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Anterior STEMI associated with decreased strain in remote cardiac myocardium

Sjögren, Hannah ; Pahlm, Ulrika LU ; Engblom, Henrik LU ; Erlinge, David LU orcid ; Heiberg, Einar LU ; Arheden, Håkan LU ; Carlsson, Marcus LU and Ostenfeld, Ellen LU orcid (2022) In International Journal of Cardiovascular Imaging 38(2). p.375-387
Abstract

To assess (1) global longitudinal strain (GLS) by feature tracking cardiac magnetic resonance (CMR) in the sub-acute and chronic phases after ST-elevation infarction (STEMI) and compare to GLS in healthy controls, and (2) the evolution of GLS and regional longitudinal strain (RLS) over time, and their relationship to infarct location and size. Seventy-seven patients from the CHILL-MI-trial (NCT01379261) who underwent CMR 2–6 days and 6 months after STEMI and 27 healthy controls were included for comparison. Steady state free precession (SSFP) long-axis cine images were obtained for GLS and RLS, and late gadolinium enhancement (LGE) images were obtained for infarct size quantifications. GLS was impaired in the sub-acute (− 11.8 ± 3.0%)... (More)

To assess (1) global longitudinal strain (GLS) by feature tracking cardiac magnetic resonance (CMR) in the sub-acute and chronic phases after ST-elevation infarction (STEMI) and compare to GLS in healthy controls, and (2) the evolution of GLS and regional longitudinal strain (RLS) over time, and their relationship to infarct location and size. Seventy-seven patients from the CHILL-MI-trial (NCT01379261) who underwent CMR 2–6 days and 6 months after STEMI and 27 healthy controls were included for comparison. Steady state free precession (SSFP) long-axis cine images were obtained for GLS and RLS, and late gadolinium enhancement (LGE) images were obtained for infarct size quantifications. GLS was impaired in the sub-acute (− 11.8 ± 3.0%) and chronic phases (− 14.3 ± 2.9%) compared to normal GLS in controls (− 18.4 ± 2.4%; p < 0.001 for both). GLS improved from sub-acute to chronic phase (p < 0.001). GLS was to some extent determined by infarct size (sub-acute: r2 = 0.2; chronic: r2 = 0.2, p < 0.001). RLS was impaired in all 6 wall-regions in LAD infarctions in both the sub-acute and chronic phase, while LCx and RCA infarctions had preserved RLS in remote myocardium at both time points. Global longitudinal strain is impaired sub-acutely after STEMI and improvement is seen in the chronic phase, although not reaching normal levels. Global longitudinal strain is only moderately determined by infarct size. Regional longitudinal strain is most impaired in the infarcted region, and LAD infarctions have effects on the whole heart. This could explain why LAD infarcts are more serious than the other culprit vessel infarctions and more often cause heart failure.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiac magnetic resonance, Culprit vessel, Feature tracking, Infarct size, Longitudinal strain, ST-elevation infarction
in
International Journal of Cardiovascular Imaging
volume
38
issue
2
pages
375 - 387
publisher
Springer
external identifiers
  • scopus:85114293696
  • pmid:34482507
ISSN
1569-5794
DOI
10.1007/s10554-021-02391-0
language
English
LU publication?
yes
id
ddb49c52-6aa9-4a83-86df-9e6c5a698526
date added to LUP
2021-10-07 12:11:26
date last changed
2024-06-15 17:32:32
@article{ddb49c52-6aa9-4a83-86df-9e6c5a698526,
  abstract     = {{<p>To assess (1) global longitudinal strain (GLS) by feature tracking cardiac magnetic resonance (CMR) in the sub-acute and chronic phases after ST-elevation infarction (STEMI) and compare to GLS in healthy controls, and (2) the evolution of GLS and regional longitudinal strain (RLS) over time, and their relationship to infarct location and size. Seventy-seven patients from the CHILL-MI-trial (NCT01379261) who underwent CMR 2–6 days and 6 months after STEMI and 27 healthy controls were included for comparison. Steady state free precession (SSFP) long-axis cine images were obtained for GLS and RLS, and late gadolinium enhancement (LGE) images were obtained for infarct size quantifications. GLS was impaired in the sub-acute (− 11.8 ± 3.0%) and chronic phases (− 14.3 ± 2.9%) compared to normal GLS in controls (− 18.4 ± 2.4%; p &lt; 0.001 for both). GLS improved from sub-acute to chronic phase (p &lt; 0.001). GLS was to some extent determined by infarct size (sub-acute: r<sup>2</sup> = 0.2; chronic: r<sup>2</sup> = 0.2, p &lt; 0.001). RLS was impaired in all 6 wall-regions in LAD infarctions in both the sub-acute and chronic phase, while LCx and RCA infarctions had preserved RLS in remote myocardium at both time points. Global longitudinal strain is impaired sub-acutely after STEMI and improvement is seen in the chronic phase, although not reaching normal levels. Global longitudinal strain is only moderately determined by infarct size. Regional longitudinal strain is most impaired in the infarcted region, and LAD infarctions have effects on the whole heart. This could explain why LAD infarcts are more serious than the other culprit vessel infarctions and more often cause heart failure.</p>}},
  author       = {{Sjögren, Hannah and Pahlm, Ulrika and Engblom, Henrik and Erlinge, David and Heiberg, Einar and Arheden, Håkan and Carlsson, Marcus and Ostenfeld, Ellen}},
  issn         = {{1569-5794}},
  keywords     = {{Cardiac magnetic resonance; Culprit vessel; Feature tracking; Infarct size; Longitudinal strain; ST-elevation infarction}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{375--387}},
  publisher    = {{Springer}},
  series       = {{International Journal of Cardiovascular Imaging}},
  title        = {{Anterior STEMI associated with decreased strain in remote cardiac myocardium}},
  url          = {{http://dx.doi.org/10.1007/s10554-021-02391-0}},
  doi          = {{10.1007/s10554-021-02391-0}},
  volume       = {{38}},
  year         = {{2022}},
}