PMID- 31096987 OWN - NLM STAT- MEDLINE DCOM- 20200128 LR - 20240117 IS - 1532-429X (Electronic) IS - 1097-6647 (Print) IS - 1097-6647 (Linking) VI - 21 IP - 1 DP - 2019 May 16 TI - Association of cardiovascular magnetic resonance-derived circumferential strain parameters with the risk of ventricular arrhythmia and all-cause mortality in patients with prior myocardial infarction and primary prevention implantable cardioverter defibrillator. PG - 28 LID - 10.1186/s12968-019-0536-5 [doi] LID - 28 AB - BACKGROUND: Impaired left ventricular (LV) contraction and relaxation may further promote adverse remodeling and may increase the risk of ventricular arrhythmia (VA) in ischemic cardiomyopathy. We aimed to examine the association of cardiovascular magnetic resonance (CMR)-derived circumferential strain parameters for LV regional systolic function, LV diastolic function and mechanical dispersion with the risk of VA in patients with prior myocardial infarction and primary prevention implantable cardioverter defibrillator (ICD). METHODS: Patients with an ischemic cardiomyopathy who underwent CMR prior to primary prevention ICD implantation, were retrospectively identified. LV segmental circumferential strain curves were extracted from short-axis cine CMR. For LV regional strain analysis, the extent of moderately and severely impaired strain (percentage of LV segments with strain between - 10% and - 5% and > - 5%, respectively) were calculated. LV diastolic function was quantified by the early and late diastolic strain rate. Mechanical dispersion was defined as the standard deviation in delay time between each strain curve and the patient-specific reference curve. Cox proportional hazard ratios (HR) (95%CI) were calculated to assess the association between LV strain parameters and appropriate ICD therapy. RESULTS: A total of 121 patients (63 +/- 11 years, 84% men, LV ejection fraction (LVEF) 27 +/- 9%) were included. During a median (interquartile range) follow-up of 47 (27;69) months, 30 (25%) patients received appropriate ICD therapy. The late diastolic strain rate (HR 1.1 (1.0;1.2) per - 0.25 1/s, P = 0.043) and the extent of moderately impaired strain (HR 1.5 (1.0;2.2) per + 10%, P = 0.048) but not the extent of severely impaired strain (HR 0.9 (0.6;1.4) per + 10%, P = 0.685) were associated with appropriate ICD therapy, independent of LVEF, late gadolinium enhancement (LGE) scar border size and acute revascularization. Mechanical dispersion was not related to appropriate ICD therapy (HR 1.1 (0.8;1.6) per + 25 ms, P = 0.464). CONCLUSIONS: In an ischemic cardiomyopathy population referred for primary prevention ICD implantation, the extent of moderately impaired strain and late diastolic strain rate were associated with the risk of appropriate ICD therapy, independent of LVEF, scar border size and acute revascularization. These findings suggest that disturbed LV contraction and relaxation may contribute to an increased risk of VA after myocardial infarction. FAU - Paiman, Elisabeth H M AU - Paiman EHM AUID- ORCID: 0000-0001-8948-7860 AD - Department of Radiology, Leiden University Medical Center, P.O. Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. E.H.M.Paiman@lumc.nl. FAU - Androulakis, Alexander F A AU - Androulakis AFA AD - Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. FAU - Shahzad, Rahil AU - Shahzad R AD - LKEB, Division of Image Processing, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. FAU - Tao, Qian AU - Tao Q AD - LKEB, Division of Image Processing, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. FAU - Zeppenfeld, Katja AU - Zeppenfeld K AD - Department of Cardiology, Leiden University Medical Center, P.O. Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. FAU - Lamb, Hildo J AU - Lamb HJ AD - Department of Radiology, Leiden University Medical Center, P.O. Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. FAU - van der Geest, Rob J AU - van der Geest RJ AD - LKEB, Division of Image Processing, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, postal zone C2-S, 2300 RC, Leiden, The Netherlands. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20190516 PL - England TA - J Cardiovasc Magn Reson JT - Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance JID - 9815616 SB - IM MH - Aged MH - Arrhythmias, Cardiac/diagnosis/mortality/physiopathology/*prevention & control MH - *Defibrillators, Implantable MH - Electric Countershock/adverse effects/*instrumentation/mortality MH - Female MH - Humans MH - *Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Myocardial Infarction/diagnostic imaging/mortality/*physiopathology MH - Predictive Value of Tests MH - Primary Prevention/*instrumentation MH - Retrospective Studies MH - Risk Assessment MH - Risk Factors MH - Time Factors MH - Treatment Outcome MH - Ventricular Dysfunction, Left/*diagnostic imaging/mortality/physiopathology/therapy MH - *Ventricular Function, Left MH - Ventricular Remodeling PMC - PMC6521513 OTO - NOTNLM OT - Circumferential strain OT - Ischemic cardiomyopathy OT - Magnetic resonance OT - Ventricular arrhythmia COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Informed consent in this retrospective study was waived by the local institutional review board (Leiden University Medical Center, the Netherlands). CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The Department of Cardiology (Leiden University Medical Center, Leiden, The Netherlands) receives unrestricted research grants from Edwards Lifesciences, Medtronic, Biotronik and Boston Scientific. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2019/05/18 06:00 MHDA- 2020/01/29 06:00 PMCR- 2019/05/16 CRDT- 2019/05/18 06:00 PHST- 2018/08/30 00:00 [received] PHST- 2019/03/27 00:00 [accepted] PHST- 2019/05/18 06:00 [entrez] PHST- 2019/05/18 06:00 [pubmed] PHST- 2020/01/29 06:00 [medline] PHST- 2019/05/16 00:00 [pmc-release] AID - S1097-6647(23)00201-6 [pii] AID - 536 [pii] AID - 10.1186/s12968-019-0536-5 [doi] PST - epublish SO - J Cardiovasc Magn Reson. 2019 May 16;21(1):28. doi: 10.1186/s12968-019-0536-5.