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 Chang
  • Eun Ju Chun
Cardiac
  • 24 Downloads

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.

Keywords

Magnetic resonance imaging Strains Left ventricular function Myocardial infarction Prognosis 

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

Notes

Acknowledgements

We thank Kyung Min Jung for excellent technical support.

Compliance with ethical standards

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.

Ethical approval

Institutional review board approval was obtained.

Methodology

• 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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