Key result
LV global longitudinal strain after primary PCI accurately predicts ≥50% reduction in 6-month infarct size.
Why the study?
Infarct size after STEMI determines LV dysfunction and outcomes, and researchers sought to investigate the association between CMR-FT-derived myocardial global strain and myocardial recovery.
Does CMR-FT-derived myocardial global strain predict myocardial recovery in patients with STEMI treated with primary PCI?
Cohort (n=14)
Yes
Does CMR-FT-derived myocardial global strain predict myocardial recovery in patients with STEMI treated with primary PCI?
LV global strains measured by CMR-FT early after primary PCI for STEMI strongly correlate with and predict the extent of myocardial recovery at 6 months.
Answers are grounded in this paper and cite their sources.
LV GLS post-primary PCI may predict STEMI recovery; hypothesis-generating and requires prospective validation before practice change.
Background Infarct size following ST-elevation myocardial infarction (STEMI) is an important determinate of left ventricular (LV) dysfunction and cardiovascular morbidity and mortality. Cardiac magnetic resonance feature tracking (CMR-FT) is a technique that allows for the assessment of myocardial function via quantification of longitudinal, radial, and circumferential strain. We investigated the association between CMR-FT-derived myocardial global strain and myocardial recovery. Methods A prospective study on patients presenting with STEMI treated with primary percutaneous coronary intervention (PCI) was conducted. CMR imaging was obtained at two interval time points, the baseline within 2 weeks of hospital discharge and follow-up at 6 months. Strain analysis was performed via FT-CMR, and recovery was quantified by the area of late gadolinium enhancement (LGE). Results A total of n = 14 patients met inclusion and exclusion criteria and were analyzed. There was a significant reduction in the infarct size, as measured by LGE mass percentage of the left ventricular muscle mass, between the initial and follow-up CMR (19.7%, IQR 12.2–23.9 vs. 17.1%, IQR 8.3–22.5, p = 0.04). Initial strain parameters were inversely correlated with the initial edema mass and the decrease in LGE mass between the initial and follow-up CMR. All LV global strains had high accuracy for the prediction of a reduction in LGE mass by 50% or more. Conclusions LV global strains measured after primary PCI can predict the extent of myocardial recovery.
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Taha et al. (2022) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=14). Cardiac magnetic resonance feature tracking (CMR-FT) global strain was evaluated on Prediction of ≥50% decrease in late gadolinium enhancement (LGE) mass by LV global longitudinal strain (AUC 0.97, 95% CI 0.95-0.99, p=<0.001). Left ventricular global longitudinal strain measured after primary percutaneous coronary intervention accurately predicted a 50% or greater reduction in infarct size at 6 months.
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