Stature estimation in Japanese cadavers using the sacral and coccygeal length measured with multidetector computed tomography

We evaluated the relationship between stature and the length of the sacrum and coccyx using multidetector computed tomography (MDCT) and derived regression equations for stature estimation in the modern Japanese population. Two hundred and sixteen Japanese subjects (110 males and 106 females) who underwent postmortem computed tomography with subsequent forensic autopsy between January 2010 and August 2013 were measured. A sagittal-plane image of the sacrum and coccyx was used. Anterior sacral length (ASL) was defined as the linear distance from the anterosuperior edge of the first sacral vertebra (S1) to the anteroinferior edge of the fifth sacral vertebra (S5), and posterior sacral length (PSL) was defined as the linear distance from the posterosuperior edge of S1 to the anteroinferior edge of S5. Anterior sacrococcygeal length (ASCL) was defined as the linear distance from the anterosuperior edge of S1 to the anteroinferior edge of the last coccygeal vertebra (LCV), and posterior sacrococcygeal length (PSCL) was defined as the linear distance from the posterosuperior edge of S1 to the anteroinferior edge of the LCV. The correlation between stature and each parameter was evaluated by simple regression analysis using Pearson product-moment correlation coefficients. Each parameter was significantly and positively correlated with stature among both males and females. Cadaver stature (CS, cm) = 0.43 × PSL (mm) + 143.67 provided the most accurate stature prediction (R = 0.507, SEE = 5.83 cm) in males. CS (cm) = 0.56 × PSCL (mm) + 85.29 provided the most accurate stature prediction (R = 0.659, SEE = 6.68 cm) in females. We conclude that sacral/sacrococcygeal length measured with MDCT is a potentially useful tool for stature estimation, particularly in cases where better predictors such as the long bones are not available.     

Stature estimation from hand and phalanges lengths of Egyptians

Estimation of stature from extremities plays an important role in identifying the deceased in forensic examinations. This study examines the relationship between stature and hand and phalanges lengths among Egyptians. Stature, hand and phalanges lengths of 159 subjects, 82 males and 77 females (18–25 years) were measured. Statistical analysis indicated that bilateral variation was insignificant for all measurements. Sex differences were significant for all measurements. Linear and multiple regression equations for stature estimation were calculated. Correlation coefficients were found to be positive, but little finger measurements of male and distal phalanges of female fingers were not correlated with stature. Regression equations were checked for accuracy by comparing the estimated stature and actual stature.     

Stature estimation formulae from radiographically determined limb bone length in a modern Japanese population

The objective of this study was to derive regression formulae for stature estimation from long limb bones in a Japanese population. Moreover, commonly employed estimation equations, such as that of Fujii, were re-evaluated through application of current data. To construct equations, measurements were conducted on 434 living subjects (342 females and 92 males; 18–59 years old). The whole or maximum length of the femur, tibia, and humerus was determined radiographically using dual-energy X-ray absorptiometry, which permitted measurement of long bones with no magnification. Regression formulae were constructed for females and males relative to the real body height measured in the erect position. Lower limbs of the femur and tibia were more accurate predictors (R = 0.813–0.903) than the humerus was (R = 0.670–0.708). Multiple regression models were produced for all three bones and the two leg bones, revealing no significant difference between R values. Comparison of these equations with those of earlier studies of Andou and Fujii verified differences in estimated stature, indicating that stature estimation formulae should be constructed based on current data obtained from precise physical measurements. These equations will benefit forensic anthropology and nutrition science for stature estimation of contemporary Japanese individuals.     

Cephalo-facial analysis to estimate stature in a Sudanese population

Medico-legal practitioners are often confronted with dismembered remains from which they need to develop a biological profile to establish identity. Accurate estimation of stature is an initial, crucial component of any meaningful medico-legal evaluation. However, sometimes only cephalo-facial remains are available. The most accurate statistical estimations of biological attributes are based on population-specific standards. Therefore, this study assessed the ability to estimate stature using 15 cephalo-facial measurements in 240 Sudanese adults (120 men, 120 women) aged 18–25 years. Stature and cephalo-facial measurements of men were significantly higher than those of women. Most of the measurements were significantly correlated with stature (p < 0.05), with better correlations for women than for men. The accuracy of stature estimation using sex-specific simple and stepwise multiple regression equations ranged from ±52.53 to ±60.28 mm. This study provides new forensic standards for stature prediction in a Sudanese population. However, the equations should be used with caution in forensic cases when the more reliable body parts (e.g., limbs) are not available for human identification.     

Estimation of stature from facial measurements in northwest Indians

Estimation of stature is one of the important component in identification of human remains in forensic anthropology. The present investigation attempts to estimate stature from seven facial measurements of 300 (173 males and 127 females) healthy subjects between the ages of 18–70 years from Northwest India. Height of all the subjects was measured and facial measurements were taken. Data was subjected to statistical analysis like mean, standard deviation, multiplication factors, Karl Pearson’s correlation coefficient (r), linear and multiple regression analyses using statistical package for social sciences (SPSS). The average height of the subjects was in the range of 154.3–178.3 cm in males and 155.1–168.4 cm in females. Estimated stature calculated by regression analysis of seven facial measurements was almost similar to mean actual stature in both males and females and the difference by using multiplication factors was found to be greater. Standard error of estimation (SEE) computed both by linear and multiple regression analyses was found to be low for the two sexes. Thus we can conclude that regression equations generated from facial measurements can be a supplementary approach for the estimation of stature when extremities are not available.     

Stature estimation from scapular measurements by CT scan evaluation in an Italian population

This study evaluated the correlation between scapula size and stature and developed standard equations in order to estimate stature by CT scan evaluation.A total of 200 healthy Italian subjects (100 men and 100 women, mean age 64.2 ± 12.8 years) underwent thoracic CT scan evaluation during pulmonary screening in our department; we measured the stature of each patient with standard anthropometric instruments and then analyzed images to calculate the longitudinal scapular length (LSL) and the transverse scapular length (TSL). The correlation between stature and each parameter measured was analyzed by dividing the population into two groups, males and females, and was examined by simple regression analysis using Pearson’s correlation coefficient (r).Each anthropometric variable showed a significant difference between males and females (p value <0.001). The correlation coefficients (r-values) were LSL = 0.74 and TSL = 0.51 in males and LSL = 0.70 and TSL = 0.48 in females. In both sexes the r-values showed a significant correlation between stature and LSL.Our study demonstrates that scapulae can be used for stature estimation; in our sample LSL was found to have a better correlation with stature then TSL. h_m = 4.247 * LSL + 93.74 and h_f = 4.031 * LSL + 92.38 are the formulae that provide the most accurate stature assessment in males and females respectively.     

Estimation of stature and sex from scapular measurements by three-dimensional volume-rendering technique using in Chinese

In order to develop population – specific discriminant function equations and stature prediction equations for predicting sex and stature from measurements of the scapula in a contemporary Chinese, 414 individual 3D CT images were collected from participants undergoing routine examination. Sex differences for the variables were tested by Student’s t-test. Fisher’s method has been followed for discriminant analysis. Regression analysis was applied to match the six linear parameters against stature. The stepwise analysis of all measurements yielded a sex classification accuracy rate of 86.7% and a sex bias of 3.1%. All the classification accuracy rates of the univariate discriminant function analyses are of more than 80%. For stature estimation, the accuracy of stature prediction ranged from 5.252 to 7.210 cm for male, from 4.630 to 6.484 cm for female, respectively. This paper provides indications that the scapula is an important bone for sex diagnosis and it could be effectively used as alternatives in forensic cases. Furthermore, the equations presented for stature estimation in this study should be used as alternatives in forensic cases when long bones were unavailable for stature estimation.     

Increased interreader agreement in diagnosis of hepatocellular carcinoma using an adapted LI-RADS algorithm

PurposeTo evaluate a simplified Liver Imaging Reporting and Data System (LI-RADS) algorithm to improve interreader agreement while maintaining diagnostic performance for HCC.Materials and methodsMRI scans of 84 cirrhotic patients with 104 distinct liver observations were retrospectively selected to equivocally match each of the LI-RADS grades (LR1-5) using histopathology and imaging follow up as standard of reference. Four independent radiologists categorized all observations as benign (LR1-2) or potentially malignant (LR3-5) and determined LI-RADS based imaging features including observation size, arterial phase hyperenhancement, washout, capsule appearance and threshold growth for LR3-5 observations and timed their readouts. LR3-5 observations were categorized according to the LI-RADS v2014 algorithm and according to a modified LI-RADS (mLI-RADS) version. Diagnostic performance and Interreader agreement were determined for LI-RADS and mLI-RADS using receiver operating characteristics (ROC) and Fleiss’ and Cohen’s Kappa analysis respectively.ResultsROC analysis revealed equal diagnostic performance for LI-RADS and mLI-RADS (area under the ROC curve = 0.91). Interreader agreement was higher using mLI-RADS as compared to current LI-RADS showing an improved overall (κ = 0.53 ± 0.04 vs. 0.45 ± 0.04), and pair-wise agreement between most readers (κ range 0.44-0.62 vs. 0.35-0.60) at a reduced median evaluation time (51 vs. 62 s per observation, p < 0.0001).ConclusionFocusing on observation size and washout criteria using a modified, stepwise LI-RADS decision tree for LR3-5 observations results in higher interobserver reliability and faster categorization while maintaining diagnostic accuracy.     

Age-at-death estimation in Caucasian females from the morphological analysis of the sternal end of the fourth rib

The morphology evaluation of the sternal end of the fourth rib through the ??can’s “phases method” is considered one of the most reliable method for age-at-death estimation of corpses of unknown identity. This study aims to develop a component model for age estimation alternative to ??can’s method. A numerical score, ranging from 3 to 9, was assigned based on the morphology of surface (S), antero/posterior walls (W) and articular margins (M) of the sternal end of the fourth rib in 71 white female corpse. For each component a regression formula was determined. The best correlation between end rib morphology and age-at-death was obtained through the formula of multiple regression with two independent variables (articular surface and antero/posterior walls): Age (years) = 6.37(S) + 5.33(W) ? 17.15 ± 3.3.     

Regression models to predict hip joint centers in pathological hip population

The purpose was to investigate the validity of Harrington's and Davis's hip joint center (HJC) regression equations on a population affected by a hip deformity, (i.e., femoroacetabular impingement). Sixty-seven participants (21 healthy controls, 46 with a cam-type deformity) underwent pelvic CT imaging. Relevant bony landmarks and geometric HJCs were digitized from the images, and skin thickness was measured for the anterior and posterior superior iliac spines. Non-parametric statistical and Bland-Altman tests analyzed differences between the predicted HJC (from regression equations) and the actual HJC (from CT images). The error from Davis's model (25.0 ± 6.7 mm) was larger than Harrington's (12.3 ± 5.9 mm, p < 0.001). There were no differences between groups, thus, studies on femoroacetabular impingement can implement conventional regression models. Measured skin thickness was 9.7 ± 7.0 mm and 19.6 ± 10.9 mm for the anterior and posterior bony landmarks, respectively, and correlated with body mass index. Skin thickness estimates can be considered to reduce the systematic error introduced by surface markers. New adult-specific regression equations were developed from the CT dataset, with the hypothesis that they could provide better estimates when tuned to a larger adult-specific dataset. The linear models were validated on external datasets and using leave-one-out cross-validation techniques; Prediction errors were comparable to those of Harrington's model, despite the adult-specific population and the larger sample size, thus, prediction accuracy obtained from these parameters could not be improved.     

The influence of tracking marker locations on three-dimensional wrist kinematics

ObjectivesTo determine the influence of tracking marker locations on wrist kinematics during free movements and the golf swing, with the intention of recommending a solution that generates meaningful three-dimensional wrist kinematics.DesignRepeated measures.MethodsSix participants performed free movements of flexion/extension, radial/ulnar deviation and forearm supination/pronation, with a further sixteen participants performing golf drives. A passive motion capture system tracked four different marker sets located on participants’ hand and forearm segments. Variables of peak angle and range of motion were used to compare marker sets during free movements and angles at the top of the backswing and impact were compared during the golf swing.ResultsWrist marker set had a large (η² ≥ 0.557) and often significant (p ≤ 0.051) effect on the variables measured during free movements, and a mixed (η² ≥ 0.108, p ≤ 0.198) effect on wrist angles during the golf swing. Wrist axial rotation range of motion during free forearm supination/pronation revealed the greatest difference between marker sets (∼42°). The large values generated by two of the marker sets for this rotation appeared to influence the values of flexion/extension and radial/ulnar deviation during the golf swing.ConclusionsThe location of markers used to measure wrist kinematics can have a large effect on the angles generated. A solution of two markers located at the distal end of the forearm and one at the proximal, appears to minimise values of wrist axial rotation during free forearm supination/pronation and, consequently, produce more meaningful three-dimensional wrist kinematics.     

Body height estimation from post-mortem CT femoral F1 measurements in a contemporary Swiss population

PurposeThe present study aimed at the comparison of body height estimations from cadaver length with body height estimations according to Trotter and Gleser (1952) and Penning and Riepert (2003) on the basis of femoral F1 section measurements in post-mortem computed tomography (PMCT) images.MethodsIn a post-mortem study in a contemporary Swiss population (226 corpses: 143 males (mean age: 53 ± 17 years) and 83 females (mean age: 61 ± 20 years)) femoral F1 measurements (403 femora: 199 right and 204 left; 177 pairs) were conducted in PMCT images and F1 was used for body height estimation using the equations after Trotter and Gleser (1952, “American Whites”), and Penning and Riepert (2003).ResultsThe mean observed cadaver length was 176.6 cm in males and 163.6 cm in females. Mean measured femoral length F1 was 47.5 cm (males) and 44.1 cm (females) respectively. Comparison of body height estimated from PMCT F1 measurements with body height calculated from cadaver length showed a close congruence (mean difference less than 0.95 cm in males and less than 1.99 cm in females) for equations both applied after Penning and Riepert and Trotter and Gleser.ConclusionsFemoral F1 measurements in PMCT images are very accurate, reproducible and feasible for body height estimation of a contemporary Swiss population when using the equations after Penning and Riepert (2003) or Trotter and Gleser (1952).     

Effects of flexibility and strength interventions on optimal lengths of hamstring muscle-tendon units

ObjectivesThe aim of the present study was to determine the effects of altering both hamstring flexibility and strength on hamstring optimal lengths.DesignControlled laboratory study.MethodsA total of 20 male and 20 female college students (aged 18–24 years) participated in this study and were randomly assigned to either a flexibility intervention group or a strength intervention group. Passive straight leg raise and isokinetic strength test were performed before and after interventions. Paired T-tests were performed to determine hamstring flexibility or strength intervention effects on hamstring optimal lengths.ResultsMale participants in the flexibility intervention group significantly increased range of hip joint flexion (P = 0.001) and optimal lengths of semimembranosus and biceps long head (P ≤ 0.026). Male participants in the strength intervention group significantly increased hamstring strength (P = 0.001), the range of hip joint flexion (P = 0.037), and optimal lengths of all three bi-articulated hamstring muscles (P ≤ 0.041). However, female participants did not significantly increase their hamstring optimal lengths in either intervention groups (P ≥ 0.097) although both groups significantly increased the range of hip joint flexion and strength (P ≤ 0.009).ConclusionHamstring optimal lengths can be modified through flexibility intervention as well as strength intervention for male participants, but not for female participants in this study. Hamstring optimal lengths should be considered as hamstring flexibility measures in future prospective studies to identify potentially modifiable risk factors for hamstring injury.     

Bone properties in child and adolescent male hockey and soccer players

Children and adolescents who train extensively in high-impact, weight-bearing activities have enhanced bone mineral density. The purpose of this study was to evaluate bone strength, as reflected by quantitative ultrasound (QUS, Sunlight Omniscence), of child (10–12 yrs old) and adolescent (14–16 yrs old) male soccer and hockey players in comparison with age-matched controls. The groups included 30 child (CH) and 31 adolescent (AH) hockey players, 26 child (CS) and 30 adolescent (AS) soccer players, as well as 34 child (CC) and 31 adolescent (AC) healthy, non-athletic, age-matched controls. All athletes trained at an elite level year-round, with no difference in training volume between groups. Ultrasound speed of sound (SOS) was measured at the distal-radius and mid-tibia. In both age groups, hockey players were the heaviest and had the highest fat-free mass. No differences were found among groups in total energy intake, calcium or vitamin D intake. Radial and tibial SOS increased with age. Hockey players had higher radial SOS in both age groups (children: CH:3763 ± 74, CS:3736 ± 77, CC:3721 ± 88 m/s; adolescents: AH:3809 ± 105, AS:3767 ± 85, AC:3760 ± 94 m/s). Tibial SOS was higher in soccer players compared with controls. In spite of the higher body mass and fat-free mass in hockey players, their tibial SOS was similar to the non-athletes in both age groups. These findings support previous suggestions of sport-specific effects on bone strength. However, they need to be corroborated with longitudinal or prospective intervention studies.     

Variability of centre of pressure movement during gait in young and middle-aged women

The variability of the centre of pressure (COP) movement is a tool that is often used for stability assessments during standing; however, this variable can provide relevant findings during dynamic conditions, which are more related to fall risks. The aim of this study was to investigate age-related differences in the variability of COP movement. Healthy young (younger group – 25 subjects, age 22.2 ± 1.8 years) and middle-aged (elder group – 25 subjects, age 56.6 ± 4.9 years) females participated in this study. The ground reaction forces and COP movement during walking at a self-selected speed were recorded using two force platforms. Each stance phase was divided into four subphases: loading response (LR), mid-stance (MSt), terminal stance (TSt) and preswing (PS). Standard deviations of the medial–lateral, anterior–posterior and total COP displacements were assessed. For statistical comparisons, one-way ANOVA and the Bonferroni post-hoc test were used. These results showed significantly higher COP movement variability in selected variables in the PS, LR and MSt subphases in the elder group (p < 0.05) compared with the younger group; no differences were found in the TSt subphase. A comparison of the subphases within the groups revealed significant differences (p < 0.001 for all cases and both groups) between the parameters in the LR × MSt, LR × TSt, MSt × PS and TSt × PS subphases. The LR and PS subphases showed significantly higher values for the variability parameters.     

Assessment of treatment response after lung stereotactic body radiotherapy using diffusion weighted magnetic resonance imaging and positron emission tomography: A pilot study

Background and purposeThere is no early predictor of treatment response after lung stereotactic body radiotherapy (SBRT). We conducted this pilot study to evaluate whether serial diffusion weighted magnetic resonance imaging (DW-MRI) or positron emission tomography (PET) could predict response after SBRT.Material and methodsEarly stage non-small cell lung cancer patients who received SBRT were eligible. DW-MRI and PET were undertaken pretreatment and every 3 months after SBRT in the first year. Patients with <1 year of follow-up were excluded from the analysis. The apparent diffusion coefficient (ADC) value and maximum standardized uptake value (SUV_max) of tumors were measured and compared between groups with or without local recurrence (LR).ResultsFifteen patients were enrolled and the data of 14 patients were analyzed. The median ADC value was significantly lower in patients with LR (n = 3) than in those without LR (n = 11) at 3 and 6 months (1.11 vs. 1.54 and 0.98 vs. 1.69 [×10⁻³ mm²/s]; p = 0.039 and 0.012, respectively) while there was no significant difference pretreatment and at 9 and 12 months after treatment. No significant difference was observed in the SUV_max at any time point.ConclusionsDW-MRI could be an early predictor of treatment response after lung SBRT.     

Effects of eccentric exercise on optimum length of the knee flexors and extensors during the preseason in professional soccer players

ObjectiveTo assess the effects of eccentric exercise on optimum lengths of the knee flexors and extensors during the preseason in professional soccer.DesignTwenty-eight athletes from a professional Spanish soccer team (Division II) were randomly assigned to an eccentric exercise intervention group (EG) or a control group (CG). Over the four-week period two athletes from the control group suffered RF injuries and two athletes were contracted by other clubs. After these exclusions, both groups (EG, n = 13; and CG, n = 11) performed regular soccer training during the four-week preseason period.ResultsAfter the four weeks, the optimum lengths of the knee flexors were significantly (P < 0.05) increased by 2.3° in the CG and by 4.0° in the EG. The change in the EG was significantly (P < 0.05) greater than that of the CG. The optimum lengths of the knee extensors were significantly increased only in the EG by 6.5°. Peak torque levels and ratios of quadriceps to hamstring (Q/H ratios) were not significantly altered throughout the study for either group.ConclusionEccentric exercise can increase the optimum lengths of both the knee extensors and knee extensors flexors during the preseason in professional soccer.     

Stature estimation from various three-dimensional anthropometric foot measurements of Taiwanese female population

Predicting a victim's stature from a dismembered body or human remains is a challenge in forensic practice. Lower extremity dimensions, such as the foot, are essential measurements for stature estimation. However, there is no available information on stature prediction generated from Taiwanese female foot measurements in the forensic science field. Hence, this study aims to investigate the correlations between various foot dimensions and stature and develop population-specific stature-prediction equations for Taiwanese females. Bilateral data of 12 foot dimensions were collected from 1058 females aged from 18 to 59 years using three-dimensional scanning. A paired t-test is performed to evaluate bilateral differences, and linear and stepwise regression analyses are performed to generate stature predictions. The results indicate significant bilateral differences in the majority of the foot measurements. All measurements are positively correlated with stature (p < .05). Higher correlation coefficients with stature are observed in length-related foot dimensions, followed by girth- and breadth-related dimensions. The foot length on both sides is selected as an accurate and reliable parameter to conduct linear stature-predicting regression for Taiwanese females because it exhibits the highest explanation rate (right: 54.1%; left: 50.8%) and lowest estimating standard error (right: 3.883 cm, left: 4.020 cm) among the 12 foot measurements. Based on the results of the stepwise regression analysis, several stature-prediction equations consisting of various foot measurements are established. The findings of this study can provide helpful information for predicting the stature of Taiwanese females from fragmentary foot remains.     

The validity and reliability of a global positioning satellite system device to assess speed and repeated sprint ability (RSA) in athletes

There is a limited understanding of the validity and reliability of commercially available global positioning satellite (GPS) devices for assessing repeated sprint performance in athletes. The aims of this study were to assess the convergent validity and the test–retest reliability of a GPS device for measuring repeated sprint ability test (RSAT) variables. Two groups participated in this study, a group of 21 physical education students (age: 20.2 ± 2.3 years, stature: 1.75 ± 0.42 m, body mass: 68.0 ± 6.8 kg) and a second group 14 elite junior soccer players (age: 14.5 ± 1.2 years, stature: 1.60 ± 0.09 m, body mass: 57.7 ± 3.8 kg) volunteered to participate in this study. Convergent validity was assessed as the correlation between sprint performance (15 and 30-m) using both timing lights and a portable GPS device during a RSAT (7 × 30-m sprints with 30-s of active recovery). The 7 × 30-m RSAT test–retest reliability using GPS device was assessed in elite junior soccer players repeating the test 1 week apart and expressing reliability as a coefficient of variation. Results showed a strong correlation between peak speed measures with the GPS device and RSAT performance measured with timing lights for the 15-m (r² = 0.87, p < 0.001, N = 147) and 30-m (r² = 0.94, p < 0.001, N = 147) splits, respectively. There was a low coefficient of variation for summated maximal speed (1.7%) and peak speed (1.2%) during the 7 × 30-m RSAT, but high variation for the percentage decrement score (36.2%). These results provide evidence to support the use of the GPS device as an alternative measure to assess repeated sprint performance but suggest a percentage decrement score is not a reliable measure of RSAT performance.     

Biventricular mechanics in prediction of severe myocardial fibrosis in patients with dilated cardiomyopathy: CMR study

PurposeThe purpose of this study was to compare the ability of various parameters of myocardial mechanics to predict large amounts of biventricular fibrosis assessed via T1 mapping in patients with dilated cardiomyopathy (DCM).MaterialCardiovascular magnetic resonance feature tracking analysis and T1 mapping were performed in 26 patients with DCM [mean age: 34.4 ± 9.1 years, 15 (57.6%) males]. The values of various parameters of myocardial mechanics at predicting advanced left-ventricle (LV) and right-ventricle (RV) fibrosis were compared using logistic regression analysis and receiver operating characteristic curve (ROC) analysis.ResultsThere were 7 (26.9%) patients with a large amount of LV fibrosis and 9 (34.6%) patients with severe RV fibrosis.ROC curve analysis revealed that the model of combined LV strain rates (AUC = 0.902) offered superb ability at predicting large amounts of LV fibrosis. The models including RV strain rates (AUC = 0.974), a combination of RV strains, strain rates and clinical parameters (AUC = 0.993) as well as the RV radial strain rate alone model (AUC = 0.961) yielded outstanding performance in discriminating large and small amounts of RV fibrosis.In multivariate analysis, the LV circumferential strain (LVCR) and RV radial (RVR) strain rate were the only independent predictors of large amounts of LV and RV fibrosis, respectively.ConclusionsIndices of myocardial deformation, especially combined with clinical features, offered a superlative ability to differentiate high from low degrees of fibrosis in DCM patients. Among all analyzed parameters of myocardial mechanics, LVCR and RVR rate alone were the independent predictors of high degrees of LV and RV fibrosis, respectively.