Comparison of Left Ventricular Global Strain in Anterior and Non-anterior Wall Myocardial Infarction With CMR Tissue Tracking

Abstract

Left ventricular (LV) myocardial dysfunction occurs after myocardial infarction (MI) is associated with the location, infarct size, and transmurality degrees of MI. The myocardial strain is a sensitive index used for the quantification of myocardium dysfunction. This study used Tissue-Tracking to evaluate whether the different location of MI would result in different myocardial dysfunction. One hundred patients diagnosed with MI who underwent cardiovascular magnetic resonance examination were included. The tissue-tracking indices, LV global radial strain (GRS), global circumferential strain (GCS), global longitudinal strain (GLS), and the infarct size (IS,% of LV mass) were quantified. There were 42 cases of anterior wall MI (AWMI) and 58 cases of non-anterior wall MI (NAWMI). The GCS of AWMI was significantly lower than that of NAWMI (P = 0.036). In the same level of infarct size, the myocardial strain of AWMI was not significantly different from NAWMI group (P > 0.05). The GRS and GCS were significantly different between transmurality > 50% group with transmurality ≤ 50% group (P < 0.05). The present study demonstrated that LV MI is associated with reduced myocardial strain, and the infarct size and degrees of transmurality were both related to the decline of myocardial strain in patients with MI.

Anterior STEMI associated with decreased strain in remote cardiac myocardium

“…In our study, infarct extent and transmurality was not associated to GLS in the sub-acute phase, which means GLS is associated to IS, but not infarct extent or transmurality in this phase. Our study is in concordance with a CMR study by Li et al showing an association between infarct size and global strain [ 38 ]. While they found global radial, circumferential and longitudinal strain differed between patients with transmurality above or below 50% in the anterior wall myocardial infarctions, they did not find any difference in these global strain values in the non-anterior wall myocardial infarctions between the dichotomised transmurality groups.…”

Impact of apical and mid-ventricular transmural infarcts in patients with acute myocardial infarction determined by using late gadolinium enhancement combined with feature tracking magnetic resonance

“…The results indicated that segmental circumferential and longitudinal strains were decreased with increased levels of infarct transmurality. The change in circumferential strain in our study was similar to previous studies (22)(23)(24) which demonstrate that circumferential strain reflects the degree of transmurality. In addition, our results showed that regional radial strain was noticeably reduced with an increased degree of transmurality across three different circular parts of LV.…”

Recovery and prognostic values of myocardial strain in acute anterior and non-anterior wall myocardial infarction

“…early (day 1-28 after MI) and late mortality of AWMI were greater in the anterior MI than inferior MI group [8]. The present study demonstrated that AWMI patients have larger IS and MVO and worse EF, which are consistent with existing literature [6,7,10], However, it remains controversial whether the location of MI is associated with poor prognosis after infarction, or whether the size of MI is more important than the anterior location of the infarction. In our opinion, larger IS always indicates greater myocardial necrosis and more serious myocardial dysfunction, and our univariate analysis showed that anterior MI location was not associated with MACE at medium-term clinic follow-up.…”