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Comparative Study
. 2017 Jan 5;17(1):7.
doi: 10.1186/s12872-016-0461-6.

Comparison of global myocardial strain assessed by cardiovascular magnetic resonance tagging and feature tracking to infarct size at predicting remodelling following STEMI

Abhishek M Shetye  1   2 , Sheraz A Nazir  1 , Naveed A Razvi  1   3 , Nathan Price  1   4 , Jamal N Khan  1 , Florence Y Lai  1 , Iain B Squire  1 , Gerald P McCann  1 , Jayanth R Arnold  5
Affiliations
Comparative Study

Comparison of global myocardial strain assessed by cardiovascular magnetic resonance tagging and feature tracking to infarct size at predicting remodelling following STEMI

Abhishek M Shetye et al. BMC Cardiovasc Disord. .

Abstract

Background: To determine if global strain parameters measured by cardiovascular magnetic resonance (CMR) acutely following ST-segment Elevation Myocardial Infarction (STEMI) predict adverse left ventricular (LV) remodelling independent of infarct size (IS).

Methods: Sixty-five patients with acute STEMI (mean age 60 ± 11 years) underwent CMR at 1-3 days post-reperfusion (baseline) and at 4 months. Global peak systolic circumferential strain (GCS), measured by tagging and Feature Tracking (FT), and global peak systolic longitudinal strain (GLS), measured by FT, were calculated at baseline, along with IS. On follow up scans, volumetric analysis was performed to determine the development of adverse remodelling - a composite score based on development of either end-diastolic volume index [EDVI] ≥20% or end-systolic volume index [ESVI] ≥15% at follow-up compared to baseline.

Results: The magnitude of GCS was higher when measured using FT (-21.1 ± 6.3%) than with tagging (-12.1 ± 4.3; p < 0.001 for difference). There was good correlation of strain with baseline LVEF (r 0.64-to 0.71) and IS (ρ -0.62 to-0.72). Baseline strain parameters were unable to predict development of adverse LV remodelling. Only baseline IS predicted adverse remodelling - Odds Ratio 1.05 (95% CI 1.01-1.10, p = 0.03), area under the ROC curve 0.70 (95% CI 0.52-0.87, p = 0.04).

Conclusion: Baseline global strain by CMR does not predict the development of adverse LV remodelling following STEMI.

Keywords: Cardiac magnetic resonance; Feature tracking; Remodelling; ST-elevation myocardial infarction; Strain; Tagging.

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Figures

Fig. 1
Fig. 1
Protocol for CMR scan. Abbreviations:CSPAMM (Complementary Spatial Modulation of Magnetisation), FOV Field of View, LGE (Late Gadolinium Enhancement), SAX (Short Axis), SSFP (Steady State Free Precession), TE Echo Time, TI Inversion Time, TR Repetition Time
Fig. 2
Fig. 2
Comparison of strain analysis by tagging and feature tracking (FT) at short axis (SAX). (a, b) Tagged complementary spatial modulation of magnetisation (CSPAMM) basal short axis slice shown with endocardial and epicardial contours at end-diastole (ED) end-systole (ES) in a patient following inferior MI. (c) The resultant peak systolic circumferential strain curve at each segment with severely hypokinetic segments denoted by an (*). (d, e) Feature Tracking (FT) on cine Steady State Free Precession (SSFP) SAX slice with endocardial borders defined is shown at ED (d) and ES (E). (f) Segmental peak systolic circumferential strain curve by FT with dyskinetic segment denoted by an asterisk (*)
Fig. 3
Fig. 3
Receiver Operator Characteristic Curve for baseline Infarct Size to predict LV End-Systolic Volume Index ≥15% at follow-up versus baseline. Abbreviations: AUC (Area Under the Curve); CI (95% Confidence Interval); IS (Infarct Size)
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