The utility of global longitudinal strain in the identification of prior myocardial infarction in patients with preserved left ventricular ejection fraction

Fent, Graham; Garg, Pankaj; Foley, James Rj; Dobson, Laura E; Musa, Tarique A; Erhayiem, Bara; Greenwood, John P; Plein, Sven; Swoboda, Peter

doi:10.1007/s10554-017-1138-7

Cited by 27 publications

(22 citation statements)

References 33 publications

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“…However, while Ogawa et al (19) showed that MI presence and position could be assessed using both feature tracking and myocardial tagging, the sensitivity and specificity for detecting MI segments were low (feature tracking: sensitivity, 72%; specificity, 71%; tagging technique: sensitivity, 71%; specificity, 75%). Fent et al (34) also reported that feature tracking could identify prior MI but the AUC was low (0.66 [95% CI: 0.54, 0.79], P = .012).…”

Section: Discussionmentioning

confidence: 99%

Deep Learning for Diagnosis of Chronic Myocardial Infarction on Nonenhanced Cardiac Cine MRI

Zhang¹,

Yang²,

Gao³

et al. 2019

Radiology

176

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iagnosis of chronic myocardial infarction (MI) is an important clinical task because the management of and treatment planning for patients is different for chronic MI versus acute MI (1,2). The extent of chronic MI, including location, size, and transmurality, provides rich information for patient diagnosis, prognosis, and therapy planning (3). Therefore, accurate delineation and comprehensive evaluation of chronic MI is of great clinical interest. Late gadolinium enhancement (LGE) MRI has been established as the ground truth reference technique for chronic MI evaluation (4-6). However, including LGE MRI in the MRI examination extends the scanning duration and there are also growing concerns about its safety (7-9). While LGE MRI is contraindicated in patients with severe renal impairment, a recent study has also shown that gadolinium might deposit into the skin, dentate nucleus, and globus pallidus of patients with normal renal function (10). A reliable technique to detect and delineate MI without the need for gadolinium-based contrast agent would therefore be highly desirable. T1 and T2 mapping techniques (11) are non-contrast material-enhanced approaches that show longer T1 and T2 relaxation times in acute MI compared with normal myocardium. In comparison, while T1 relaxation time is

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Section: Discussionmentioning

confidence: 99%

Deep Learning for Diagnosis of Chronic Myocardial Infarction on Nonenhanced Cardiac Cine MRI

Zhang¹,

Yang²,

Gao³

et al. 2019

Radiology

176

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“…Longitudinal strain is altered in ischemic heart disease, also in cases with preserved EF [14], and represents an early marker of subclinical myocardial contractility dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors found that CS Reducer may positively affect global left ventricle (LV) systolic function [6][7][8]12], other did not find any modification [13]. Longitudinal strain is known to be altered in acute and chronic heart disease, representing a more sensitive tool than ejection fraction for the evaluation of subclinical alteration of myocardial contractility in ischemic patients [14]. However, the real impact of CS Reducer on myocardial systolic deformation proprieties remains unstudied.…”

Section: Introductionmentioning

confidence: 99%

Feature tracking and mapping analysis of myocardial response to improved perfusion reserve in patients with refractory angina treated by coronary sinus Reducer implantation: a CMR study

Palmisano

Giannini

Rancoita

et al. 2020

Int J Cardiovasc Imaging

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Coronary sinus (CS) Reducer implantation improves myocardial perfusion and symptoms in patients with debilitating refractory angina. Its impact on myocardial remodeling remain uncertain. Aim of the present study was to assess possible impact of CS Reducer on myocardial systolic-diastolic deformation and microstructural remodeling, as assessed through cardiac magnetic resonance (CMR) feature tracking and mapping analysis. Twenty-eight consecutive patients with refractory angina underwent multiparametric stress CMR before and 4 months after CS Reducer implantation. Eight patients were excluded (6 for absence of inducible ischemia, 2 for artifacts). Modifications in 3D systo-diastolic myocardial deformation were evaluated using feature tracking analysis on rest cine images. Myocardial microstructural remodeling was assessed by native T1 mapping, cellular and matrix volume and extracellular volume fraction (ECV). Collaterally, the percentage of ischemic myocardium (ischemic burden %) and the myocardial perfusion reserve index (MPRI) were measured. After CS Reducer implantation, myocardial contractility improved (ejection fraction rose from 61 to 67%; p = 0.0079), along with longitudinal (from − 16 to − 19%; p = 0.0192) and circumferential strain (from − 18 to − 21%; p = 0.0017). Peak diastolic radial, circumferential and longitudinal strain rate did not change (p > 0.05), and no changes in native T1, ECV, cellular and matrix volume were observed. Myocardial perfusion improved, with a reduction of ischemic burden (13-11%; p = 0.0135), and recovery of intramural perfusion balance in segments with baseline ischemia (MPRi endocardial/epicardial ratio from 0.67 to 0.96; p = 0.0107). CS Reducer improves myocardial longitudinal and circumferential strain, without microstructural remodeling and no impact on diastolic proprieties.

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“…Strain analysis was performed using a cvi42 (v5.1) feature tracking (FT) module in a semi-automated manner (Fig. 2 ; [ 11 ]). FT analysis was done by two observers (GF and PG).…”

Section: Methodsmentioning

confidence: 99%

Effects of hyperaemia on left ventricular longitudinal strain in patients with suspected coronary artery disease

et al. 2018

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AimsMyocardial perfusion imaging during hyperaemic stress is commonly used to detect coronary artery disease. The aim of this study was to investigate the relationship between left ventricular global longitudinal strain (GLS), strain rate (GLSR), myocardial early (E’) and late diastolic velocities (A’) with adenosine stress first-pass perfusion cardiovascular magnetic resonance (CMR) imaging.Methods and results44 patients met the inclusion criteria and underwent CMR imaging. The CMR imaging protocol included: rest/stress horizontal long-axis (HLA) cine, rest/stress first-pass adenosine perfusion and late gadolinium enhancement imaging. Rest and stress HLA cine CMR images were analysed using feature-tracking software for the assessment of myocardial deformation. The presence of perfusion defects was scored on a binomial scale. In patients with hyperaemia-induced perfusion defects, rest global longitudinal strain GLS (−16.9 ± 3.7 vs. −19.6 ± 3.4; p-value = 0.02), E’ (−86 ± 22 vs. −109 ± 38; p-value = 0.02), GLSR (69 ± 31 vs. 93 ± 38; p-value = 0.01) and stress GLS (−16.5 ± 4 vs. −21 ± 3.1; p < 0.001) were significantly reduced when compared with patients with no perfusion defects. Stress GLS was the strongest independent predictor of perfusion defects (odds ratio 1.43 95% confidence interval 1.14–1.78, p-value <0.001). A threshold of −19.8% for stress GLS demonstrated 78% sensitivity and 73% specificity for the presence of hyperaemia-induced perfusion defects.ConclusionsAt peak myocardial hyperaemic stress, GLS is reduced in the presence of a perfusion defect in patients with suspected coronary artery disease. This reduction is most likely caused by reduced endocardial blood flow at maximal hyperaemia because of transmural redistribution of blood flow in the presence of significant coronary stenosis.Electronic supplementary materialThe online version of this article (10.1007/s12471-017-1071-3) contains supplementary material, which is available to authorized users.

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The utility of global longitudinal strain in the identification of prior myocardial infarction in patients with preserved left ventricular ejection fraction

Cited by 27 publications

References 33 publications

Deep Learning for Diagnosis of Chronic Myocardial Infarction on Nonenhanced Cardiac Cine MRI

Deep Learning for Diagnosis of Chronic Myocardial Infarction on Nonenhanced Cardiac Cine MRI

Feature tracking and mapping analysis of myocardial response to improved perfusion reserve in patients with refractory angina treated by coronary sinus Reducer implantation: a CMR study

Effects of hyperaemia on left ventricular longitudinal strain in patients with suspected coronary artery disease

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