European Radiology

, Volume 28, Issue 8, pp 3454–3463 | Cite as

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

  • Yeonyee E. Yoon
  • Si-Hyuck Kang
  • Hong-Mi Choi
  • Seonji Jeong
  • Ji Min Sung
  • Sang-Eun Lee
  • Injeong Cho
  • Goo-Yeong Cho
  • Hyuk-Jae ChangEmail author
  • Eun Ju ChunEmail author



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).


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.


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.


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.


Magnetic resonance imaging Strains Left ventricular function Myocardial infarction Prognosis 



Confidence interval


Cardiac magnetic resonance imaging


Global systolic circumferential strain


Global systolic longitudinal strain


Global systolic radial strain


Hazard ratio


Late gadolinium enhancement


Left ventricular ejection fraction


Tissue tracking



We thank Kyung Min Jung for excellent technical support.


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).

Compliance with ethical standards


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.

Ethical approval

Institutional review board approval was obtained.


• retrospective

• observational

• multicentre study


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Cardiology, Cardiovascular CenterSeoul National University Bundang HospitalSeongnamKorea
  2. 2.Department of Internal MedicineSeoul National University College of MedicineSeoulKorea
  3. 3.Department of Radiology, Cardiovascular CenterSeoul National University Bundang HospitalSeongnamKorea
  4. 4.Department of RadiologySeoul National University College of MedicineSeoulKorea
  5. 5.Severance Cardiovascular Hospital, Yonsei-Cedar Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of MedicineYonsei University Health SystemSeoulKorea

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