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- Title
Strain analysis is superior to wall thickening in discriminating between infarcted myocardium with and without microvascular obstruction.
- Authors
Everaars, Henk; Robbers, Lourens F. H. J.; Götte, Marco; Croisille, Pierre; Hirsch, Alexander; Teunissen, Paul F. A.; van de Ven, Peter M.; van Royen, Niels; Zijlstra, Felix; Piek, Jan J.; van Rossum, Albert C.; Nijveldt, Robin
- Abstract
<bold>Objectives: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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).<bold>Conclusions: </bold>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.<bold>Key Points: </bold>• 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.
- Subjects
MYOCARDIUM; MYOCARDIAL infarction; CARDIAC magnetic resonance imaging; GADOLINIUM; MAGNETIC resonance imaging
- Publication
European Radiology, 2018, Vol 28, Issue 12, p5171
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5493-0