Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 56, Issue 13, Pages 1056-1062Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2010.02.070
Keywords
myocardial dysfunction; myocardial infarction; SENC
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Funding
- National Institutes of Health [R01 HL072704]
- Medical Faculty of the University Hospital Aachen
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Objectives This study evaluated the value of systolic and diastolic deformation indexes determined by strain-encoded imaging to predict persistent severe dysfunction at follow-up in patients after reperfused acute myocardial infarction (AMI) in comparison with late gadolinium enhancement (LGE). Background Animal studies suggest that regional diastolic function provides information about myocardial viability after AMI. However, data in humans are sparse. Methods Twenty-six patients underwent magnetic resonance imaging 3 +/- 1 days after successfully reperfused ST-segment elevation myocardial infarction and at a follow-up of 6 months. Cine, strain-encoded, and LGE images were acquired. Peak systolic circumferential strain (E(cc)) and early diastolic strain rate (E(cc)/s) were calculated for each segment at baseline and at follow-up. A cutoff E(cc) value of -9% was used to define severe dysfunction at follow-up. Results A total of 312 segments were analyzed; 119 segments showed abnormal baseline function. Thirty-five segments showed severe dysfunction at follow-up, which was defined as Ecc at follow-up <9%. The area under the curve for E(cc)/s was 0.82 (95% confidence interval [CI]: 0.72 to 0.89), for E(cc) 0.74 (95% CI: 0.64 to 0.83), and for LGE 0.85 (95% CI: 0.77 to 0.92). A comparison of receiver-operating characteristic curves demonstrates that LGE is not significantly different than E(cc)/s but is significantly different than E(cc) (p = 0.32 vs. p < 0.05) for prediction of severe dysfunction at follow-up. Conclusions Regional diastolic function provides similar accuracy to predict persistent severe dysfunction at follow-up to LGE and is superior to regional systolic function in patients after AMI. Diastolic deformation indexes may serve as a new parameter for assessment of viability in patients after AMI. (SENC in AMI Study; NCT00752713). (J Am Coll Cardiol 2010; 56: 1056-62) (C) 2010 by the American College of Cardiology Foundation
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