Anterior STEMI associated with decreased strain in remote cardiac myocardium

Figures

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  Fig. 1. Example of strain and infarct delineations in a patient with STEMI in the LAD in the sub-acute (top row) and chronic (bottom row) phase. A–D show a patient in the sub-acute phase (2–6 days) after ST-elevation myocardial infarction (STEMI) in the left anterior descending artery (LAD), and E–H show the same patient in the chronic phase 6 months after the STEMI. The end-diastolic delineations of the left ventricular myocardial borders in red are illustrated in the 4-chamber view (A, E), 3-chamber view (B, F) and 2-chamber view (C, G). Infarct delineation is illustrated in one midventricular short-axis late gadolinium enhancement image (D, H) with epicardial contour (green), endocardial contour (red), extent infarction (pink) and core of infarction (yellow)

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  Fig. 2. Bullseye plots over distribution of infarction after STEMI. Polar plots of the distribution of infarction in the sub-acute and chronic phase after STEMI in the left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA). The grayscale intensity represents the average amount of infarction, expressed in percentage, as shown on the bar to the right with white representing 0% and black 100% infarction

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  Fig. 3. Global longitudinal strain, ejection fraction and infarction size. Boxes (median and 25th and 75th percentile) with whiskers (min to max). A Global longitudinal strain (GLS) for patients at the sub-acute and chronic phase as well as healthy controls. B Ejection fraction (EF) for patients at the sub-acute and chronic phase as well as healthy controls. C Patients’ infarction size at the sub-acute and chronic phase. Three patients had missing infarct size data at six months, why paired comparisons of IS% was only performed with 74 patients. ***p < 0.001 compared to controls. ###p < 0.001 compared to 2–6 days

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  Fig. 4. Scatter plot between infarct size, global longitudinal strain and ejection fraction. Scatter plots with linear regression best fit line and coefficient of determination (r2) for patients’ infarct size vs. global longitudinal strain (GLS) (A, B) and ejection fraction (C, D). A and C shows the sub-acute phase and B and D the chronic phase

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  Fig. 5. Regional longitudinal strain by myocardial wall regions. Radar charts of longitudinal regional strain divided into 6 walls according to (A). Note that the apical cap (segment 17) is excluded and that segments 14 and 16 are both shared by two wall regions. B–D Chart axis (light gray) show strain, and data points show the mean strain of the segments included in the region. B Patients with STEMI in the left anterior descending artery (LAD); C Patients with STEMI in the left circumflex artery (LCx); D Patients with STEMI in the right coronary artery (RCA). Black represents strain values of healthy controls, blue represents strain values in STEMI patients at 2–6 days, and orange represents strain values in patients at 6 months follow up. *p < 0.05, **p < 0.01, ***p < 0.001 compared to controls. #p < 0.05, ##p < 0.01, ###p < 0.001 compared to 2–6 days