Functional and prognostic implications of cardiac magnetic resonance feature tracking-derived remote myocardial strain analyses in patients following acute myocardial infarction
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Key result
Impaired remote myocardial circumferential strain was a strong predictor of major adverse cardiac events at 12 months following acute myocardial infarction (HR 1.05).
Why the study?
Functional analyses of the remote myocardium are scarce and whether they provide additional prognostic value after acute myocardial infarction is unknown.
Does CMR-FT-derived remote myocardial circumferential strain predict major adverse cardiac events in patients following acute myocardial infarction?
Population
1034 patients following acute myocardial infarction after primary percutaneous coronary intervention
Comparison
Remote myocardial circumferential strain levels
Design
Cohort study
Follow-up
12 months
Authors
Discussion
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Implication
Impaired remote myocardium strain was associated with MACE beyond standard CMR parameters; extends post-AMI risk stratification but leaves practice change open.
Study Design
Type
Cohort (n=1,034)
Multicenter
Yes
Structured PICO
Does CMR-FT-derived remote myocardial circumferential strain predict major adverse cardiac events in patients following acute myocardial infarction?
P
Population
1,034 patients following acute myocardial infarction treated with primary percutaneous coronary intervention, evaluated with cardiac magnetic resonance imaging and followed for 12 months.
E
Exposure
Cardiac magnetic resonance feature tracking (CMR-FT)-derived remote myocardial circumferential strain (RM CS) analysis
O
Outcome
Major adverse cardiac events (MACE) within 12 months after the index eventcomposite
Main Result
Hazard Ratio: 1.05 (95% CI 1.07–1.14)
p-value: p=0.003
CMR-FT-derived remote myocardial circumferential strain provides incremental prognostic value for predicting 12-month MACE in patients following acute myocardial infarction, especially in high-risk subgroups.
Limitations
- Several study sites performed CMR imaging using different vendors.
- When defining remote myocardium segments, the percentage of infarct area in infarcted segments is not considered.
- Effects of a minimally affected infarct segment might be different compared to a completely infarcted segment.
Cite This Study
Lange et al. (2020) conducted a cohort in Acute myocardial infarction (n=1,034). Impaired remote myocardial circumferential strain vs. Preserved remote myocardial circumferential strain was evaluated on Major adverse cardiac events (MACE) within 12 months (HR 1.05, 95% CI 1.07-1.14, p=0.003). Impaired remote myocardial circumferential strain was a strong predictor of major adverse cardiac events at 12 months following acute myocardial infarction (HR 1.05).
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