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October 14, 2022Frontiers in PharmacologyOpen Access

Predictive value of myocardial strain on myocardial infarction size by cardiac magnetic resonance imaging in ST-segment elevation myocardial infarction with preserved left ventricular ejection fraction

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Key result

CMR-derived global circumferential strain emerged as the strongest predictor of myocardial infarction size >25% in STEMI patients with preserved LVEF, demonstrating an AUC of 0.836.

Why the study?

The correlation between myocardial strain and myocardial infarction size by cardiac magnetic resonance imaging in STEMI patients with preserved LVEF is not clear.

Does CMR-derived global circumferential strain accurately predict myocardial infarction size in STEMI patients with preserved LVEF?

Population

31 STEMI patients after primary PCI with preserved LVEF and 21 healthy adults

Comparison

STEMI patients with preserved LVEF vs healthy controls

Design

Retrospective study

Authors

QWQiang WangJWJian WangYMYingjie Ma

Discussion

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Overview

May aid identification of larger infarcts in preserved-LVEF STEMI; hypothesis-generating pending prospective validation.

Study Design

Type

Observational (n=52)

Multicenter

No

Structured PICO

Does CMR-derived global circumferential strain accurately predict myocardial infarction size in STEMI patients with preserved LVEF?

P
Population
52 participants, including 31 patients with acute STEMI and preserved LVEF after PCI and 21 healthy controls, evaluated for myocardial strain and infarct size using cardiac magnetic resonance imaging.
E
Exposure
Cardiac magnetic resonance (CMR) feature-tracking derived global circumferential strain (GCS)
C
Comparator
Global longitudinal strain (GLS) and left ventricular ejection fraction (LVEF)
O
Outcome
Diagnostic accuracy (Area Under the Curve [AUC]) for predicting myocardial infarction size (late gadolinium enhancement [LGE] >25%)surrogate

Main Result

Effect estimate: AUC 0.836 (95% CI 0.692-0.981)

Absolute Event Rate: 0.836% vs 0.673%

p-value: p=0.001

In STEMI patients with preserved LVEF, CMR-derived global circumferential strain is a superior surrogate marker for predicting myocardial infarct size compared to LVEF.

Limitations

  • Small sample size
  • Single-center retrospective study
  • CMR scans performed up to 14 days after MI, which may not be the optimal time point
  • Limited extrapolation to STEMI patients with decreased LVEF or non-STEMI patients
  • Lack of follow-up for prognostic analysis

Cite This Study

Wang et al. (2022) conducted an observational in ST-segment elevation myocardial infarction with preserved left ventricular ejection fraction (n=52). Global circumferential strain (GCS) by CMR vs. Left ventricular ejection fraction (LVEF) was evaluated on Diagnostic accuracy (AUC) for predicting late gadolinium enhancement (LGE) size >25% (AUC 0.836, 95% CI 0.692-0.981, p=0.001). CMR-derived global circumferential strain emerged as the strongest predictor of myocardial infarction size >25% in STEMI patients with preserved LVEF, demonstrating an AUC of 0.836.

synapsesocial.com/papers/6a8ade173fd21775a53377fehttps://doi.org/10.3389/fphar.2022.1015390
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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 in ST-segment elevation myocardial infarction with preserved LVEF2024
  2. 2Early 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
  3. 3Left Ventricular Strain Is Associated With Myocardial Recovery Following ST-Elevation Myocardial Infarction, a Prospective Longitudinal CMR Study2022 · 6 citations
  4. 4Comparison of global myocardial strain assessed by cardiovascular magnetic resonance tagging and feature tracking to infarct size at predicting remodelling following STEMI2017 · 26 citations
  5. 5Identification of High-Risk Patients with Non-ST Segment Elevation Myocardial Infarction using Strain Doppler Echocardiography: Correlation with Cardiac Magnetic Resonance Imaging2016 · 7 citations