow-up conducted in five urban German cities (Berlin, Cologne, Frankfurt, Hamburg, Munich; NCT07185100). Asymptomatic patients between the ages of 40 and 69 with cardiovascular risk factors but without a history of symptomatic HF are enrolled via outpatient physician referral or self-referral. Participants undergo a standardized diagnostic evaluation including a medical history review, laboratory testing, cardiac magnetic resonance (CMR) imaging with GLS analysis, and quality-of-life questionnaires. CMR examinations are performed using both stationary and mobile magnetic resonance imaging (MRI) units. Subclinical pre-HF (stage B HF) is defined as GLS ≥ -15%. The primary endpoint is the prevalence of subclinical pre-HF (stage B HF) in the urban population. Secondary endpoints assess therapy adherence, quality of life, and the prevalence of chronic kidney disease. CMR images are analyzed centrally following standardized protocols to ensure comparability with HERZCHECK rural data. The WE-CARE-HF-CMR trial will provide critical data on the prevalence of subclinical pre-HF (stage B HF) in urban populations. Using CMR-based GLS analysis with stationary and mobile units, and building on the HERZCHECK trial methodology, the study will close the diagnostic gap between rural and urban areas. These findings may ultimately support the implementation of targeted screening programs for subclinical pre-HF (stage B HF) to enable early intervention and prevent the progression to symptomatic HF. NCT07185100.

Background: While left-bundle-branch-block-related contraction patterns as well as echocardiography derived strain are variably associated with volumetric response to cardiac resynchronization therapy (CRT), the role of CMR-derived strain parameters is unexplored. Methods: 50 patients receiving CRT implantation were retrospectively analysed, all of which had undergone CMR imaging within one year before, and echocardiography within 6 months before and 6-12 months after CRT implantation. We assessed CMR-derived morphological and functional parameters with regard to echocardiographic response, defined as reduction of left ventricular end-systolic volume ≥15%. Results: Among standard CMR parameters, indexed right ventricular volumes in end-diastole (RVEDVi) (74.5 ±19.5 vs. 94.8 ±30.2 ml/m², P=.006) and end-systole (RVESVi) (43.2 ±13.3 vs. 61.6 ±28.8 ml/m², P=.003) as well as left atrial (LA) area (24.8 ±3.5 vs. 30.4 ±9.5 cm², P=.020) differed significantly between CRT responders and non-responders. In strain analysis, CRT responders showed significantly better LA global longitudinal strain (GLS) (25.1 ±10.4 vs. 15.3 ±10.5, P=.002), LA global circumferential strain (GCS) (27.9 ±14.7 vs. 17.1 ±13.1%, P=.012), RV GLS (-25.0 ±6.5 vs. -18.9 ±7.6%, P=.004) and RV free wall strain (-31.1 ±7.9 vs. -24.9 ±9.5, P=.017). Conclusions: CMR-derived peak septal circumferential strain and RVEDVi correlated with echocardiographic volumetric response to CRT at 6-12 months.

Purpose: Echocardiographic studies have shown that patients with mitral valve prolapse (MVP) exhibit altered regional contraction patterns. With cardiovascular magnetic resonance (CMR) becoming increasingly important in the evaluation of global and regional cardiac function, we aimed to quantify the regional contraction patterns of patients with MVP using CMR feature tracking (FT) strain analysis in comparison to a control group. Methods: Of all patients who underwent CMR scans from 2013 to 2022 at our institution, 132 patients with MVP were identified and compared to 50 controls without any cardiac condition. CMR scans were performed on 1.5-T and 3-T scanners, and CMR-FT strain analysis was performed on cine images using MEDIS QStrain 4.1. The primary endpoints were regional peak left ventricular (LV) longitudinal strain values. Secondary endpoints included LV global circumferential strain (GCS) and global longitudinal strain (GLS) and left atrial (LA) reservoir strain and right ventricular (RV) free wall longitudinal strain. Differences between groups were assessed using linear regression models, adjusting for age and sex. Results: Patients with MVP showed worse regional peak longitudinal strain compared to controls in the basal and part of the medial LV segments, especially in segments S1, S4, S6, S7, and S12. In contrast, the apical segments S13, S14, S15, and S16 showed better strain values. Additionally, LA reservoir strain was reduced in MVP patients. LV GCS, LV GLS, and RV free wall longitudinal strain were similar between both groups. Conclusion: While patients with MVP showed preserved LV GCS and GLS compared to controls, LV regional longitudinal strain analysis showed impaired strain in the basal segments and increased strain in the apical segments.