Quantitative assessment of global and regional strain in relation to infarct size in patients with myocardial infarction
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POSTER PRESENTATION
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Quantitative assessment of global and regional strain in relation to infarct size in patients with myocardial infarction Nabil A Shafi1*, Kathleen Bertman1, Andrew Yoon1, Rena Toole1, Matthew Ronin1, Simcha Pollack2, Nathaniel Reichek3, Madhavi Kadiyala1 From 2011 SCMR/Euro CMR Joint Scientific Sessions Nice, France. 3-6 February 2011 Introduction Assessment of regional and global left ventricular (LV) function and strain are important in the setting of prior myocardial infarction (MI). Feature tracking (FT-MRI) is a novel cardiac MRI method for assessment of myocardial strain, similar to speckle tracking in 2-D echocardiography, which provides multi-planar strain data without the need for tagged images. Purpose The goal of our study was to characterize LV global and regional strains in patients with prior MI using FT-MRI and determine the relationship of strains to infarct size, location and LV ejection fraction (EF). Methods Eighty patients with history of past MI were grouped by MI coronary territory {left anterior descending (LAD), left circumflex (LCX), right coronary (RCA)}. Scar quantification was done by computer-assisted planimetry (Medis Qmass v7.2) of gadolinium enhanced delayed images and MI percentage was determined. Global and regional circumferential subendocardial (Ecc Endo) and subepicardial (Ecc Epi) and longitudinal (Ell) strains were derived from three long axis (4, 3 and 2 chamber) and three short axis (basal, mid, apical) steady state free procession cine planes. Semi-automated tracing of endocardial and epicardial borders using FT-MRI (Diogenes MRI, Tomtec Systems) was performed and strains were mapped to a 17 segment AHA model. Repeated measures ANOVA was used to compare normal strain
values from 60 healthy subjects to MI patients controlling for scar percentage.
Results The mean age was 64.4(12) years and mean EF was 42.1% (11). Peak global Ecc Epi and Ecc Endo were decreased in all MI patients, except in Ecc endo LCx infarcts, compared to normals (all with p≤ 0.01) (Table 1). Peak Ell strain was relatively preserved in the majority of infarcts except in LAD infarcts, where it was significantly decreased in the LAD territory (p =0.01). The best predictor of reduced LVEF in MI patients was reduced global Ecc Endo (r =0.82, p
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