Left atrial mechanics in patients with acute STEMI and secondary mitral regurgitation: A prospective pilot CMR feature tracking study

Autor: Tomas Lapinskas, Rimantas Benetis, Remigijus Žaliūnas, Paulius Bučius, Živilė Valuckienė, Lina Jankauskaitė, Agnieta Stabinskaitė, Laura Urbonaitė
Rok vydání: 2016
Předmět:
Male
Cardiac magnetic resonance
Left atrium
Pilot Projects
030204 cardiovascular system & hematology
030218 nuclear medicine & medical imaging
0302 clinical medicine
Myocardial infarction
Prospective Studies
Feature tracking
Myocardial deformation
Reproducibility
Medicine(all)
Observer Variation
lcsh:R5-920
medicine.diagnostic_test
Mitral Valve Insufficiency
Middle Aged
Magnetic Resonance Imaging
616.127 [udc]
medicine.anatomical_structure
Echocardiography
Atrial Function
Left
Female
Radiology
lcsh:Medicine (General)
medicine.medical_specialty
Statistics
Nonparametric
03 medical and health sciences
medicine
Humans
In patient
cardiovascular diseases
Heart Atria
Aged
Mitral regurgitation
business.industry
Reproducibility of Results
Magnetic resonance imaging
Stroke Volume
medicine.disease
Automotive Engineering
ST Elevation Myocardial Infarction
Mitral valve insufficiency
Myocardium
pathology
Heart atria
diagnostic imaging
methods
Nuclear medicine
business
Zdroj: Medicina; Volume 53; Issue 1; Pages: 11-18
Medicina, Wrocław : Elsevier, 2017, vol. 53, no. 1, p. 11-18
Medicina, Vol 53, Iss 1, Pp 11-18 (2017)
Medicina
Volume 53
Issue 1
Pages 11-18
ISSN: 1648-9144
1010-660X
Popis: Background and objective: Left atrium (LA) is an important biomarker of adverse cardiovascular outcomes and cerebrovascular events. This study aimed to evaluate LA myocardial deformation using cardiac magnetic resonance feature tracking (CMR-FT) in patients with acute ST-segment elevation myocardial infarction (STEMI) and secondary mitral regurgita- tion (MR). Additionally, to assess interobserver and intraobserver variability of the technique.Materials and methods: Twenty patients with STEMI underwent CMR with a 1.5 Tesla MRI scanner. According to the presence of MR patients were divided into two groups: MR(+) and MR(−). Total LA strain (εs), passive LA strain (εe), and active LA strain (εa) were obtained. Additionally, total, passive and active strain rates (SRs, SRe, and SRa) were calculated. To assess interobserver agreement data analysis was performed by second independent observer.Results: LA volumetric and functional parameters were similar in both groups. All LA strain values were significantly higher in patients with MR: εs (27.67 ± 10.25 for MR(−) vs. 32.80 ± 6.95 for MR(+)
P = 0.01), εe (15.29 ± 7.30 for MR(−) vs. 19.22 ± 6.04 for MR(+)
P = 0.01) and εa (12.38 ± 4.23 for MR(−) vs. 14.44 ± 5.19 for MR(+)
P = 0.03). Only SRe significantly increased in patients with MR (−0.57 ± 0.24 for MR(−) vs. −0.70 ± 0.20 for MR(+)
P = 0.01). All LA deformation parameters demonstrated high interobserver and intraobserver agreement. Conclusions: Conventional volumetric and functional LA parameters do not detect early changes in LA performance in patients with STEMI and secondary MR. In contrast, LA reservoir, passive and active strain are significantly higher in patients with MR. Only peak early negative strain rate substantially increases during secondary MR. LA deformation parameters derived from conventional cine images using CMR-FT technique are highly reproducible.
Databáze: OpenAIRE
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