Circumferential strain predicts major adverse cardiovascular events following an acute ST-segment-elevation myocardial infarction

Mangion, K. et al. (2019) Circumferential strain predicts major adverse cardiovascular events following an acute ST-segment-elevation myocardial infarction. Radiology, 290(2), pp. 329-337. (doi: 10.1148/radiol.2018181253) (PMID:30457480)

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Purpose: To investigate the prognostic value of circumferential left ventricular (LV) strain measured by using cardiac MRI for prediction of major adverse cardiac events (MACE) following an acute ST-segment–elevation myocardial infarction (STEMI). Materials and Methods: Participants with acute STEMI were prospectively enrolled from May 11, 2011, to November 22, 2012. Cardiac MRI was performed at 1.5 T during the index hospitalization. Displacement encoding with stimulated echoes (DENSE) and feature tracking of cine cardiac MRI was used to assess circumferential LV strain. MACE that occurred after discharge were independently assessed by cardiologists blinded to the baseline observations. Results: A total of 259 participants (mean age, 58 years ± 11 [standard deviation]; 198 men [mean age, 58 years ± 11] and 61 women [mean age, 58 years ± 12]) underwent cardiac MRI 2.2 days ± 1.9 after STEMI. Average infarct size was 18% ± 13 of LV mass and circumferential strain was −13% ± 3 (DENSE method) and −24% ± 7 (feature- tracking method). Fifty-one percent (131 of 259 participants) had presence of microvascular obstruction. During a median follow-up period of 4 years, 8% (21 of 259) experienced MACE. Area under the curve (AUC) for DENSE was different from that of feature tracking (AUC, 0.76 vs 0.62; P = .03). AUC for DENSE was similar to that of initial infarct size (P = .06) and extent of microvascular obstruction (P = .08). DENSE-derived strain provided incremental prognostic benefit over infarct size for prediction of MACE (hazard ratio, 1.3; P < .01). Conclusion: Circumferential strain has independent prognostic importance in study participants with acute ST-segment–elevation myocardial infarction.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Mccomb, Dr Christie and Carrick, Dr David and Mangion, Dr Kenneth and Hood, Dr Stuart and Eteiba, Dr Hany and Petrie, Professor Mark and Oldroyd, Dr Keith and Carberry, Dr Jaclyn and Berry, Professor Colin and Haig, Dr Caroline
Authors: Mangion, K., Carrick, D., Carberry, J., Mahrous, A., McComb, C., Oldroyd, K. G., Eteiba, H., Lindsay, M., McEntegart, M., Hood, S., Petrie, M. C., Watkins, S., Davie, A., Zhong, X., Epstein, F. H., Haig, C. E., and Berry, C.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Radiology
Publisher:Radiological Society of North America
ISSN (Online):1527-1315
Published Online:20 November 2018
Copyright Holders:Copyright © 2018 RSNA
First Published:First published in Radiology 290(2):329-337
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
617771BHF centre of excellenceRhian TouyzBritish Heart Foundation (BHF)RE/13/5/30177RI CARDIOVASCULAR & MEDICAL SCIENCES
525991Cardiac magnetic resonance imaging: new pathological insights and functional significance in acute myocardial infarctionColin BerryMedical Research Scotland (MEDRESSC)343 FRG FRI CARDIOVASCULAR & MEDICAL SCIENCES
544551Validation and significance of myocardial haemorrhage revealed by "bright blood" T2-weighted MRI in heart attack survivors: a prospective cohort study.Colin BerryBritish Heart Foundation (BHF)PG/11/2/28474RI CARDIOVASCULAR & MEDICAL SCIENCES