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He XT, Zhang J, Pan Y, Yu F, Tang G, Zhu LZ, Qin YN, Zheng XZ. Prediction of an impaired myocardial work using infarct size in acute myocardial infarction. Coron Artery Dis 2024; 35:59-66. [PMID: 37990589 DOI: 10.1097/mca.0000000000001306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
BACKGROUND The relationship between myocardial infarct size (MIS) on late gadolinium-enhanced cardiac MRI (LGE MRI) and myocardial work (MW) indices assessed with MW echocardiography (MWE) has not been well characterized. This study aimed to determine an impaired MW using MIS in patients with acute myocardial infarction. METHODS Left ventricular (LV) two-dimensional speckle-tracking echocardiography, MWE, and LGE MRI were performed in 33 patients with ST-segment elevation myocardial infarction and in 30 age- and sex-comparable controls. LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE) and MIS were acquired, respectively. RESULTS MIS was negatively correlated with GWI (r = -0.60, P = 0.005), GCW (r =- 0.66, P = 0.002) and GWE (r = -0.71, P = 0.0004), but positively correlated with GLS (r = 0.68, P = 0.001). With the receiver operating characteristic curve, the cutoff value of MIS for the prediction of an impaired GLS was 16.5% [area under the curve (AUC) = 0.867)], an impaired GWI was 19.2% (AUC = 0.727), an impaired GCW was 19.2% (AUC = 0.725), an increased GWW was 15.8% (AUC = 0.656), an impaired GWE was 15.8% (AUC = 0.880). CONCLUSION MIS is a strong predictor of impaired MW. Timely reduction of infarct size is essential to improve myocardial function.
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Affiliation(s)
- Xiao-Ting He
- Department of Ultrasound, The Fifth People's Hospital of Huai'an, Huai'an City
| | - Jie Zhang
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Lianyungang, Jiangsu Province
| | - Yang Pan
- Department of Ultrasound, The Fifth People's Hospital of Huai'an, Huai'an City
| | - Fan Yu
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Lianyungang, Jiangsu Province
| | - Ge Tang
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Lianyungang, Jiangsu Province
| | - Li-Zhou Zhu
- Department of Ultrasound, The Fifth People's Hospital of Huai'an, Huai'an City
| | - Yi-Nan Qin
- Department of Ultrasound, The Fifth People's Hospital of Huai'an, Huai'an City
| | - Xiao-Zhi Zheng
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
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Yu F, Tang G, Chen YA, Zhang PY, Ren F, Zhang J, Zheng XZ. Number of segments with motion abnormalities is better correlated with infarct size in acute myocardial infarction. Coron Artery Dis 2023; 34:489-495. [PMID: 37471279 DOI: 10.1097/mca.0000000000001266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND The relationship between the number of segments with motion abnormalities (SMA) on the bull's-eye plots of speckle-tracking echocardiography (STE) and myocardial infarct size (MIS) on late gadolinium-enhanced cardiac MRI (LGE-cMRI) has not been well characterized. This study aimed to determine MIS using the number of SMA in patients with acute myocardial infarction (MI). METHODS Left ventricular two-dimensional STE and LGE-cMRI were performed in 380 patients with ST-segment elevation MI within 48 h and 5-6 days after primary percutaneous intervention, respectively. RESULTS Patients with impaired global and regional myocardial strain, work and greater number of SMA had significantly larger infarcts ( P < 0.05). Multivariate logistic regression analysis that included myocardial strain, work, and number of SMA showed that total number of SMA [odds ratio (OR) = 1.976; 95% confidence interval (CI): 1.539-2.538, P < 0.0001], the number of segments with paradoxalic systolic movements (SPSM, OR = 3.703; 95% CI: 2.112-6.493, P < 0.0001) were independent risk factors of large MIS (>19%). The area under receiver operating characteristic curve (AUC) of 0.904 (0.866~0.942) for total number of SMA was superior to that for global longitudinal strain (GLS, AUC = 0.813, 0.761~0.865), global work efficiency (GWE, AUC = 0.794, 0.730~0.857) and number of SPSM (AUC = 0.851, 0.804-0.899) to predict a large MIS ( P < 0.05). The optimal cutoff value of total number of SMA was 7, with a sensitivity of 85.31%, a specificity of 81.48%, and an accuracy of 83.27%. CONCLUSION Total number of SMA is better associated with infarct size, which provided an incremental prognostic value above established prognostic parameters such as GLS and GWE.
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Affiliation(s)
- Fan Yu
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Jiangsu Province
| | - Ge Tang
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Jiangsu Province
| | - Yun-An Chen
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Jiangsu Province
| | - Peng-Ying Zhang
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Jiangsu Province
| | - Fei Ren
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Jiangsu Province
| | - Jie Zhang
- Department of Ultrasound, The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People's Hospital of Lianyugang, Jiangsu Province
| | - Xiao-Zhi Zheng
- Department of Ultrasound, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China
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Ye J, Zong W, Wu X, Shao X, Wu Y. Quantitative evaluation of acute myocardial infarction by feature-tracking cardiac magnetic resonance imaging. Pak J Med Sci 2023; 39:804-808. [PMID: 37250547 PMCID: PMC10214789 DOI: 10.12669/pjms.39.3.7248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/14/2022] [Accepted: 02/25/2023] [Indexed: 11/02/2023] Open
Abstract
Objective To assess the value of feature-tracking cardiac magnetic resonance (FT-CMR) imaging in the quantitative evaluation of acute myocardial infarction (AMI). Methods We retrospectively analyzed medical records of patients with acute myocardial infarction (AMI) diagnosed in the Department of Cardiology of Hubei No.3 People's Hospital of Jianghan University from April 2020 to April 2022, who underwent feature-tracking cardiac magnetic resonance (FT-CMR) examination. Based on the electrocardiogram (ECG) findings, patients were divided into ST-elevation myocardial infarction (STEMI) (n=52) and non-STEMI (NSTEMI) (n=48) groups. We compared myocardial strain parameters between the two groups and applied the Pearson's test to reveal any correlations between the left ventricular myocardial strain parameters and the number of late gadolinium enhancement (LGE) positive segments; we assessed the clinical value of FT-CMR for predicting STEMI using a receiver operating characteristic (ROC) curve. Results The number of LGE-positive segments in the STEMI group was significantly higher than that in the NSTEMI group. The myocardial radial, circumferential and longitudinal strains in the STEMI group were significantly lower than those in the NSTEMI group (p<0.05). The number of LGE-positive segments in patients with AMI negatively correlated with the radial, circumferential and longitudinal strains. The results of the ROC curve analysis showed that radial, circumferential and longitudinal strain values have a diagnostic value for STEMI (p<0.05). Conclusion FT-CMR, a non-invasive and rapid method for analyzing myocardial strains, has a high diagnostic value for AMI and should be helpful for the prevention and intervention of ventricular remodeling after myocardial infarctions.
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Affiliation(s)
- Jun Ye
- Jun Ye, Department of Radiology, Wuhan No.7 Hospital, Wuhan 430071, Hubei Province, P.R. China
| | - Wenxia Zong
- Wenxia Zong, Department of Cardiology, Hubei No.3 People’s Hospital of Jianghan University, Wuhan 430000, Hubei Province, P.R. China
| | - Xing Wu
- Xing Wu Clinical Laboratory, Xianning Central Hospital, (The First Affiliated Hospital of Hubei University of Science & Technology), Xianning 437100, Hubei Province, P.R. China
| | - Xiaonan Shao
- Xiaonan Shao, Department of Radiology, Wuhan No.7 Hospital, Wuhan 430071, Hubei Province, P.R. China
| | - Yue Wu
- Yue Wu, Department of Cardiology, Hubei No.3 People’s Hospital of Jianghan University, Wuhan 430000, Hubei Province, P.R. China
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Dannenberg V, Christiansen F, Schneider M, Kastl S, Hofbauer TM, Scherz T, Mascherbauer J, Beitzke D, Testori C, Lang IM, Mangold A. Exploratory echocardiographic strain parameters for the estimation of myocardial infarct size in ST-elevation myocardial infarction. Clin Cardiol 2021; 44:925-931. [PMID: 34117638 PMCID: PMC8259148 DOI: 10.1002/clc.23608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 03/28/2021] [Accepted: 03/31/2021] [Indexed: 12/20/2022] Open
Abstract
Background Outcome after ST‐elevation myocardial infarction (STEMI) can be most reliably estimated by cardiac magnetic resonance (CMR) imaging. However, CMR is expensive, laborious, and has only limited availability. In comparison, transthoracic echocardiography (TTE) is widely available and cost‐efficient. Hypothesis TTE strain parameters can be used as surrogate markers for CMR‐measured parameters after STEMI. Methods TTE strain analysis was performed of patients included in a controlled, prospective STEMI trial (NCT01777750) 4 ± 2 days after the event. Longitudinal peak strain (LPS), post‐systolic shortening, early systolic lengthening, early systolic lengthening time, and time to peak shortening were measured, and index parameters were computed. Global longitudinal strain (GLS) and ejection fraction (EF) were compiled. Parameters were correlated with CMR‐measured variables 4 ± 2 days after STEMI. Results In 70 STEMI patients, high quality CMR and TTE data were available. Highest correlation with CMR‐measured infarct size was observed with GLS (r = 0.577, p < 0.0001), LPS (r = 0.571, p < 0.0001), and EF (r = −0.533, p < 0.0001). Highest correlation with CMR‐measured area at risk was observed with GLS (r = 0.666, p < 0.0001), LPS (0.661, p < 0.0001) and early systolic lengthening index (r = 0.540, p < 0.0001). Receiver operating characteristics for the detection of large infarcts (quartile with highest infarct size) showed the highest area under the curve for LPS, GLS, EF, and myocardial dysfunction index. Multiple linear regression displayed the best association between GLS and infarct size. Conclusion Exploratory strain parameters significantly correlate with CMR‐measured area at risk and infarct size and are of potential interest as endpoint variables in clinical trials.
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Affiliation(s)
- Varius Dannenberg
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Finn Christiansen
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Matthias Schneider
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Stefan Kastl
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Thomas Martin Hofbauer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Thomas Scherz
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.,Department of Dermatology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Julia Mascherbauer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.,Department of Internal Medicine, Karl Landsteiner University of Health Sciences, University Hospital St. Poelten, Krems, Austria
| | - Dietrich Beitzke
- Department of Biomedical Imaging and Image-guided therapy, Medical University of Vienna, Vienna, Austria
| | - Christoph Testori
- Department of Internal Medicine, Cardiology and Nephrology, Landesklinikum Wiener Neustadt, Vienna, Austria.,Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
| | - Irene Marthe Lang
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Andreas Mangold
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
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