Impact of infarct transmurality on layer-specific impairment of myocardial function: a myocardial deformation imaging study

Becker, Michael; Ocklenburg, Christina; Altiok, Ertunc; Füting, A.; Balzer, Jan C.; Krombach, Gabriele A.; Lysyansky, Michael; Kühl, Harald P.; Krings, Renate; Kelm, Malte; Hoffmann, Rainer

doi:10.1093/eurheartj/ehp112

Cited by 104 publications

(77 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The validation results have a close agreement with results of previous studies, which assessed peak systolic strain in normal subject using TMRI [33][34][35][36]. The concept of assessment of myocardial viability based on the analysis of function has been proven in many previous studies to allow reliable evaluation of the extent of myocardial infarction in ischemic cardiomyopathy [2,[37][38][39][40][41]. As a threshold of 50% hyper-enhancement was reported in previous studies to regain functional recovery [5,15,42,43], this cutoff value was chosen to differentiate between non-transmural and transmural infarcted tissue.…”

Section: Accepted Manuscriptsupporting

confidence: 82%

See 1 more Smart Citation

Myocardial strain assessment by cine cardiac magnetic resonance imaging using non-rigid registration

Tsadok

Friedman

Haluska

et al. 2016

Magnetic Resonance Imaging

View full text Add to dashboard Cite

AimsTo evaluate a novel post-processing method for assessment of longitudinal mid-myocardial strain in standard cine cardiac magnetic resonance (CMR) imaging sequences. Methods and resultsCine CMR and tagged cardiac magnetic resonance imaging (TMRI) were performed in 15 patients with acute myocardial infarction (AMI) and 15 healthy volunteers served as control group. A second group of 37 post-AMI patients underwent both cine CMR and late gadolinium enhancement (LGE) CMR exams. Speckle tracking echocardiography (STE) was performed in 36 of these patients. Cine CMR, TMRI and STE were analyzed to obtain longitudinal strain. LGE-CMR datasets were analyzed to evaluate scar extent. Comparison of peak systolic strain (PSS) measured from CMR and TMRI yielded a strong correlation (r=0.86, p<0.001). PSS measured from CMR and STE correlated well (r=0.75, p<0.001). A cutoff longitudinal PSS value of -13.14% differentiated non-infarction from any infarcted myocardium, with a sensitivity of 93% and a specificity of 89% (area under curve (AUC) 0.95). PSS value of -9.39% differentiated non-transmural from transmural infarcted myocardium, with a sensitivity of 75% and a specificity of 67% (AUC 0.78). ConclusionThe present study showed a novel off-line post-processing method for segmental longitudinal strain analysis in mid-myocardium layer based on cine CMR data. The method was found to be highly correlated with strain measurements obtained by TMRI and STE. This tool allows accurate discrimination between different transmurality states of myocardial infarction.

show abstract

Section: Accepted Manuscriptsupporting

confidence: 82%

“…Both ischemia and infarction can be detected and localized through analysis of the regional patterns of motion within the heart [1,2].…”

Section: Introductionmentioning

confidence: 99%

Myocardial strain assessment by cine cardiac magnetic resonance imaging using non-rigid registration

Tsadok

Friedman

Haluska

et al. 2016

Magnetic Resonance Imaging

View full text Add to dashboard Cite

show abstract

“…15 The usefulness of this new sensitive indicator for detecting cardiac dysfunction in various cardiac diseases has been reported. [15][16][17] To the best of our knowledge, no previous study has analyzed layer-specific deformation of the LV in patients with rTOF, so our aim was to assess the details and time course of LV dysfunction in patients with rTOF using layer-specific strain analysis.…”

mentioning

confidence: 99%

Mechanisms of Left Ventricular Dysfunction Assessed by Layer-Specific Strain Analysis in Patients With Repaired Tetralogy of Fallot

Yamada

Takahashi

Kobayashi

et al. 2017

Circ J

View full text Add to dashboard Cite

importance of LV-RV interaction in patients who have undergone TOF repair. 8 Geva et al showed that lower LVEF and older age at repair were the strongest independent factors associated with impaired clinical status in long-term survivors of rTOF. 13 Recently, Diller et al showed that LV longitudinal dysfunction, such as impairment in longitudinal global strain and decreased mitral annular plane systolic excursion, were associated with an increased risk of sudden cardiac death and/or life threatening ventricular arrhythmias in patients with rTOF. 12 Therefore, the assessment of LV function in patients with TOF is crucial because it is the strongest determinant of a poor clinical outcome in these patients. Despite the importance of LV dysfunction, the mechanisms and time course of the development of LV dysfunction remain poorly understood. 14 Its mechanisms and time course in patients with rTOF are important because it has the potential to become T etralogy of Fallot (TOF) is the most prevalent form of cyanotic congenital heart disease. 1 Significant advances in the early management of TOF have dramatically improved the survival of TOF patients, 2 with current 30-year survival rates reaching 89%. 3 However, late ventricular dysfunction related to residual hemodynamic and electrophysiological abnormalities remains a problem, contributing to increasing morbidity and mortality rates beginning in the third decade of life. 2,4-6 Previous investigators assessing ventricular function in patients with repaired TOF (rTOF) have primarily focused on right ventricular (RV) mechanics and their interaction with pulmonary regurgitation (PR). 7-9 Moreover, the importance of left ventricular (LV) dysfunction as a risk factor for long-term adverse outcomes is increasingly acknowledged. (rTOF) is an important risk factor for adverse outcomes. The aim of this study was to assess the details and time course of such LV dysfunction using layer-specific strain analysis by echocardiography.

show abstract

“…In conclusion, at acute stages of MI, before collagen deposition, scar tissue formation, and remodeling have occurred, damage may be nontransmural, and thus the use of endocardial S C peak is advantageous over total wall thickness S C peak . speckle tracking; transmurality; myocardial viability; left ventricular function THE MYOCARDIAL LAYERS contribute differently to deformation of the left ventricle (LV) at the normal state (4,8,11,23,29), during wall motion abnormalities (1,6,24), and particularly during myocardial infarction (MI) (6). Since nontransmural MI is associated with a high risk for mortality (21), it is essential to identify it at its early stages.…”

mentioning

confidence: 99%

Layer-specific strain analysis: investigation of regional deformations in a rat model of acute versus chronic myocardial infarction

Bachner-Hinenzon

Ertracht

Malka

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

View full text Add to dashboard Cite

-specific strain analysis: investigation of regional deformations in a rat model of acute versus chronic myocardial infarction. Am J Physiol Heart Circ Physiol 303: H549 -H558, 2012. First published July 9, 2012; doi:10.1152/ajpheart.00294.2012.-Myocardial infarction (MI) injury extends from the endocardium toward the epicardium. This phenomenon should be taken into consideration in the detection of MI. To study the extent of damage at different stages of MI, we hypothesized that measurement of layer-specific strain will allow better delineation of the MI extent than total wall thickness strain at acute stages but not at chronic stages, when fibrosis and remodeling have already occurred. After baseline echocardiography scans had been obtained, 24 rats underwent occlusion of the left anterior descending coronary artery for 30 min followed by reperfusion. Thirteen rats were rescanned at 24 h post-MI and eleven rats at 2 wk post-MI. Next, rats were euthanized, and histological analysis for MI size was performed. Echocardiographic scans were postprocessed by a layer-specific speckle tracking program to measure the peak circumferential strain (S C peak ) at the endocardium, midlayer, and epicardium as well as total wall thickness S C peak . Linear regression for MI size versus S C peak showed that the slope was steeper for the endocardium compared with the other layers (P Ͻ 0.001), meaning that the endocardium was more sensitive to MI size than the other layers. Moreover, receiver operating characteristics analysis yielded better sensitivity and specificity in the detection of MI using endocardial S C peak instead of total wall thickness S C peak at 24 h post-MI (P Ͻ 0.05) but not 2 wk later. In conclusion, at acute stages of MI, before collagen deposition, scar tissue formation, and remodeling have occurred, damage may be nontransmural, and thus the use of endocardial S C peak is advantageous over total wall thickness S C peak . speckle tracking; transmurality; myocardial viability; left ventricular function THE MYOCARDIAL LAYERS contribute differently to deformation of the left ventricle (LV) at the normal state (4,8,11,23,29), during wall motion abnormalities (1,6,24), and particularly during myocardial infarction (MI) (6). Since nontransmural MI is associated with a high risk for mortality (21), it is essential to identify it at its early stages. The identification of nontransmural MI is challenging, since the myocardial injury is heterogeneous within the myocardial layers (13,15,35), where usually nontransmural MI affects the endocardium first (35).Therefore, the viable layers cause the injured layers to passively contract and move (i.e., tethering). Tethering makes it difficult to identify the MI using the traditional speckle tracking echocardiography (STE) method. The STE method is an angle-independent tool developed for the automatic evaluation of LV regional function (25, 26, 37) by tracking speckle movement in two-dimensional grayscale echocardiographic cine loops (34). The STE is advantageous, among other ...

show abstract

Impact of infarct transmurality on layer-specific impairment of myocardial function: a myocardial deformation imaging study

Cited by 104 publications

References 29 publications

Myocardial strain assessment by cine cardiac magnetic resonance imaging using non-rigid registration

Myocardial strain assessment by cine cardiac magnetic resonance imaging using non-rigid registration

Mechanisms of Left Ventricular Dysfunction Assessed by Layer-Specific Strain Analysis in Patients With Repaired Tetralogy of Fallot

Layer-specific strain analysis: investigation of regional deformations in a rat model of acute versus chronic myocardial infarction

Contact Info

Product

Resources

About