Circumferential strain acquired by CMR early after acute myocardial infarction adds incremental predictive value to late gadolinium enhancement imaging to predict late myocardial remodeling and subsequent risk of sudden cardiac death

Autor: Cynthia C. Taub, Lina Restrepo, Newton Phuong, Mario J. Garcia, Jeffrey M. Levsky, Anthony A. Holmes, Luigi Di Biase, Luis Ruiz-Guerrero, Linda B. Haramati, Stuart L. Cohen, Jorge Romero, Leila Rezai-Gharai, John D. Fisher
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Time Factors
Myocardial Infarction
Contrast Media
Magnetic Resonance Imaging
Cine

Gadolinium
030204 cardiovascular system & hematology
Risk Assessment
Sudden cardiac death
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Physiology (medical)
Internal medicine
medicine
Clinical endpoint
Late gadolinium enhancement
Circumferential strain
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Prospective Studies
Angioplasty
Balloon
Coronary

Aged
Analysis of Variance
Ejection fraction
Ventricular Remodeling
business.industry
Middle Aged
medicine.disease
Predictive value
Radiographic Image Enhancement
Death
Sudden
Cardiac

ROC Curve
Conventional PCI
Cardiology
ST Elevation Myocardial Infarction
Female
Radiology
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. 50(3)
ISSN: 1572-8595
Popis: Late adverse myocardial remodeling after acute myocardial infarction (AMI) is strongly associated with sudden cardiac death (SCD). Cardiac magnetic resonance (CMR) performed early after AMI can predict late remodeling and SCD risk with moderate accuracy. This study assessed the ability of CMR-measured circumferential strain (CS) to add incremental predictive information to late gadolinium enhancement (LGE).Patients with an AMI and LVEF 50% were screened for inclusion. A total of 27 patients, totaling 432 myocardial segments, prospectively underwent CMR 7 ± 5 days after percutaneous coronary intervention (PCI). LGE, microvascular obstruction (MVO), and myocardial CS were measured for each segment. The primary endpoint was late segmental adverse remodeling defined as segmental wall motion score (WMS) 1 measured by echocardiography 3 months after PCI.A total of 141 segments experienced the primary endpoint at 3 months. The mean LGE volume was higher in these segments, but LGE was also present in many segments with normal WMS (40 ± 28 versus 20 ± 26%, p 0.01). Segments that met the primary endpoint also showed greater impairment of CS. Segments with both LGE 17% and impaired CS- 7.2% on CMR were more likely to experience late adverse remodeling (73%) as compared to segments with neither (9%, p 0.001) or one abnormal parameter (36%, p 0.001). CS- 7.2% also added incremental accuracy to LGE 17% for predicting late adverse remodeling (AUC 0.81 from 0.70, p 0.001).When performed early after AMI, LGE is a moderate predictor of late remodeling and CS is a powerful predictor of late myocardial remodeling. When combined, they can predict late remodeling, a surrogate of SCD, with high accuracy.
Databáze: OpenAIRE