Correlation of Myocardial Strain and Late Gadolinium Enhancement by Cardiac Magnetic Resonance After a First Anterior ST-Segment Elevation Myocardial Infarction

Shiqin Yu; Jinying Zhou; Kai Yang; Xiuyu Chen; Yucong Zheng; Kankan Zhao; Jialin Song; Keshan Ji; Peng Zhou; Hongbing Yan; Shihua Zhao

doi:10.3389/fcvm.2021.705487

Correlation of Myocardial Strain and Late Gadolinium Enhancement by Cardiac Magnetic Resonance After a First Anterior ST-Segment Elevation Myocardial Infarction

Front Cardiovasc Med. 2021 Jul 2:8:705487. doi: 10.3389/fcvm.2021.705487. eCollection 2021.

Authors

Shiqin Yu¹, Jinying Zhou², Kai Yang¹, Xiuyu Chen¹, Yucong Zheng¹, Kankan Zhao³, Jialin Song¹, Keshan Ji¹, Peng Zhou², Hongbing Yan^{2

4}, Shihua Zhao¹

Affiliations

¹ State Key Laboratory of Cardiovascular Disease, MR Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
² Stata Key Laboratory of Cardiovascular Disease, Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, SZ University Town, Shenzhen, China.
⁴ Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, China.

Abstract

Objectives: To investigate the correlation of cardiac magnetic resonance (CMR) feature-tracking with conventional CMR parameters in patients with a first anterior ST-segment elevation myocardial infarction (STEMI). Methods: This sub-analysis of OCTAMI (Optical Coherence Tomography Examination in Acute Myocardial Infarction) registry included 129 patients who finished a CMR examination 1 month after a first anterior STEMI. Cine images were applied to calculate both global and segmental left ventricular peak strain parameters. The patients were divided into two groups by left ventricular ejection fraction (LVEF) and compared with 42 healthy controls. Segmental late gadolinium enhancement (LGE) was graded according to LGE transmurality as follows: (1) >0 to ≤ 25%; (2) >25 to ≤ 50%; (3) >50 to ≤ 75%; (4) >75%. Left ventricle was divided into infarcted, adjacent, and remote regions to assess regional function. Results: Compared with controls, global radial (28.39 ± 5.08% vs. 38.54 ± 9.27%, p < 0.05), circumferential (-16.91 ± 2.11% vs. -20.77 ± 2.78%, p < 0.05), and longitudinal (-13.06 ± 2.15 vs. -15.52 ± 2.69, p < 0.05) strains were impaired in STEMI patients with normal LVEF (≥55%). Strain parameters were strongly associated with LGE (radial: r = 0.65; circumferential: r = 0.69; longitudinal: r = 0.61; all p < 0.05). A significant and stepwise impairment of global strains was observed in groups divided by LGE tertiles. Furthermore, segmental strain was different in various degrees of LGE transmurality especially for radial and circumferential strain. Strains of adjacent region were better than infarcted region in radial and circumferential directions and worse than remote region in all three directions. Conclusion: Global and regional strain could stratify different extent and transmurality of LGE, respectively. Although without LGE, adjacent region had impaired strains comparing with remote region.

Keywords: ST-segment elevation myocardial infarction; late gadolinium enhancement; left ventricle; magnetic resonance imaging; strain.