Magnetic resonance-derived circumferential strain provides a superior and incremental assessment of improvement in contractile function in patients early after ST-segment elevation myocardial infarction

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• 作者：Dennis T. L. Wong (1) (2) (3)
  Darryl P. Leong (1)
  Michael J. Weightman (1)
  James D. Richardson (1)
  Benjamin K. Dundon (3)
  Peter J. Psaltis (1) (2) (3)
  Michael C. H. Leung (3)
  Ian T. Meredith (3)
  Matthew I. Worthley (1)
  Stephen G. Worthley (1)
  
• 关键词：Circumferential strain ; Myocardial viability ; Late gadolinium enhancement ; Myocardial grid tagging ; Magnetic resonance imaging
• 刊名：European Radiology
• 出版年：2014
• 出版时间：June 2014
• 年：2014
• 卷：24
• 期：6
• 页码：1219-1228
• 全文大小：
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• 作者单位：Dennis T. L. Wong (1) (2) (3)
  Darryl P. Leong (1)
  Michael J. Weightman (1)
  James D. Richardson (1)
  Benjamin K. Dundon (3)
  Peter J. Psaltis (1) (2) (3)
  Michael C. H. Leung (3)
  Ian T. Meredith (3)
  Matthew I. Worthley (1)
  Stephen G. Worthley (1)
  
  1. Discipline of Medicine, University of Adelaide, Adelaide, Australia
  2. South Australian Health & Medical Research Institute (SAHMRI), Adelaide, Australia
  3. Monash Cardiovascular Research Centre, Department of Medicine (Monash Medical Centre)Monash University and Monash Heart, Southern Health, 246 Clayton Road, Clayton, 3168, VIC, Australia
  
• ISSN：1432-1084

文摘

Background We evaluate whether circumferential strain derived from grid-tagged CMR is a better method for assessing improvement in segmental contractile function after STEMI compared to late gadolinium enhancement (LGE). Methods STEMI patients post primary PCI underwent baseline CMR (day 3) and follow-up (day 90). Cine, grid-tagged and LGE images were acquired. Baseline LGE infarct hyperenhancement was categorised as ?5?%, 26-50?%, 51-75?% and >75?% hyperenhancement. The segmental baseline circumferential strain (CS) and circumferential strain rate (CSR) were calculated from grid-tagged images. Segments demonstrating an improvement in wall motion of ? grade compared to baseline were regarded as having improved segmental contractile-function. Results Forty-five patients (aged 58?±-2?years) and 179 infarct segments were analysed. A baseline CS cutoff of -5?% had sensitivity of 89?% and specificity of 70?% for detection of improvement in segmental-contractile-function. On receiver-operating characteristic analysis for predicting improvement in contractile function, AUC for baseline CS (0.82) compared favourably to LGE hyperenhancement (0.68), MVO (0.67) and baseline-CSR (0.74). On comparison of AUCs, baseline CS was superior to LGE hyperenhancement and MVO in predicting improvement in contractile function (P-lt;-.001). On multivariate-analysis, baseline CS was the independent predictor of improvement in segmental contractile function (P-lt;-.001). Conclusion Grid-tagged CMR-derived baseline CS is a superior predictor of improvement in segmental contractile function, providing incremental value when added to LGE hyperenhancement and MVO following STEMI. Key points -Baseline CS predicts contractile function recovery better than LGE and MVO following STEMI -Baseline CS predicts contractile function recovery better than baseline CSR following STEMI -Baseline CS provides incremental value to LGE and MVO following STEMI