کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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5968184 | 1576169 | 2015 | 9 صفحه PDF | دانلود رایگان |
PurposeTo investigate whether myocardial deformation imaging, assessed by feature tracking cardiac magnetic resonance (FTI-CMR), would allow objective quantification of myocardial strain and estimation of functional recovery in patients with first time ST-elevation myocardial infarction (STEMI).MethodsCardiac magnetic resonance (CMR) imaging was performed in 74 consecutive patients 2-4 days after successfully reperfused STEMI, using a 1.5 T CMR scanner (Philips Achieva). Peak systolic circumferential and longitudinal strains were measured using the FTI applied to SSFP cine sequences and were compared to infarct size, determined by late gadolinium enhancement (LGE). Follow-up CMR at 6 months was performed in order to assess residual ejection fraction, which deemed as the reference standard for the estimation of functional recovery.ResultsDuring the follow-up period 53 of 74 (72%) patients exhibited preserved residual ejection fraction â¥Â 50%. A cut-off value of â 19.3% for global circumferential strain identified patients with preserved ejection fraction â¥Â 50% at follow-up with sensitivity of 76% and specificity of 85% (AUC = 0.86, 95% CI = 0.75-0.93, p < 0.001), which was superior to that provided by longitudinal strain (ÎAUC = 0.13, SE = 0.05, z-statistic = 2.5, p = 0.01), and non-inferior to that provided by LGE (ÎAUC = 0.07, p = NS). Multivariate analysis showed that global circumferential strain and LGE exhibited independent value for the prediction of preserved LV-function, surpassing that provided by age, diabetes and baseline ejection fraction (HR = 1.4, 95% CI = 1.0-1.9 and HR = 1.4, 95% CI = 1.1-1.7, respectively, p < 0.05 for both).ConclusionsEstimation of circumferential strain by FTI provides objective assessment of infarct size without the need for contrast agent administration and estimation of functional recovery with non-inferior accuracy compared to that provided by LGE.
Journal: International Journal of Cardiology - Volume 183, 15 March 2015, Pages 162-170