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July 14, 2022Frontiers in Cardiovascular MedicineOpen Access

For detecting MVO segments, SCS showed an AUC of 0.764 with a cut-off of -11.2% yielding 78% sensitivity and 67% specificity; for LGE segments, SCS AUC was 0.848 with a cut-off of -13.8% yielding 76% sensitivity and 74% specificity.

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Why the study?

MVO and LGE assessed by CMR are associated with adverse outcomes in STEMI, motivating an evaluation of the diagnostic performance of segmental strain to detect MVO and LGE.

Does CMR segmental myocardial strain accurately detect microvascular obstruction and late gadolinium enhancement in patients presenting after a ST-elevation myocardial infarction?

Comparison

Diagnostic performance of segmental circumferential peak strain across derivation and validation cohorts

Design

Sub-study of the CARE-AMI trial

Authors

CGChristoph GräniASAnselm W. StarkKFKady Fischer

Discussion

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Overview

May support strain as contrast-free MVO surrogate in STEMI; leaves open prospective validation before practice change.

Structured PICO

Does CMR segmental myocardial strain accurately detect microvascular obstruction and late gadolinium enhancement in patients presenting after a ST-elevation myocardial infarction?

P
Population
48 patients with anterior STEMI and reduced LVEF (≤45%) who underwent primary PCI within 24 h, mean age 61.8 ± 12.5 years, 81% male.
I
Intervention
CMR feature tracking (FT) segmental circumferential peak strain (SCS) and segmental longitudinal peak strain (SLS)
C
Comparator
Visual classification of segments for MVO and LGE (LGE+/MVO+, LGE+/MVO-, LGE-)
O
Outcome
Diagnostic performance (AUC, sensitivity, specificity, PPV, NPV) of SCS and SLS to discriminate MVO and LGE segmentssurrogate

Segmental strain assessed by CMR feature tracking shows good diagnostic performance for detecting microvascular obstruction and late gadolinium enhancement, offering a potential contrast-free surrogate marker for early risk stratification in STEMI patients.

Limitations

  • single center study
  • rather small sample size
  • no pre-specified power analysis

Cite This Study

Gräni et al. (2022) studied this question.

synapsesocial.com/papers/6a109a722badbc352a005c3ahttps://doi.org/10.3389/fcvm.2022.909204
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Predictive value of myocardial strain on myocardial infarction size by cardiac magnetic resonance imaging in ST-segment elevation myocardial infarction with preserved left ventricular ejection fraction2022 · 9 citations
  2. 2The role of left ventricular deformation in the assessment of microvascular obstruction and intramyocardial haemorrhage2016 · 24 citations
  3. 3Comparison of Diagnostic Value Between STE+LDDSE and CMR-FT for Evaluating Coronary Microvascular Obstruction in Post-PCI Patients for STEMI2022 · 2 citations
  4. 4Cardiac magnetic resonance feature tracking global and segmental strain in acute and chronic ST-elevation myocardial infarction2022 · 22 citations
  5. 5Early Cardiac Magnetic Resonance-derived Cardiac Strain as a Predictor of Adverse Events and Ventricular Remodeling in Patients with Reperfused STEMI: A Two-center Cohort Study2023