Cardiac magnetic resonance-tissue tracking for the early prediction of adverse left ventricular remodeling after ST-segment elevation myocardial infarction.
Min Jae ChaJeong Hyun LeeHye Na JungYiseul KimYeon Hyeon ChoeSung Mok KimPublished in: The international journal of cardiovascular imaging (2019)
Cardiac magnetic resonance-tissue tracking (CMR-TT)-derived myocardial strain after ST-elevation myocardial infarction (STEMI) is related to adverse cardiac events. We aimed to investigate the feasibility of CMR-TT for the early prediction of adverse left ventricular (LV) remodeling after STEMI. We retrospectively searched our institution's STEMI registry for patients who underwent reperfusion therapy, post-reperfusion CMR within 1 week after STEMI, and follow-up CMR. CMR-TT analysis was performed using cine imaging of post-reperfusion CMR. Adverse LV remodeling was defined as an increase in end-diastolic LV volume by 20% or more on follow-up CMR (median interval between serial CMR exams, 197 days; interquartile, 174-241 days). A total of 82 patients (age, 59.2 ± 11.1 years; male:female = 73:9) were included and divided into two groups: STEMI without (n = 62) and with (n = 20) adverse LV remodeling. Patients with LV remodeling showed significantly higher peak creatine kinase-MB and troponin I levels and a larger infarct size compared with those without LV remodeling (p = 0.001, p = 0.001, and p = 0.010, respectively). Global circumferential, radial, and longitudinal strain (GLS) also differed significantly between the groups (p = 0.001, p = 0.004, and p < 0.001, respectively). Logistic regression and receiver operating characteristic curve analyses demonstrated that GLS was an independent predictor of LV remodeling [odds ratio (OR) = 1.282, 95% confidence interval (CI) = 1.060-1.55 p = 0.011] with an optimal cut-off of - 12.84 (AUC = 0.756, 95% CI = 0.636-0.887, p < 0.001). CMR-TT-derived GLS may aid the early prediction of adverse LV remodeling after reperfusion, within 1 week after STEMI.
Keyphrases
- percutaneous coronary intervention
- st elevation myocardial infarction
- st segment elevation myocardial infarction
- acute myocardial infarction
- left ventricular
- magnetic resonance
- acute coronary syndrome
- coronary artery disease
- end stage renal disease
- ejection fraction
- newly diagnosed
- heart failure
- chronic kidney disease
- aortic stenosis
- randomized controlled trial
- peritoneal dialysis
- prognostic factors
- hypertrophic cardiomyopathy
- adverse drug
- stem cells
- acute ischemic stroke
- high resolution
- atrial fibrillation
- blood brain barrier
- patient reported outcomes
- mass spectrometry
- left atrial
- mesenchymal stem cells
- mitral valve
- magnetic resonance imaging