Global longitudinal strain by feature tracking for optimized prediction of adverse remodeling after ST-elevation myocardial infarction View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-04-15

AUTHORS

Martin Reindl, Christina Tiller, Magdalena Holzknecht, Ivan Lechner, Dorothea Eisner, Laura Riepl, Mathias Pamminger, Benjamin Henninger, Agnes Mayr, Johannes P. Schwaiger, Gert Klug, Axel Bauer, Bernhard Metzler, Sebastian J. Reinstadler

ABSTRACT

BackgroundThe role of left ventricular (LV) myocardial strain by cardiac magnetic resonance feature tracking (CMR-FT) for the prediction of adverse remodeling following ST-elevation myocardial infarction (STEMI), as well as its prognostic validity compared to LV ejection fraction (LVEF) and CMR infarct severity parameters, is unclear. This study aimed to evaluate the independent and incremental value of LV strain by CMR-FT for the prediction of adverse LV remodeling post-STEMI.MethodsSTEMI patients treated with primary percutaneous coronary intervention were enrolled in this prospective observational study. CMR core laboratory analysis was performed to assess LVEF, infarct pathology and LV myocardial strain. The primary endpoint was adverse remodeling, defined as ≥ 20% increase in LV end-diastolic volume from baseline to 4 months.ResultsFrom the 232 patients included, 38 (16.4%) reached the primary endpoint. Global longitudinal strain (GLS), global radial strain, and global circumferential strain were all predictive of adverse remodeling (p < 0.01 for all), but only GLS was an independent predictor of adverse remodeling (odds ratio: 1.36[1.03–1.78]; p = 0.028) after adjustment for strain parameters, LVEF and CMR markers of infarct severity. A GLS > − 14% was associated with a fourfold increase in the risk for LV remodeling (odds ratio: 4.16[1.56–11.13]; p = 0.005). Addition of GLS to a baseline model comprising LVEF, infarct size and microvascular obstruction resulted in net reclassification improvement of 0.26 ([0.13–0.38]; p < 0.001) and integrated discrimination improvement of 0.02 ([0.01–0.03]; p = 0.006).ConclusionsIn STEMI survivors, determination of GLS using CMR-FT provides important prognostic information for the development of adverse remodeling that is incremental to LVEF and CMR markers of infarct severity.Clinical Trial RegistrationNCT04113356. More... »

PAGES

61-71

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00392-020-01649-2

    DOI

    http://dx.doi.org/10.1007/s00392-020-01649-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1126694950

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/32296969


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        "description": "BackgroundThe role of left ventricular (LV) myocardial strain by cardiac magnetic resonance feature tracking (CMR-FT) for\u00a0the prediction of adverse remodeling following ST-elevation myocardial infarction (STEMI), as well as its prognostic validity compared to LV ejection fraction (LVEF) and CMR infarct severity parameters, is unclear. This study aimed to evaluate the independent and incremental value of LV strain by CMR-FT for the prediction of adverse LV remodeling post-STEMI.MethodsSTEMI patients treated with primary percutaneous coronary intervention were enrolled in this prospective observational study. CMR core laboratory analysis was performed to assess LVEF, infarct pathology and LV myocardial strain. The primary endpoint was adverse remodeling, defined as\u2009\u2265\u200920% increase in LV end-diastolic volume from baseline to 4\u00a0months.ResultsFrom the 232 patients included, 38 (16.4%) reached the primary endpoint. Global longitudinal strain (GLS), global radial strain, and global circumferential strain were all predictive of adverse remodeling (p\u2009<\u20090.01 for all), but only GLS was an independent predictor of adverse remodeling (odds ratio: 1.36[1.03\u20131.78]; p\u2009=\u20090.028) after adjustment for strain parameters, LVEF and CMR markers of infarct severity. A GLS\u2009>\u2009\u2212\u00a014% was associated with a fourfold increase in the risk for LV remodeling (odds ratio: 4.16[1.56\u201311.13]; p\u2009=\u20090.005). Addition of GLS to a baseline model comprising LVEF, infarct size and microvascular obstruction resulted in net reclassification improvement of 0.26 ([0.13\u20130.38]; p\u2009<\u20090.001) and integrated discrimination improvement of 0.02 ([0.01\u20130.03]; p\u2009=\u20090.006).ConclusionsIn STEMI survivors, determination of GLS using CMR-FT provides important prognostic information for the development of adverse remodeling that is incremental to LVEF and CMR markers of infarct severity.Clinical Trial RegistrationNCT04113356.", 
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