Impact of systolic and diastolic deformation indexes assessed by strain-encoded imaging to predict persistent severe myocardial dysfunction in patients after acute myocardial infarction at follow-up.
OBJECTIVE
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 E(cc) 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).
Neizel
Mirja
M
Department of Cardiology, University Hospital Heidelberg, Heidelberg, Germany. mirja.neizel@med.uni-duesseldorf.de
Korosoglou
Grigorios
G
Lossnitzer
Dirk
D
Kühl
Harald
H
Hoffmann
Rainer
R
Ocklenburg
Christina
C
Giannitsis
Evangelos
E
Osman
Nael F
NF
Katus
Hugo A
HA
Steen
Henning
H
D016022:Case-Control Studies; D003971:Diastole; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology
D019275:Radiopharmaceuticals; D005682:Gadolinium