Key result
LGE-negative CTO segments show lower systolic and ~17% higher diastolic longitudinal strain rates versus controls.
Why the study?
To explore whether LGE-negative areas with coronary artery chronic total occlusion appear normal when analyzed for longitudinal strain using CMR imaging.
Does longitudinal strain analysis using CMR detect myocardial abnormalities in LGE-negative areas with coronary artery chronic total occlusion compared to healthy controls?
Case-Control (n=47)
No
Does longitudinal strain analysis using CMR detect myocardial abnormalities in LGE-negative areas with coronary artery chronic total occlusion compared to healthy controls?
Absolute Event Rate: 1.19% vs 1.02%
p-value: p=0.018
Longitudinal strain analysis using CMR can detect subclinical myocardial dysfunction in LGE-negative territories supplied by chronic total occlusion vessels.
Strain CMR may detect subclinical CTO dysfunction despite negative LGE; leaves open clinical impact and need for prospective validation.
Background Strain analysis has become commonly used in clinical practice in various heart diseases. Purpose To explore whether late gadolinium enhancement (LGE)-negative areas with coronary artery chronic total occlusion (CTO) appear normal when analyzed for longitudinal strain using cardiac magnetic resonance (CMR) imaging. Material and Methods A total of 16 patients and 31 healthy controls who underwent 1.5-T MR at our hospital between January 2015 and July 2017 were included in the study. The LGE-CMR of patients with CTO was negative. Left ventricular functional parameters, segmental longitudinal strain/strain rate, and perfusion parameters were measured using CVI42 software. Results For myocardial segments supplied by CTO vessels, systolic longitudinal strain rate (SLSR)was significantly lower than that of healthy controls, and diastolic longitudinal strain rate (DLSR) was significantly higher (1.19 1/s vs. 1.02 1/s; P = 0.018). Moreover, longitudinal strain (LS), SLSR, and DLSR did not differ between good and poor collateral circulation. Perfusion index of CTO territory segments was lower than non-CTO territory segments (0.20 vs. 0.22; P = 0.027). No correlation was found between longitudinal strain parameters and perfusion parameters. Conclusion Although LGE-CMR was negative in patients with CTO, the myocardial SLSR of CTO territory segments was significantly lower than that of healthy controls.
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Zhang et al. (2021) conducted a case-control in Coronary artery chronic total occlusion (CTO) (n=47). LGE-negative coronary artery chronic total occlusion vs. Healthy controls was evaluated on Diastolic longitudinal strain rate (DLSR) (p=0.018). Myocardial segments supplied by LGE-negative chronic total occlusion vessels had significantly lower systolic and higher diastolic longitudinal strain rates (1.19 vs. 1.02 1/s; P=0.018) than controls.
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