changes within the RV that are associated with adverse surgical outcomes and poorer prognosis following mitral valve surgery. Future studies are needed to confirm whether LGE is a new imaging biomarker that can be used to risk stratify severe asymptomatic MR patients for surgery. Abstract 110 Table 1 Features of patients with and without gadolinium enhancement Late gadolinium enhancement Number of patients MR fraction (%) Systolic RV volume (ml/ m 2) RV ejection fraction (%) Peak VO 2 (ml/ kg/min) VE/ VCO 2 None 43 32±12 28.5±7.7 61±8 24.6±6.9 31.1 ±5.0 RV insertion gadolinium 8 46±17* 31.4±7.6* 55±6* 23.1±8.7 33.2 ±3.2* LV myocardial gadolinium 10 42±19* 35.1±11.1* 55±8* 23.0±5.9 36.7 ±6.9* *denotes statistical significance of P0.05 compared to non-gadolinium cohort on Independent samples 2 tailed T-Test Abstract 110 Figure 1 Late gadolinium enhancement of the basal inferolateral LV

Supplemental Digital Content is available in the text.

Midwall fibrosis is an independent predictor of mortality and morbidity in patients with DCM undergoing CRT. The outcome of DCM with midwall fibrosis is similar to that of ICM. This relationship is mediated by both pump failure and sudden cardiac death.

BackgroundLeft 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.MethodsPatients 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.ResultsDespite a similar LVEF (24.3 vs 27.5 %, p = 0.20), patients with MWF (32 [24 %]) had lower global circumferential strain (Ɛcc: −6.6 % vs −9.4 %, P = 0.004), but similar longitudinal (Ɛll: −7.6 % vs. −9.4 %, p = 0.053) and radial (Ɛrr: 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 <0.001). In addition, +MWF was associated with reduced LV diastolic strain rates (DSRcc: 0.34 vs. 0.46 s−1; DSRll: 0.38 vs. 0.50s−1; DSRrr: −0.55 vs. −0.75 s−1; all p <0.05).ConclusionsMWF is associated with reduced LV global circumferential strain, strain rate and torsion. In addition, MWF is associated with rigid LV body rotation and reduced diastolic strain rates. These systolic and diastolic disturbances may be related to the increased risk of pump failure observed in patients with NICM and MWF.

Purpose To compare cardiovascular magnetic resonance‐feature tracking (CMR‐FT) with spatial modulation of magnetization (SPAMM) tagged imaging for the calculation of short and long axis Lagrangian strain measures in systole and diastole. Materials and Methods Healthy controls (n = 35) and patients with dilated cardiomyopathy (n = 10) were identified prospectively and underwent steady‐state free precession (SSFP) cine imaging and SPAMM imaging using a gradient‐echo sequence. A timed offline analysis of images acquired at identical horizontal long and short axis slice positions was performed using CMR‐FT and dynamic tissue‐tagging (CIMTag2D). Agreement between strain and strain rate (SR) values calculated using these two different methods was assessed using the Bland–Altman technique. Results Across all participants, there was good agreement between CMR‐FT and CIMTag for calculation of peak systolic global circumferential strain (−22.7 ± 6.2% vs. −22.5 ± 6.9%, bias 0.2 ± 4.0%) and SR (−1.35 ± 0.42 1/s vs. −1.22 ± 0.42 1/s, bias 0.13 ± 0.33 1/s) and early diastolic global circumferential SR (1.21 ± 0.44 1/s vs. 1.07 ± 0.30 1/s, bias −0.14 ± 0.34 1/s) at the subendocardium. There was satisfactory agreement for derivation of peak systolic global longitudinal strain (−18.1 ± 5.0% vs. −16.7 ± 4.8%, bias 1.3 ± 3.8%) and SR (−1.04 ± 0.29 1/s vs. −0.95 ± 0.32 1/s, bias 0.09 ± 0.26 1/s). The weakest agreement was for early diastolic global longitudinal SR (1.10 ± 0.40 1/s vs. 0.67 ± 0.32 1/s, bias −0.42 ± 0.40 1/s), although the correlation remained significant (r = 0.42, P < 0.01). CMR‐FT generated these data over four times quicker than CIMTag. Conclusion There is sufficient agreement between systolic and diastolic strain measures calculated using CMR‐FT and myocardial tagging for CMR‐FT to be considered as a potentially feasible and rapid alternative. J. Magn. Reson. Imaging 2015;41:1000–1012. © 2014 Wiley Periodicals, Inc.

RV longitudinal and circumferential strains can be quickly assessed with good intra-observer and inter-observer variability using TT.

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In patients with NICM, CRT-D was superior to CRT-P in +MWF but not -MWF. These findings have implications for the choice of device therapy in patients with NICM.