Quantitative assessment of right ventricular myocardial strain in pulmonary hypertension using cardiac magnetic resonance feature tracking: a feasibility study

AIM  To evaluate the feasibility of cardiac magnetic resonance feature tracking (CMR-FT) for quantitatively assessing right ventricular (RV) myocardial strain in patients with pulmonary hypertension (PH).

METHODS  A total of 22 PH patients and 20 healthy controls underwent CMR imaging. Using CVI42 software, CMR-FT was applied to measure peak longitudinal strain (LS), peak circumferential strain (CS), and peak radial strain (RS) across basal, mid, apical, and global segments of RV. Differences in strain parameters between the two groups were analyzed using SPSS 26.0, and receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic utility of these strain parameters.

RESULTS  Compared with the control group, the PH group showed a decrease in RVEF and SV/BSA; RVEDV/BSA, RVESV/BSA, Diastolic MyoMass/BSA, and Systolic MyoMass/BSA all increased (all P<0.01). The PH group showed a decrease in RS_Basal, RS_Mid, and RS_Global (all P<0.01), as well as a decrease in the absolute values of CS_Mid and CS_Global (all P<0.05), The absolute values of CS_Apical, LS_Mid, LS_Apical, and LS_Global all decreased (all P<0.01); ROC curve analysis showed that RS_Global, CS_Global, LS_Global, RS_Basal, RS_Mid, CS_Mid, CS_Apical, LS_Mid, and LS_Apical were predictive factors for PH patients, with LS_Apical having the highest diagnostic efficacy (cut-off value=−15.15%, AUC=0.92, sensitivity=0.773, specificity=0.95).

CONCLUSION  RV myocardial strain parameters, as measured by CMR-FT, effectively reflect disease progression in PH patients and may serve as potential indicators of early RV dysfunction.