TY - JOUR
T1 - Strain analysis is superior to wall thickening in discriminating between infarcted myocardium with and without microvascular obstruction
AU - Everaars, Henk
AU - Robbers, Lourens F. H. J.
AU - Götte, Marco
AU - Croisille, Pierre
AU - Hirsch, Alexander
AU - Teunissen, Paul F. A.
AU - van de Ven, Peter M.
AU - van Royen, Niels
AU - Zijlstra, Felix
AU - Piek, Jan J.
AU - van Rossum, Albert C.
AU - Nijveldt, Robin
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives: The aim of the present study was to evaluate the diagnostic performances of strain and wall thickening analysis in discriminating among three types of myocardium after acute myocardial infarction: non-infarcted myocardium, infarcted myocardium without microvascular obstruction (MVO) and infarcted myocardium with MVO. Methods: Seventy-one patients with a successfully treated ST-segment elevation myocardial infarction underwent cardiovascular magnetic resonance imaging at 2-6 days after reperfusion. The imaging protocol included conventional cine imaging, myocardial tissue tagging and late gadolinium enhancement. Regional circumferential and radial strain and associated strain rates were analyzed in a 16-segment model as were the absolute and relative wall thickening. Results: Hyperenhancement was detected in 418 (38%) of 1096 segments and was accompanied by MVO in 145 (35%) of hyperenhanced segments. Wall thickening, circumferential and radial strain were all significantly diminished in segments with hyperenhancement and decreased even further if MVO was also present (all p < 0.001). Peak circumferential strain (CS) surpassed all other strain and wall thickening parameters in its ability to discriminate between hyperenhanced and non-enhanced myocardium (all p < 0.05). Furthermore, CS was superior to both absolute and relative wall thickening in differentiating infarcted segments with MVO from infarcted segments without MVO (p = 0.02 and p = 0.001, respectively). Conclusions: Strain analysis is superior to wall thickening in differentiating between non-infarcted myocardium, infarcted myocardium without MVO and infarcted myocardium with MVO. Peak circumferential strain is the most accurate marker of regional function. Key Points: • CMR can quantify regional myocardial function by analysis of wall thickening on cine images and strain analysis of tissue tagged images. • Strain analysis is superior to wall thickening in differentiating between different degrees of myocardial injury after acute myocardial infarction. • Peak circumferential strain is the most accurate marker of regional function.
AB - Objectives: The aim of the present study was to evaluate the diagnostic performances of strain and wall thickening analysis in discriminating among three types of myocardium after acute myocardial infarction: non-infarcted myocardium, infarcted myocardium without microvascular obstruction (MVO) and infarcted myocardium with MVO. Methods: Seventy-one patients with a successfully treated ST-segment elevation myocardial infarction underwent cardiovascular magnetic resonance imaging at 2-6 days after reperfusion. The imaging protocol included conventional cine imaging, myocardial tissue tagging and late gadolinium enhancement. Regional circumferential and radial strain and associated strain rates were analyzed in a 16-segment model as were the absolute and relative wall thickening. Results: Hyperenhancement was detected in 418 (38%) of 1096 segments and was accompanied by MVO in 145 (35%) of hyperenhanced segments. Wall thickening, circumferential and radial strain were all significantly diminished in segments with hyperenhancement and decreased even further if MVO was also present (all p < 0.001). Peak circumferential strain (CS) surpassed all other strain and wall thickening parameters in its ability to discriminate between hyperenhanced and non-enhanced myocardium (all p < 0.05). Furthermore, CS was superior to both absolute and relative wall thickening in differentiating infarcted segments with MVO from infarcted segments without MVO (p = 0.02 and p = 0.001, respectively). Conclusions: Strain analysis is superior to wall thickening in differentiating between non-infarcted myocardium, infarcted myocardium without MVO and infarcted myocardium with MVO. Peak circumferential strain is the most accurate marker of regional function. Key Points: • CMR can quantify regional myocardial function by analysis of wall thickening on cine images and strain analysis of tissue tagged images. • Strain analysis is superior to wall thickening in differentiating between different degrees of myocardial injury after acute myocardial infarction. • Peak circumferential strain is the most accurate marker of regional function.
KW - Left ventricular function
KW - Magnetic resonance Imaging
KW - Myocardial contraction
KW - ST elevation myocardial infarction
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85048255745&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29948065
UR - http://www.scopus.com/inward/record.url?scp=85048255745&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00330-018-5493-0
DO - https://doi.org/10.1007/s00330-018-5493-0
M3 - Article
C2 - 29948065
SN - 0938-7994
VL - 28
SP - 5171
EP - 5181
JO - European Radiology
JF - European Radiology
IS - 12
ER -