Left Ventricular Strain Is Associated With Myocardial Recovery Following ST-Elevation Myocardial Infarction, a Prospective Longitudinal CMR Study.
Left Ventricular Strain Is Associated With Myocardial Recovery Following ST-Elevation Myocardial Infarction, a Prospective Longitudinal CMR Study.
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DOI：
10.3389/fcvm.2022.842619
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发表时间：
2022
影响因子：
3.6
通讯作者：
Al-Ani MA
中科院分区：
文献类型：
--
作者：
Taha MB;Jeng EI;Salerno M;Moguillansky D;Keeley EC;Al-Ani MA
ST段抬高型心肌梗死（STEMI）后的冠状动脉大小是左心室功能障碍和心血管病发病率和死亡率的重要决定因素。心脏磁共振特征跟踪（CMR-FT）是一种通过量化纵向、径向和周向应变来评估心肌功能的技术。我们研究了CMR-FT衍生的心肌整体应变和心肌恢复之间的关系。对接受直接经皮冠状动脉介入治疗（PCI）的STEMI患者进行了一项前瞻性研究。CMR成像在两个间隔时间点获得，出院后2周内的基线和6个月的随访。通过FT-CMR进行应变分析，并通过晚期钆增强（LGE）的面积定量恢复。共有n = 14例患者符合入选和排除标准，并进行了分析。在初始CMR和随访CMR之间，通过左心室肌肉质量的LGE质量百分比测量的梗死面积显著减小（19.7%，IQR 12.2-23.9 vs. 17.1%，IQR 8.3-22.5，p = 0.04）。初始应变参数与初始水肿质量和初始和随访CMR之间LGE质量的减少呈负相关。所有LV全局菌株预测LGE质量减少50%或更多的准确度都很高。直接PCI术后测量左室整体应变可以预测心肌恢复的程度。
Infarct size following ST-elevation myocardial infarction (STEMI) is an important determinate of left ventricular (LV) dysfunction and cardiovascular morbidity and mortality. Cardiac magnetic resonance feature tracking (CMR-FT) is a technique that allows for the assessment of myocardial function via quantification of longitudinal, radial, and circumferential strain. We investigated the association between CMR-FT-derived myocardial global strain and myocardial recovery. A prospective study on patients presenting with STEMI treated with primary percutaneous coronary intervention (PCI) was conducted. CMR imaging was obtained at two interval time points, the baseline within 2 weeks of hospital discharge and follow-up at 6 months. Strain analysis was performed via FT-CMR, and recovery was quantified by the area of late gadolinium enhancement (LGE). A total of n = 14 patients met inclusion and exclusion criteria and were analyzed. There was a significant reduction in the infarct size, as measured by LGE mass percentage of the left ventricular muscle mass, between the initial and follow-up CMR (19.7%, IQR 12.2–23.9 vs. 17.1%, IQR 8.3–22.5, p = 0.04). Initial strain parameters were inversely correlated with the initial edema mass and the decrease in LGE mass between the initial and follow-up CMR. All LV global strains had high accuracy for the prediction of a reduction in LGE mass by 50% or more. LV global strains measured after primary PCI can predict the extent of myocardial recovery.