Longitudinal strain in remote non-infarcted myocardium by tissue tracking CMR: characterization, dynamics, structural and prognostic implications

PURPOSE: In ST-segment elevation myocardial infarction (STEMI) patients, longitudinal strain (LS) in remote non-infarcted myocardium (RNM) has not yet been characterized by tissue tracking (TT) cardiovascular magnetic resonance (CMR). In STEMI patients, we aimed to characterize RNM-LS by TT-CMR and...

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Autores: Gavara, Jose, Rodriguez-Palomares, Jose F, Rios-Navarro, Cesar, Valente, Filipa, Monmeneu, Jose V, Lopez-Lereu, Maria P, Ferreira-Gonzalez, Ignacio, Garcia Del Blanco, Bruno, Otaegui, Imanol, Canoves, Joaquim, de Dios, Elena, Perez, Nerea, Racugno, Paolo, Bonanad, Clara, Minana, Gema, Marcos, Victor, Barrabes, Jose A, Evangelista, Arturo, Moratal, David, Bayes-Genis, Antoni, Nunez, Julio, Chorro, Francisco J, Bodi, Vicente
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p4533
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/4533
Access Level:acceso abierto
Palabra clave:Cardiovascular magnetic resonance
Myocardial infarction
Prognosis
Strain
Tissue tracking
Descripción
Sumario:PURPOSE: In ST-segment elevation myocardial infarction (STEMI) patients, longitudinal strain (LS) in remote non-infarcted myocardium (RNM) has not yet been characterized by tissue tracking (TT) cardiovascular magnetic resonance (CMR). In STEMI patients, we aimed to characterize RNM-LS by TT-CMR and to assess both its dynamics and its structural and prognostic implications. METHODS: We recruited 271 patients with a first STEMI studied with TT-CMR 1 week after infarction. Of these patients, 145 underwent 1-week and 6-month TT-CMR and were used to characterize both the dynamics and the short-term and long-term structural implications of RNM-LS. Based on previously validated data, RNM areas were defined depending on the culprit coronary artery. RESULTS: Reduced RNM-LS at 1 week (n = 70, 48%) was associated with larger infarct size and more depressed left ventricular ejection fraction (LVEF) at both the 1-week and 6-month TT-CMR (p value < 0.001). Late normalization of RNM-LS was frequent (28/70, 40%) and independently related to late recovery of LVEF (p value = 0.002). Patients with reduced RNM-LS at 1-week TT-CMR had more major adverse cardiac events (death, heart failure or re-infarction) in both the 271 patients included in the study group (26% vs. 11%, p value = 0.002) and in an external validation cohort made up of 177 STEMI patients (57% vs. 13%, p value < 0.001). CONCLUSION: After STEMI, reduced RNM-LS by TT-CMR is common and is associated with more severe short- and long-term structural damage. There is a beneficial tendency towards recovery of RNM-LS that parallels late recovery of LVEF. More events occur in patients with reduced RNM-LS.

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