Anterior STEMI associated with decreased strain in remote cardiac myocardium.
Hannah SjögrenUlrika PahlmHenrik EngblomDavid ErlingeEinar HeibergHåkan ArhedenMarcus CarlssonEllen OstenfeldPublished in: The international journal of cardiovascular imaging (2021)
To assess (1) global longitudinal strain (GLS) by feature tracking cardiac magnetic resonance (CMR) in the sub-acute and chronic phases after ST-elevation infarction (STEMI) and compare to GLS in healthy controls, and (2) the evolution of GLS and regional longitudinal strain (RLS) over time, and their relationship to infarct location and size. Seventy-seven patients from the CHILL-MI-trial (NCT01379261) who underwent CMR 2-6 days and 6 months after STEMI and 27 healthy controls were included for comparison. Steady state free precession (SSFP) long-axis cine images were obtained for GLS and RLS, and late gadolinium enhancement (LGE) images were obtained for infarct size quantifications. GLS was impaired in the sub-acute (- 11.8 ± 3.0%) and chronic phases (- 14.3 ± 2.9%) compared to normal GLS in controls (- 18.4 ± 2.4%; p < 0.001 for both). GLS improved from sub-acute to chronic phase (p < 0.001). GLS was to some extent determined by infarct size (sub-acute: r2 = 0.2; chronic: r2 = 0.2, p < 0.001). RLS was impaired in all 6 wall-regions in LAD infarctions in both the sub-acute and chronic phase, while LCx and RCA infarctions had preserved RLS in remote myocardium at both time points. Global longitudinal strain is impaired sub-acutely after STEMI and improvement is seen in the chronic phase, although not reaching normal levels. Global longitudinal strain is only moderately determined by infarct size. Regional longitudinal strain is most impaired in the infarcted region, and LAD infarctions have effects on the whole heart. This could explain why LAD infarcts are more serious than the other culprit vessel infarctions and more often cause heart failure.
Keyphrases
- liver failure
- drug induced
- heart failure
- respiratory failure
- magnetic resonance
- acute myocardial infarction
- percutaneous coronary intervention
- cross sectional
- aortic dissection
- deep learning
- left ventricular
- end stage renal disease
- st elevation myocardial infarction
- chronic kidney disease
- ejection fraction
- randomized controlled trial
- hepatitis b virus
- magnetic resonance imaging
- machine learning
- peritoneal dialysis
- contrast enhanced
- phase ii
- acute respiratory distress syndrome
- extracorporeal membrane oxygenation