Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain a
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ORIGINAL PAPER
Functional and prognostic implications of cardiac magnetic resonance feature tracking‑derived remote myocardial strain analyses in patients following acute myocardial infarction Torben Lange1 · Thomas Stiermaier2,3 · Sören J. Backhaus1 · Patricia C. Boom1 · Johannes T. Kowallick4 · Suzanne de Waha‑Thiele2,3 · Joachim Lotz4 · Shelby Kutty5 · Boris Bigalke6 · Matthias Gutberlet7 · Hans‑Josef Feistritzer8 · Steffen Desch8 · Gerd Hasenfuß1 · Holger Thiele8 · Ingo Eitel2,3 · Andreas Schuster1 Received: 30 June 2020 / Accepted: 14 September 2020 © The Author(s) 2020
Abstract Background Cardiac magnetic resonance myocardial feature tracking (CMR-FT)-derived global strain assessments provide incremental prognostic information in patients following acute myocardial infarction (AMI). Functional analyses of the remote myocardium (RM) are scarce and whether they provide an additional prognostic value in these patients is unknown. Methods 1034 patients following acute myocardial infarction were included. CMR imaging and strain analyses as well as infarct size quantification were performed after reperfusion by primary percutaneous coronary intervention. The occurrence of major adverse cardiac events (MACE) within 12 months after the index event was defined as primary clinical endpoint. Results Patients with MACE had significantly lower RM circumferential strain (CS) compared to those without MACE. A cutoff value for RM CS of − 25.8% best identified high-risk patients (p − 18.3% (p = 0.015 on log-rank testing), and (3) patients with large microvascular obstruction ≥ 1.46% (p = 0.002 on log-rank testing). Conclusion CMR-FT-derived RM CS is a useful parameter to characterize the response of the remote myocardium and allows improved stratification following AMI beyond commonly used parameters, especially of high-risk patients. Trial registration ClinicalTrials.gov, NCT00712101 and NCT01612312
Torben Lange, Thomas Stiermaier, Ingo Eitel and Andreas Schuster: equal contribution. * Andreas Schuster [email protected]‑goettingen.de 1
2
Department of Cardiology and Pneumology, Göttingen Germany and German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, University Medical Center Göttingen, Georg-August University, Robert‑Koch‑Straße 40, Göttingen, Germany University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany
3
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany
4
Institute for Diagnostic and Interventional Radiology, Göttingen Germany and German Centre for Cardiovascular
Research (DZHK), Partner Site Göttingen, University Medical Center Göttingen, Georg-August University, Göttingen, Germany 5
Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, MD, USA
6
Department of Cardiology, Charité Campus Benjamin Franklin, University Medical Center Berlin, Berlin, Germany
7
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