Aim: Scarce data are available whether cardiac magnetic resonance (CMR) assessment of myocardial deformation provides independent and incremental prognostic information in patients with ST-segment elevation myocardial infarction (STEMI). The aim of the present study was to investigate the prognostic utility of CMR feature-tracking derived left ventricular (LV) global circumferential strain (GCS) in STEMI patients. Methods: A total of 180 patients (mean age 60 +/- 12 years, 72% male) admitted because of a first STEMI were included. CMR with late gadolinium enhancement (LGE) imaging was performed to assess LV function, infarct size, and microvascular obstruction. The feature-tracking analysis was applied to cine-CMR short-axis images to assess LV GCS. Patients were followed-up for a median of 95 months. The outcome event was a composite endpoint including cardiovascular death, aborted sudden cardiac death, and hospitalization for heart failure. Results: During follow-up, 40 (22%) patients experienced at least 1 event. After adjustment for other clinical and CMR imaging characteristics, LV GCS remained significantly and independently associated with the outcome event (HR 1.16 per %; 95% CI 1.07-1.25; p < 0.001). A significant increase of global chi(2) was observed when adding LV GCS to a model including clinical and non-contrast CMR variables (chi(2) change=8.2; p=0.004) and to a model including clinical, non-contrast and LGE variables (chi(2) change=4.8; p = 0.028). Conclusion: LV GCS assessed by CMR feature-tracking can predict a worse long-term prognosis in patients admitted with a first STEMI. More importantly, the predictive ability of LV GCS is incremental to other clinical and CMR variables. (c) 2018 Elsevier B.V. All rights reserved.
Prognostic value of myocardial deformation imaging by cardiacmagnetic resonance feature-tracking in patients with a first ST-segment elevation myocardial infarction
Muser D;
2018-01-01
Abstract
Aim: Scarce data are available whether cardiac magnetic resonance (CMR) assessment of myocardial deformation provides independent and incremental prognostic information in patients with ST-segment elevation myocardial infarction (STEMI). The aim of the present study was to investigate the prognostic utility of CMR feature-tracking derived left ventricular (LV) global circumferential strain (GCS) in STEMI patients. Methods: A total of 180 patients (mean age 60 +/- 12 years, 72% male) admitted because of a first STEMI were included. CMR with late gadolinium enhancement (LGE) imaging was performed to assess LV function, infarct size, and microvascular obstruction. The feature-tracking analysis was applied to cine-CMR short-axis images to assess LV GCS. Patients were followed-up for a median of 95 months. The outcome event was a composite endpoint including cardiovascular death, aborted sudden cardiac death, and hospitalization for heart failure. Results: During follow-up, 40 (22%) patients experienced at least 1 event. After adjustment for other clinical and CMR imaging characteristics, LV GCS remained significantly and independently associated with the outcome event (HR 1.16 per %; 95% CI 1.07-1.25; p < 0.001). A significant increase of global chi(2) was observed when adding LV GCS to a model including clinical and non-contrast CMR variables (chi(2) change=8.2; p=0.004) and to a model including clinical, non-contrast and LGE variables (chi(2) change=4.8; p = 0.028). Conclusion: LV GCS assessed by CMR feature-tracking can predict a worse long-term prognosis in patients admitted with a first STEMI. More importantly, the predictive ability of LV GCS is incremental to other clinical and CMR variables. (c) 2018 Elsevier B.V. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
