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 |
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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 |
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