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Prediction of infarct size and adverse cardiac outcomes by tissue tracking-cardiac magnetic resonance imaging in ST-segment elevation myocardial infarction

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Abstract

Objectives

We investigated whether quantification of global left ventricular (LV) strain by tissue tracking-CMR (TT-CMR) can estimate the infarct size and clinical outcomes in patients with acute myocardial infarction (MI).

Methods

We retrospectively registered 247 consecutive patients (58 ± 12 years; male, 81%) who underwent 1.5-T CMR within 1 month after ST-segment elevation MI (median, 4 days; interquartile range, 3–6 days), and 20 age- and sex-matched controls (58 ± 11 years; male, 80%). TT-CMR analysis was applied to cine-images to measure global LV radial, circumferential and longitudinal peak strains (GRS, GCS and GLS, respectively). Adverse cardiac events were defined as cardiac death and hospitalization for heart failure.

Results

During the follow-up (median, 7.8 years), 20 patients (8.1%) experienced adverse events. LV myocardial deformation was significantly decreased in MI patients compared to controls and closely related to the infarct size. The GRS, GCS and GLS were all significant predictors of adverse cardiac events. In particular, a GLS > −14.1% was independently associated with a > 5-fold increased risk for adverse events, even after adjustment for the LV ejection fraction and infarct size.

Conclusions

TT-CMR-derived LV strain is significantly related to the infarct size and adverse events. GLS measurement provides strong prognostic information in MI patients.

Key Points

• TT-CMR provides reliable quantification of LV strain in MI patients.

• TT-CMR allows prediction of the infarct size and adverse events.

• In particular, GLS by TT-CMR had independent prognostic value in MI patients.

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Abbreviations

CI:

Confidence interval

CMR:

Cardiac magnetic resonance imaging

GCS:

Global systolic circumferential strain

GLS:

Global systolic longitudinal strain

GRS:

Global systolic radial strain

HR:

Hazard ratio

LGE:

Late gadolinium enhancement

LVEF:

Left ventricular ejection fraction

TT:

Tissue tracking

References

  1. Claus P, Omar AM, Pedrizzetti G, Sengupta PP, Nagel E (2015) Tissue tracking technology for assessing cardiac mechanics: principles, normal values, and clinical applications. JACC Cardiovasc Imaging 8:1444–1460

    Article  PubMed  Google Scholar 

  2. Mordi I, Bezerra H, Carrick D, Tzemos N (2015) The combined incremental prognostic value of LVEF, late gadolinium enhancement, and global circumferential strain assessed by CMR. JACC Cardiovasc Imaging 8:540–549

    Article  PubMed  Google Scholar 

  3. Larose E, Rodes-Cabau J, Pibarot P et al (2010) Predicting late myocardial recovery and outcomes in the early hours of ST-segment elevation myocardial infarction traditional measures compared with microvascular obstruction, salvaged myocardium, and necrosis characteristics by cardiovascular magnetic resonance. J Am Coll Cardiol 55:2459–2469

    Article  PubMed  Google Scholar 

  4. Perazzolo Marra M, Lima JA, Iliceto S (2011) MRI in acute myocardial infarction. Eur Heart J 32:284–293

    Article  PubMed  Google Scholar 

  5. Eitel I, de Waha S, Wohrle J et al (2014) Comprehensive prognosis assessment by CMR imaging after ST-segment elevation myocardial infarction. J Am Coll Cardiol 64:1217–1226

    Article  PubMed  Google Scholar 

  6. Lacalzada J, de la Rosa A, Izquierdo MM et al (2015) Left ventricular global longitudinal systolic strain predicts adverse remodeling and subsequent cardiac events in patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Int J Cardiovasc Imaging 31:575–584

    Article  PubMed  Google Scholar 

  7. Antoni ML, Mollema SA, Delgado V et al (2010) Prognostic importance of strain and strain rate after acute myocardial infarction. Eur Heart J 31:1640–1647

    Article  PubMed  Google Scholar 

  8. Ersboll M, Valeur N, Mogensen UM et al (2013) Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction. J Am Coll Cardiol 61:2365–2373

    Article  PubMed  Google Scholar 

  9. Mignot A, Donal E, Zaroui A et al (2010) Global longitudinal strain as a major predictor of cardiac events in patients with depressed left ventricular function: a multicenter study. J Am Soc Echocardiogr 23:1019–1024

    Article  PubMed  Google Scholar 

  10. Schuster A, Stahnke VC, Unterberg-Buchwald C et al (2015) Cardiovascular magnetic resonance feature-tracking assessment of myocardial mechanics: intervendor agreement and considerations regarding reproducibility. Clin Radiol 70:989–998

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Schulz-Menger J, Bluemke DA, Bremerich J et al (2013) Standardized image interpretation and post processing in cardiovascular magnetic resonance: Society for Cardiovascular Magnetic Resonance (SCMR) board of trustees task force on standardized post processing. J Cardiovasc Magn Reson 15:35

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hanley JA, McNeil BJ (1982) The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 143:29–36

    Article  PubMed  CAS  Google Scholar 

  13. Shehata ML, Cheng S, Osman NF, Bluemke DA, Lima JA (2009) Myocardial tissue tagging with cardiovascular magnetic resonance. J Cardiovasc Magn Reson 11:55

    Article  PubMed  PubMed Central  Google Scholar 

  14. Gotte MJ, Germans T, Russel IK et al (2006) Myocardial strain and torsion quantified by cardiovascular magnetic resonance tissue tagging: studies in normal and impaired left ventricular function. J Am Coll Cardiol 48:2002–2011

    Article  PubMed  Google Scholar 

  15. Amundsen BH, Helle-Valle T, Edvardsen T et al (2006) Noninvasive myocardial strain measurement by speckle tracking echocardiography: validation against sonomicrometry and tagged magnetic resonance imaging. J Am Coll Cardiol 47:789–793

    Article  PubMed  Google Scholar 

  16. Padiyath A, Gribben P, Abraham JR et al (2013) Echocardiography and cardiac magnetic resonance-based feature tracking in the assessment of myocardial mechanics in tetralogy of Fallot: an intermodality comparison. Echocardiography 30:203–210

    Article  PubMed  Google Scholar 

  17. Hor KN, Gottliebson WM, Carson C et al (2010) Comparison of magnetic resonance feature tracking for strain calculation with harmonic phase imaging analysis. JACC Cardiovasc Imaging 3:144–151

    Article  PubMed  Google Scholar 

  18. Tantiongco JP, Grover S, Perry R, Bradbrook C, Leong D, Selvanayagam J (2015) Comparison of GLS via echocardiography and tissue tracking by cardiac magnetic resonance imaging. J Cardiovasc Magn Reson 17:P77

    Article  PubMed Central  Google Scholar 

  19. Mukai K, Kallianos K, Seguro F, Acevedo-Bolton G, Ordovas K (2016) Left ventricular myocardial deformation measurements by magnetic resonance tissue tracking agrees with tagging (HARP) in healthy volunteers. J Cardiovasc Magn Reson 18:Q54

    Article  PubMed Central  Google Scholar 

  20. Onishi T, Saha SK, Delgado-Montero A et al (2015) Global longitudinal strain and global circumferential strain by speckle-tracking echocardiography and feature-tracking cardiac magnetic resonance imaging: comparison with left ventricular ejection fraction. J Am Soc Echocardiogr 28:587–596

    Article  PubMed  Google Scholar 

  21. Taylor RJ, Moody WE, Umar F et al (2015) Myocardial strain measurement with feature-tracking cardiovascular magnetic resonance: normal values. Eur Heart J Cardiovasc Imaging 16:871–881

    Article  PubMed  Google Scholar 

  22. Buss SJ, Krautz B, Hofmann N et al (2015) Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement. Int J Cardiol 183:162–170

    Article  PubMed  Google Scholar 

  23. Wu L, Germans T, Guclu A, Heymans MW, Allaart CP, van Rossum AC (2014) Feature tracking compared with tissue tagging measurements of segmental strain by cardiovascular magnetic resonance. J Cardiovasc Magn Reson 16:10

    Article  PubMed  PubMed Central  Google Scholar 

  24. Khan JN, Singh A, Nazir SA, Kanagala P, Gershlick AH, McCann GP (2015) Comparison of cardiovascular magnetic resonance feature tracking and tagging for the assessment of left ventricular systolic strain in acute myocardial infarction. Eur J Radiol 84:840–848

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank Kyung Min Jung for excellent technical support.

Funding

This research was supported by the National Research Foundation of Korea (NRF), funded by the Ministry of Science, ICT & Future Planning (MSIP) (No. 2012027176) and the Ministry of Education, Science & Technology (MEST) (No. 2015R1D1A1A01059717).

Author information

Authors and Affiliations

  1. Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea

    Yeonyee E. Yoon, Si-Hyuck Kang, Hong-Mi Choi & Goo-Yeong Cho

  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Yeonyee E. Yoon, Si-Hyuck Kang, Hong-Mi Choi & Goo-Yeong Cho

  3. Department of Radiology, Cardiovascular Center, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam, Korea

    Seonji Jeong & Eun Ju Chun

  4. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    Seonji Jeong & Eun Ju Chun

  5. Severance Cardiovascular Hospital, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, 50 Yonsei-ro, Seodaemun-gu, Seoul, Korea

    Ji Min Sung, Sang-Eun Lee, Injeong Cho & Hyuk-Jae Chang

Authors
  1. Yeonyee E. Yoon
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  2. Si-Hyuck Kang
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  7. Injeong Cho
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  8. Goo-Yeong Cho
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  9. Hyuk-Jae Chang
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  10. Eun Ju Chun
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Corresponding authors

Correspondence to Hyuk-Jae Chang or Eun Ju Chun.

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Guarantor

The scientific guarantor of this publication is Eun Ju Chun

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the institutional review board.

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Institutional review board approval was obtained.

Methodology

• retrospective

• observational

• multicentre study

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Yoon, Y.E., Kang, SH., Choi, HM. et al. Prediction of infarct size and adverse cardiac outcomes by tissue tracking-cardiac magnetic resonance imaging in ST-segment elevation myocardial infarction. Eur Radiol 28, 3454–3463 (2018). https://doi.org/10.1007/s00330-017-5296-8

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  • DOI: https://doi.org/10.1007/s00330-017-5296-8

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