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

Abstract

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.

Protective Value of Aspirin Loading Dose on Left Ventricular Remodeling After ST-Elevation Myocardial Infarction

“…In particular, we demonstrated that cut-offs of −11.09% for GCS and −10.21 for GLS, measured at baseline CMR, are highly specific in predicting LV adverse remodeling whereas those parameters do not differ between patients with null and reverse remodeling. Although both strain CMR parameters have been used previously to predict adverse LV remodeling ( 11 , 12 , 21 ), they have never been applied to these new categories ( 7 ). Furthermore, we retrospectively evaluated the effect of ASA dose before pPCI in STEMI patients for the first time, and described a positive effect of a loading dose of 500 mg on early LV remodeling.…”

“…Moreover, different factors assessed by CMR within the first week of an acute STEMI, such as LVEF, IS, and microvascular obstruction (MVO), have been reported to be independent strong predictors of LV adverse remodeling and clinical outcomes after STEMI ( 9 , 10 ). The quantitative assessment of myocardial contractile deformation enabled by CMR feature tracking analysis (CMR-FT) offers deeper information on regional and global LV function other than LVEF, helping to predict LV remodeling ( 11 , 12 ). Furthermore, CMR-FT has been increasingly used in STEMI patients to assess the efficacy of cardioprotective therapies in preventing post-infarction LV remodeling ( 12 – 14 ), such as to evaluate the effect of intravenous administration of metoprolol on long term prognostic effect in the randomized METOCARD-CNIC trial ( 13 ).…”

Predictive Value of Fasting Blood Glucose for Microvascular Obstruction in Nondiabetic Patients with ST-Segment Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention

“…Several studies have illustrated that longitudinal strain was significantly correlated with MVO development in infarcted myocardium of patients with STEMI [ 30 , 31 ]. Additionally, circumferential strain predicted the recovery of LV systolic function and late myocardial remodeling in myocardial infarction [ 32 , 33 ]. However, in the present study, GCS was not a predictor for MVO after adjustment of other parameters.…”

Late Versus Early Myocardial Remodeling After Acute Myocardial Infarction: A Comparative Review on Mechanistic Insights and Clinical Implications

“…arginine vasopressin system, renin-angiotensin-aldosterone system [RAAS], and adrenergic activation). 1,3,[5][6][7][8][9][10][11][12][13][14][15][16][17] Temporally, classical remodeling might be further categorized into 2 phases17: the early phase (within the first 3 days after AMI) primarily characterized by infarct expansion (leading to wall thinning and chamber dilatation), and the late phase (beyond 3 days) characterized by myocyte hypertrophy as well as diffuse fibrosis involving the infarcted and remote myocardial segments. 17 However, the abovementioned conventional insights have been already discussed in detail elsewhere 1,3,[5][6][7][8][9][10][11][12][13][14][15][16][17] and hence are not within the scope of this review.…”

“…4 However, a couple of reports have exclusively regarded "late AMR" as a variety of morphological changes representing later stages of classical early AMR (characterized by compensatory hypertrophy and dysfunction involving remote myocardium and usually arising 1 month after AMI) rather than a distinct phenomenon with a de novo presentation. 8,9 Notably, these late changes were also suggested to serve as the fundamental determinants of prognosis among AMI survivors. 9 Surprisingly, there has been no clear-cut and uniform categorization of myocardial remodeling suggested so far based on temporal trends and characteristics along with no mention of late AMR as a separate clinical and pathophysiological entity in the post-AMI setting.…”