PMID- 24723232 OWN - NLM STAT- MEDLINE DCOM- 20141110 LR - 20211021 IS - 1432-1084 (Electronic) IS - 0938-7994 (Linking) VI - 24 IP - 6 DP - 2014 Jun TI - Magnetic resonance-derived circumferential strain provides a superior and incremental assessment of improvement in contractile function in patients early after ST-segment elevation myocardial infarction. PG - 1219-28 LID - 10.1007/s00330-014-3137-6 [doi] AB - BACKGROUND: We evaluate whether circumferential strain derived from grid-tagged CMR is a better method for assessing improvement in segmental contractile function after STEMI compared to late gadolinium enhancement (LGE). METHODS: STEMI patients post primary PCI underwent baseline CMR (day 3) and follow-up (day 90). Cine, grid-tagged and LGE images were acquired. Baseline LGE infarct hyperenhancement was categorised as 75 % hyperenhancement. The segmental baseline circumferential strain (CS) and circumferential strain rate (CSR) were calculated from grid-tagged images. Segments demonstrating an improvement in wall motion of >/=1 grade compared to baseline were regarded as having improved segmental contractile-function. RESULTS: Forty-five patients (aged 58 +/- 12 years) and 179 infarct segments were analysed. A baseline CS cutoff of -5 % had sensitivity of 89 % and specificity of 70 % for detection of improvement in segmental-contractile-function. On receiver-operating characteristic analysis for predicting improvement in contractile function, AUC for baseline CS (0.82) compared favourably to LGE hyperenhancement (0.68), MVO (0.67) and baseline-CSR (0.74). On comparison of AUCs, baseline CS was superior to LGE hyperenhancement and MVO in predicting improvement in contractile function (P < 0.001). On multivariate-analysis, baseline CS was the independent predictor of improvement in segmental contractile function (P < 0.001). CONCLUSION: Grid-tagged CMR-derived baseline CS is a superior predictor of improvement in segmental contractile function, providing incremental value when added to LGE hyperenhancement and MVO following STEMI. KEY POINTS: Baseline CS predicts contractile function recovery better than LGE and MVO following STEMI. Baseline CS predicts contractile function recovery better than baseline CSR following STEMI. Baseline CS provides incremental value to LGE and MVO following STEMI. FAU - Wong, Dennis T L AU - Wong DT AD - Discipline of Medicine, University of Adelaide, Adelaide, Australia, drdenniswong@yahoo.com.au. FAU - Leong, Darryl P AU - Leong DP FAU - Weightman, Michael J AU - Weightman MJ FAU - Richardson, James D AU - Richardson JD FAU - Dundon, Benjamin K AU - Dundon BK FAU - Psaltis, Peter J AU - Psaltis PJ FAU - Leung, Michael C H AU - Leung MC FAU - Meredith, Ian T AU - Meredith IT FAU - Worthley, Matthew I AU - Worthley MI FAU - Worthley, Stephen G AU - Worthley SG LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20140412 PL - Germany TA - Eur Radiol JT - European radiology JID - 9114774 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) RN - K2I13DR72L (Gadolinium DTPA) SB - IM MH - Aged MH - Contrast Media MH - Early Diagnosis MH - Electrocardiography MH - Female MH - Follow-Up Studies MH - Gadolinium MH - Gadolinium DTPA MH - Humans MH - Image Enhancement MH - Magnetic Resonance Spectroscopy/*methods/statistics & numerical data MH - Male MH - Middle Aged MH - Myocardial Contraction/*physiology MH - *Myocardial Infarction/pathology/physiopathology/therapy MH - Observer Variation MH - *Percutaneous Coronary Intervention MH - Predictive Value of Tests MH - Prospective Studies MH - ROC Curve EDAT- 2014/04/12 06:00 MHDA- 2014/11/11 06:00 CRDT- 2014/04/12 06:00 PHST- 2013/10/12 00:00 [received] PHST- 2014/02/18 00:00 [accepted] PHST- 2014/01/28 00:00 [revised] PHST- 2014/04/12 06:00 [entrez] PHST- 2014/04/12 06:00 [pubmed] PHST- 2014/11/11 06:00 [medline] AID - 10.1007/s00330-014-3137-6 [doi] PST - ppublish SO - Eur Radiol. 2014 Jun;24(6):1219-28. doi: 10.1007/s00330-014-3137-6. Epub 2014 Apr 12.