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

Abstract

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.

Relationship of Myocardial Strain and Markers of Myocardial Injury to Predict Segmental Recovery After Acute ST-Segment–Elevation Myocardial Infarction

“…24 Segmental dysfunction was defined as wall motion score (WMS) of ≥2 at acute CMR and improvement as a WMS decrease of ≥1, and normalization where WMS returned to 1 at follow-up CMR. [10][11][12]16 Infarct Characterization Edema (area-at-risk [AAR]) and infarct were quantified using cvi42 v4.1 on T2w-STIR and LGE imaging, using Otsu's Automated Method and full-width half-maximum thresholding, respectively, as previously described by our group. 25 Hypointense regions within enhancement on LGE and T2w-STIR imaging were included, corresponding to MVO and IMH, respectively, and expressed as present or absent for each of the 16 segments.…”

“…11,12,16 Segmental MSI defined the proportion of the AAR that did not progress to infarction and was calculated as [(segmental AAR−SEE)/segmental AAR] × 100.…”

“…1,2 However, the evidence base in acute STEMI is limited by a small number of single-center studies and heterogeneity of LGE assessment. [5][6][7][8][9][10][11][12] Moreover, several reports have shown that LGE, measured within days of STEMI, overestimates acute infarct size (IS) and underestimates the potential for functional recovery. [13][14][15] The accuracy of segmental LGE expressed as segmental area of late gadolinium-enhancement (SEE) defined as enhanced percentage of segmental area, [10][11][12]16 rather than maximum transmurality in predicting segmental recovery in acute STEMI has shown promise.…”

“…[13][14][15] The accuracy of segmental LGE expressed as segmental area of late gadolinium-enhancement (SEE) defined as enhanced percentage of segmental area, [10][11][12]16 rather than maximum transmurality in predicting segmental recovery in acute STEMI has shown promise.…”

“…LGE-derived microvascular obstruction (late MVO), 11,17,18 and intramyocardial hemorrhage (IMH) 18 have been assessed in a few small studies. There are no studies investigating whether they offer additive value to the predictive accuracy of LGE.…”