Magnetic resonance imaging of myocardial strain after acute ST-segment-elevation myocardial infarction: a systematic review

Mangion, K., McComb, C., Auger, D. A., Epstein, F. H. and Berry, C. (2017) Magnetic resonance imaging of myocardial strain after acute ST-segment-elevation myocardial infarction: a systematic review. Circulation: Cardiovascular Imaging, 10(8), e006498. (doi:10.1161/CIRCIMAGING.117.006498) (PMID:28733364)

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Abstract

The purpose of this systematic review is to provide a clinically relevant, disease-based perspective on myocardial strain imaging in patients with acute myocardial infarction or stable ischemic heart disease. Cardiac magnetic resonance imaging uniquely integrates myocardial function with pathology. Therefore, this review focuses on strain imaging with cardiac magnetic resonance. We have specifically considered the relationships between left ventricular (LV) strain, infarct pathologies, and their associations with prognosis. A comprehensive literature review was conducted in accordance with the PRISMA guidelines. Publications were identified that (1) described the relationship between strain and infarct pathologies, (2) assessed the relationship between strain and subsequent LV outcomes, and (3) assessed the relationship between strain and health outcomes. In patients with acute myocardial infarction, circumferential strain predicts the recovery of LV systolic function in the longer term. The prognostic value of longitudinal strain is less certain. Strain differentiates between infarcted versus noninfarcted myocardium, even in patients with stable ischemic heart disease with preserved LV ejection fraction. Strain recovery is impaired in infarcted segments with intramyocardial hemorrhage or microvascular obstruction. There are practical limitations to measuring strain with cardiac magnetic resonance in the acute setting, and knowledge gaps, including the lack of data showing incremental value in clinical practice. Critically, studies of cardiac magnetic resonance strain imaging in patients with ischemic heart disease have been limited by sample size and design. Strain imaging has potential as a tool to assess for early or subclinical changes in LV function, and strain is now being included as a surrogate measure of outcome in therapeutic trials.

Item Type:Articles
Keywords:ST-segment–elevation myocardial infarction, angiotensin-converting enzyme inhibitor, coronary artery disease, heart failure, magnetic resonance imaging.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mccomb, Dr Christie and Mangion, Dr Kenneth and Berry, Professor Colin
Authors: Mangion, K., McComb, C., Auger, D. A., Epstein, F. H., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Circulation: Cardiovascular Imaging
Publisher:American Heart Association
ISSN:1941-9651
ISSN (Online):1942-0080
Published Online:21 July 2017
Copyright Holders:Copyright © 2017 American Heart Association, Inc.
First Published:First published in Circulation: Cardiovascular Imaging 10(8): e006498
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
699321Myocardial strain measurements in survivors of acute ST-elevation myocardial infarction: implementation and prognostic significance of novel magnetic resonance imaging methods.Colin BerryBritish Heart Foundation (BHF)FS/15/54/31639RI CARDIOVASCULAR & MEDICAL SCIENCES
662681"First steps towards modelling myocardial infarction (a computed MI Physiome): A case-control study of novel biomechanical parameters in acute MI survivors with left ventricular dysfunction."Colin BerryBritish Heart Foundation (BHF)PG/14/64/31043RI CARDIOVASCULAR & MEDICAL SCIENCES
617771BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177RI CARDIOVASCULAR & MEDICAL SCIENCES