Identification and further differentiation of subendocardial and transmural myocardial infarction by fast strain-encoded (SENC) magnetic resonance imaging at 3.0 Tesla

Abstract

Objectives: To investigate whether subendocardial and transmural myocardial infarction can be identified and differentiated using the peak circumferential and longitudinal strains measured by fast strain-encoding (SENC).Methods: Nineteen patients with ischemic heart diseases underwent imaging with fast SENC and late gadolinium enhancement (LGE) MRI at 3T. Fast SENC measurements were performed in three short-axis slices (basal, mid-ventricular and apical levels) and one long-axis view (four-chamber) to assess peak longitudinal and circumferential systolic strains.Results: All patients showed myocardial infarction with an average of 7 positive LGE segments. A total of 304 segments for longitudinal strains (LS) and 114 segments for circumferential strains (CS) could be analysed. Positive LGE segments showed lower peak CS and LS compared with the no-LGE segments (P<0.0001 for both). Segments with subendocardial infarction showed reduced CS and LS compared with the no-LGE segments (P<0.0001 for both). There was a significant difference in CS between subendocardial and transmural infarct segments (P=0.03), but no significant difference in LS between them (P=0.64).Conclusions: Fast SENC can identify old myocardial infarction and differentiate subendocardial from transmural infarction.

Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

“…Another echocardiographic study also demonstrated the noninferiority of circumferential strain compared to LGE for the prediction of global functional recovery, which is in close agreement to our findings [35]. In the same line, a recent CMR study showed that circumferential strain has higher sensitivity and specificity for the differentiation of subendocardial versus transmural myocardial infarction, compared to longitudinal strain [36]. Although the prognostic value of circumferential compared to that of longitudinal strain is rated differently in the current literature [37,38], it seems that such differential effects between subendocardial and transmural infarctions on longitudinal and circumferential strains may be a consequence of the helical wrapping of cardiac fibers into three different anatomical layers, as described in previous experimental studies [39].…”

Global and Regional Functional Assessment of Ischemic Heart Disease with Cardiac MR Imaging

“…60 Peak systolic E CC and E LL at real-time fast SENC has shown usefulness in identifying chronic myocardial infarctions and determining the myocardial scar transmurality. 61 Few studies have been performed to date assessing the clinical utility of FT-CMR in patients with IHD. FT-CMR applied to patients enrolled in the Amoricyte Phase I trial evaluating the influence of stem cell therapy infused into an infarct-related artery 5 to 11 days after primary coronary intervention demonstrated modest improvement in peak segmental E CC in a comparison with control subjects, suggesting the feasibility of this technique.…”

Comparison of SPAMM and SENC Methods for Evaluating Peak Circumferential Strain at 3T

“…In contrast, the pixel-based evaluation with SENC was useful for diŠerentiating subendocardial and transmural myocardial infarctions. 7 The Compared to SENC, the SPAMM method is limited by tag space and its segment-based analysis. DiŠerences between the 2 methods might be due to the limitations of the SPAMM method.…”

“…We excluded 40 patients with late gadolinium enhancement (LGE) because of the inhomogeneous nature of the myocardium. 7 We used a diŠerent analysis software package for each method. We focused on diŠerences in the 2 diŠerent methods without errors due to regional inhomogeneity.…”