PMID- 29143170 OWN - NLM STAT- MEDLINE DCOM- 20180810 LR - 20181113 IS - 1572-8595 (Electronic) IS - 1383-875X (Linking) VI - 50 IP - 3 DP - 2017 Dec TI - Circumferential strain acquired by CMR early after acute myocardial infarction adds incremental predictive value to late gadolinium enhancement imaging to predict late myocardial remodeling and subsequent risk of sudden cardiac death. PG - 211-218 LID - 10.1007/s10840-017-0296-9 [doi] AB - PURPOSE: Late adverse myocardial remodeling after acute myocardial infarction (AMI) is strongly associated with sudden cardiac death (SCD). Cardiac magnetic resonance (CMR) performed early after AMI can predict late remodeling and SCD risk with moderate accuracy. This study assessed the ability of CMR-measured circumferential strain (CS) to add incremental predictive information to late gadolinium enhancement (LGE). METHODS: Patients with an AMI and LVEF < 50% were screened for inclusion. A total of 27 patients, totaling 432 myocardial segments, prospectively underwent CMR 7 +/- 5 days after percutaneous coronary intervention (PCI). LGE, microvascular obstruction (MVO), and myocardial CS were measured for each segment. The primary endpoint was late segmental adverse remodeling defined as segmental wall motion score (WMS) > 1 measured by echocardiography 3 months after PCI. RESULTS: A total of 141 segments experienced the primary endpoint at 3 months. The mean LGE volume was higher in these segments, but LGE was also present in many segments with normal WMS (40 +/- 28 versus 20 +/- 26%, p < 0.01). Segments that met the primary endpoint also showed greater impairment of CS. Segments with both LGE > 17% and impaired CS >- 7.2% on CMR were more likely to experience late adverse remodeling (73%) as compared to segments with neither (9%, p < 0.001) or one abnormal parameter (36%, p < 0.001). CS >- 7.2% also added incremental accuracy to LGE > 17% for predicting late adverse remodeling (AUC 0.81 from 0.70, p < 0.001). CONCLUSIONS: When performed early after AMI, LGE is a moderate predictor of late remodeling and CS is a powerful predictor of late myocardial remodeling. When combined, they can predict late remodeling, a surrogate of SCD, with high accuracy. FAU - Holmes, Anthony A AU - Holmes AA AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. AD - Leon H. Charney Division of Cardiology, NYU Langone Medical Center, NYU School of Medicine, New York, NY, USA. FAU - Romero, Jorge AU - Romero J AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. FAU - Levsky, Jeffrey M AU - Levsky JM AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. AD - Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Haramati, Linda B AU - Haramati LB AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. AD - Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Phuong, Newton AU - Phuong N AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. FAU - Rezai-Gharai, Leila AU - Rezai-Gharai L AD - Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. AD - Department of Radiology, VCU Medical Center, Virginia Commonwealth University, Richmond, VA, USA. FAU - Cohen, Stuart AU - Cohen S AD - Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. AD - Department of Radiology, North Shore Long Island Jewish Medical Center, New Hyde Park, NY, USA. FAU - Restrepo, Lina AU - Restrepo L AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. FAU - Ruiz-Guerrero, Luis AU - Ruiz-Guerrero L AD - Division of Cardiology, Hospital Universitario Marques de Valdecilla, Santander, Spain. FAU - Fisher, John D AU - Fisher JD AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. FAU - Taub, Cynthia C AU - Taub CC AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. FAU - Di Biase, Luigi AU - Di Biase L AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. FAU - Garcia, Mario J AU - Garcia MJ AD - Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY, 10467, USA. mariogar@montefiore.org. AD - Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. mariogar@montefiore.org. LA - eng GR - CR-2280/Medtronic/ PT - Journal Article DEP - 20171115 PL - Netherlands TA - J Interv Card Electrophysiol JT - Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing JID - 9708966 RN - 0 (Contrast Media) RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Aged MH - Analysis of Variance MH - Angioplasty, Balloon, Coronary/*methods/mortality MH - Cohort Studies MH - Contrast Media MH - Death, Sudden, Cardiac MH - Female MH - Follow-Up Studies MH - Gadolinium MH - Humans MH - Magnetic Resonance Imaging, Cine/*methods MH - Male MH - Middle Aged MH - Myocardial Infarction/*diagnostic imaging/*mortality/therapy MH - Predictive Value of Tests MH - Prospective Studies MH - ROC Curve MH - *Radiographic Image Enhancement MH - Risk Assessment MH - ST Elevation Myocardial Infarction/diagnostic imaging/mortality/therapy MH - Time Factors MH - Ventricular Remodeling/*physiology OTO - NOTNLM OT - Late gadolinium enhancement OT - Myocardial infarction OT - Remodeling OT - Strain EDAT- 2017/11/17 06:00 MHDA- 2018/08/11 06:00 CRDT- 2017/11/17 06:00 PHST- 2017/07/09 00:00 [received] PHST- 2017/10/30 00:00 [accepted] PHST- 2017/11/17 06:00 [pubmed] PHST- 2018/08/11 06:00 [medline] PHST- 2017/11/17 06:00 [entrez] AID - 10.1007/s10840-017-0296-9 [pii] AID - 10.1007/s10840-017-0296-9 [doi] PST - ppublish SO - J Interv Card Electrophysiol. 2017 Dec;50(3):211-218. doi: 10.1007/s10840-017-0296-9. Epub 2017 Nov 15.