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Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction

BACKGROUND: Cardiac magnetic resonance myocardial feature tracking (CMR-FT)-derived global strain assessments provide incremental prognostic information in patients following acute myocardial infarction (AMI). Functional analyses of the remote myocardium (RM) are scarce and whether they provide an a...

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Autores principales: Lange, Torben, Stiermaier, Thomas, Backhaus, Sören J., Boom, Patricia C., Kowallick, Johannes T., de Waha-Thiele, Suzanne, Lotz, Joachim, Kutty, Shelby, Bigalke, Boris, Gutberlet, Matthias, Feistritzer, Hans-Josef, Desch, Steffen, Hasenfuß, Gerd, Thiele, Holger, Eitel, Ingo, Schuster, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862195/
https://www.ncbi.nlm.nih.gov/pubmed/33083869
http://dx.doi.org/10.1007/s00392-020-01747-1
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author Lange, Torben
Stiermaier, Thomas
Backhaus, Sören J.
Boom, Patricia C.
Kowallick, Johannes T.
de Waha-Thiele, Suzanne
Lotz, Joachim
Kutty, Shelby
Bigalke, Boris
Gutberlet, Matthias
Feistritzer, Hans-Josef
Desch, Steffen
Hasenfuß, Gerd
Thiele, Holger
Eitel, Ingo
Schuster, Andreas
author_facet Lange, Torben
Stiermaier, Thomas
Backhaus, Sören J.
Boom, Patricia C.
Kowallick, Johannes T.
de Waha-Thiele, Suzanne
Lotz, Joachim
Kutty, Shelby
Bigalke, Boris
Gutberlet, Matthias
Feistritzer, Hans-Josef
Desch, Steffen
Hasenfuß, Gerd
Thiele, Holger
Eitel, Ingo
Schuster, Andreas
author_sort Lange, Torben
collection PubMed
description BACKGROUND: Cardiac magnetic resonance myocardial feature tracking (CMR-FT)-derived global strain assessments provide incremental prognostic information in patients following acute myocardial infarction (AMI). Functional analyses of the remote myocardium (RM) are scarce and whether they provide an additional prognostic value in these patients is unknown. METHODS: 1034 patients following acute myocardial infarction were included. CMR imaging and strain analyses as well as infarct size quantification were performed after reperfusion by primary percutaneous coronary intervention. The occurrence of major adverse cardiac events (MACE) within 12 months after the index event was defined as primary clinical endpoint. RESULTS: Patients with MACE had significantly lower RM circumferential strain (CS) compared to those without MACE. A cutoff value for RM CS of − 25.8% best identified high-risk patients (p < 0.001 on log-rank testing) and impaired RM CS was a strong predictor of MACE (HR 1.05, 95% CI 1.07–1.14, p = 0.003). RM CS provided further risk stratification among patients considered at risk according to established CMR parameters for (1) patients with reduced left ventricular ejection fraction (LVEF) ≤ 35% (p = 0.038 on log-rank testing), (2) patients with reduced global circumferential strain (GCS) > −  18.3% (p = 0.015 on log-rank testing), and (3) patients with large microvascular obstruction ≥ 1.46% (p = 0.002 on log-rank testing). CONCLUSION: CMR-FT-derived RM CS is a useful parameter to characterize the response of the remote myocardium and allows improved stratification following AMI beyond commonly used parameters, especially of high-risk patients. TRIAL REGISTRATION: ClinicalTrials.gov, NCT00712101 and NCT01612312 GRAPHIC ABSTRACT: Defining remote segments (R) in the presence of infarct areas (I) for the analysis of remote circumferential strain (CS). Remote CS was significantly lower in patients who suffered major adverse cardiac events (MACE) and a cutoff value for remote CS of − 25.8% best identified high-risk patients. In addition, impaired remote CS ≥ − 25.8 % (Remote −) and preserved remote CS < − 25.8 % (Remote +) enabled further risk stratification when added to established parameters like left ventricular ejection fraction (LVEF), global circumferential strain (GCS) or microvascular obstruction (MVO). [Image: see text]
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spelling pubmed-78621952021-02-11 Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction Lange, Torben Stiermaier, Thomas Backhaus, Sören J. Boom, Patricia C. Kowallick, Johannes T. de Waha-Thiele, Suzanne Lotz, Joachim Kutty, Shelby Bigalke, Boris Gutberlet, Matthias Feistritzer, Hans-Josef Desch, Steffen Hasenfuß, Gerd Thiele, Holger Eitel, Ingo Schuster, Andreas Clin Res Cardiol Original Paper BACKGROUND: Cardiac magnetic resonance myocardial feature tracking (CMR-FT)-derived global strain assessments provide incremental prognostic information in patients following acute myocardial infarction (AMI). Functional analyses of the remote myocardium (RM) are scarce and whether they provide an additional prognostic value in these patients is unknown. METHODS: 1034 patients following acute myocardial infarction were included. CMR imaging and strain analyses as well as infarct size quantification were performed after reperfusion by primary percutaneous coronary intervention. The occurrence of major adverse cardiac events (MACE) within 12 months after the index event was defined as primary clinical endpoint. RESULTS: Patients with MACE had significantly lower RM circumferential strain (CS) compared to those without MACE. A cutoff value for RM CS of − 25.8% best identified high-risk patients (p < 0.001 on log-rank testing) and impaired RM CS was a strong predictor of MACE (HR 1.05, 95% CI 1.07–1.14, p = 0.003). RM CS provided further risk stratification among patients considered at risk according to established CMR parameters for (1) patients with reduced left ventricular ejection fraction (LVEF) ≤ 35% (p = 0.038 on log-rank testing), (2) patients with reduced global circumferential strain (GCS) > −  18.3% (p = 0.015 on log-rank testing), and (3) patients with large microvascular obstruction ≥ 1.46% (p = 0.002 on log-rank testing). CONCLUSION: CMR-FT-derived RM CS is a useful parameter to characterize the response of the remote myocardium and allows improved stratification following AMI beyond commonly used parameters, especially of high-risk patients. TRIAL REGISTRATION: ClinicalTrials.gov, NCT00712101 and NCT01612312 GRAPHIC ABSTRACT: Defining remote segments (R) in the presence of infarct areas (I) for the analysis of remote circumferential strain (CS). Remote CS was significantly lower in patients who suffered major adverse cardiac events (MACE) and a cutoff value for remote CS of − 25.8% best identified high-risk patients. In addition, impaired remote CS ≥ − 25.8 % (Remote −) and preserved remote CS < − 25.8 % (Remote +) enabled further risk stratification when added to established parameters like left ventricular ejection fraction (LVEF), global circumferential strain (GCS) or microvascular obstruction (MVO). [Image: see text] Springer Berlin Heidelberg 2020-10-20 2021 /pmc/articles/PMC7862195/ /pubmed/33083869 http://dx.doi.org/10.1007/s00392-020-01747-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Paper
Lange, Torben
Stiermaier, Thomas
Backhaus, Sören J.
Boom, Patricia C.
Kowallick, Johannes T.
de Waha-Thiele, Suzanne
Lotz, Joachim
Kutty, Shelby
Bigalke, Boris
Gutberlet, Matthias
Feistritzer, Hans-Josef
Desch, Steffen
Hasenfuß, Gerd
Thiele, Holger
Eitel, Ingo
Schuster, Andreas
Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
title Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
title_full Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
title_fullStr Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
title_full_unstemmed Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
title_short Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
title_sort functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862195/
https://www.ncbi.nlm.nih.gov/pubmed/33083869
http://dx.doi.org/10.1007/s00392-020-01747-1
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