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Review
. 2023 Jan 17;12(3):743.
doi: 10.3390/jcm12030743.

Clinical Utility of Strain Imaging in Assessment of Myocardial Fibrosis

Lang Gao  1   2   3 , Li Zhang  1   2   3   4 , Zisang Zhang  1   2   3 , Yixia Lin  1   2   3 , Mengmeng Ji  1   2   3 , Qing He  1   2   3 , Mingxing Xie  1   2   3   4   5 , Yuman Li  1   2   3
Affiliations
Review

Clinical Utility of Strain Imaging in Assessment of Myocardial Fibrosis

Lang Gao et al. J Clin Med. .

Abstract

Myocardial fibrosis (MF) is a non-reversible process that occurs following acute or chronic myocardial damage. MF worsens myocardial deformation, remodels the heart and raises myocardial stiffness, and is a crucial pathological manifestation in patients with end-stage cardiovascular diseases and closely related to cardiac adverse events. Therefore, early quantitative analysis of MF plays an important role in risk stratification, clinical decision, and improvement in prognosis. With the advent and development of strain imaging modalities in recent years, MF may be detected early in cardiovascular diseases. This review summarizes the clinical usefulness of strain imaging techniques in the non-invasive assessment of MF.

Keywords: clinical utility; myocardial fibrosis; strain imaging.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
LV images of 3D−STE strain in a HF patient who underwent the heart transplantation. (A) Three−dimensional LV reconstruction image. (B) LV endocardial border outlining and tracking. (C) LV global strain. Different colored lines represent the strain curves of different myocardial segments of LV. (D) Example of LV myocardial samples with Masson’s staining obtained from the explanted heart immediately after transplantation (original magnification ×200). LV: left ventricular; MF: myocardial fibrosis; 3D−STE: three−dimensional speckle tracking echocardiography; HF: heart failure.
Figure 2
Figure 2
RV images of 3D−STE strain in a HF patient who underwent the heart transplantation. (A) Three−dimensional RV reconstruction image. (B) RV endocardial border outlining and tracking. (C) longitudinal strain of RV septum and free wall. (D) Example of RV myocardial samples stained with Masson’s staining acquired from the explanted heart (original magnification ×200). RV: right ventricular; other abbreviations as in Figure 1.
Figure 3
Figure 3
CMR−FT strain images of left ventricle in a DCM patient who underwent the heart transplantation. (A) LV endocardial border outlining and tracking. (B) Bulls−eye plot of LV segmental longitudinal strain. (C) LV global longitudinal strain (yellow curve) and global circumferential strain (pink curve). (D) Example of LV myocardial samples stained with Masson’s staining (original magnification ×200). CMR−FT: cardiac magnetic resonance feature tracking; DCM: dilated cardiomyopathy; other abbreviations as in Figure 1 and Figure 2.
Figure 4
Figure 4
CMR−FT strain images of right ventricle in a DCM patient who underwent the heart transplantation. (A) RV endocardial border outlining and tracking. (B) Time to peak RV longitudinal strain and phase. (C) RV longitudinal strain. (D) Example of RV myocardial samples stained with Masson’s staining (original magnification ×200). The abbreviations as in Figure 1, Figure 2 and Figure 3.
See this image and copyright information in PMC

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