title: Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement.
abstract: OBJECTIVE
  To investigate whether myocardial deformation imaging, assessed by feature tracking cardiac magnetic resonance (FTI-CMR), would allow objective quantification of myocardial strain and estimation of functional recovery in patients with first time ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  Cardiac magnetic resonance (CMR) imaging was performed in 74 consecutive patients 2-4 days after successfully reperfused STEMI, using a 1.5T CMR scanner (Philips Achieva). Peak systolic circumferential and longitudinal strains were measured using the FTI applied to SSFP cine sequences and were compared to infarct size, determined by late gadolinium enhancement (LGE). Follow-up CMR at 6 months was performed in order to assess residual ejection fraction, which deemed as the reference standard for the estimation of functional recovery.
  
  
  RESULTS
  During the follow-up period 53 of 74 (72%) patients exhibited preserved residual ejection fraction ≥50%. A cut-off value of -19.3% for global circumferential strain identified patients with preserved ejection fraction ≥50% at follow-up with sensitivity of 76% and specificity of 85% (AUC=0.86, 95% CI=0.75-0.93, p<0.001), which was superior to that provided by longitudinal strain (ΔAUC=0.13, SE=0.05, z-statistic=2.5, p=0.01), and non-inferior to that provided by LGE (ΔAUC=0.07, p=NS). Multivariate analysis showed that global circumferential strain and LGE exhibited independent value for the prediction of preserved LV-function, surpassing that provided by age, diabetes and baseline ejection fraction (HR=1.4, 95% CI=1.0-1.9 and HR=1.4, 95% CI=1.1-1.7, respectively, p<0.05 for both).
  
  
  CONCLUSIONS
  Estimation of circumferential strain by FTI provides objective assessment of infarct size without the need for contrast agent administration and estimation of functional recovery with non-inferior accuracy compared to that provided by LGE.
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Sebastian J
authors: SJ
authors: Buss
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Birgit
authors: B
authors: Krautz
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Nina
authors: N
authors: Hofmann
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Yannick
authors: Y
authors: Sander
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Lukas
authors: L
authors: Rust
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Sorin
authors: S
authors: Giusca
authors: TomTec Imaging Systems GmbH, Munich, Germany.
authors: Christian
authors: C
authors: Galuschky
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Sebastian
authors: S
authors: Seitz
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Evangelos
authors: E
authors: Giannitsis
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Sven
authors: S
authors: Pleger
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Philip
authors: P
authors: Raake
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Patrick
authors: P
authors: Most
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany.
authors: Hugo A
authors: HA
authors: Katus
authors: Department of Cardiology, University of Heidelberg, INF 410, 69120 Heidelberg, Germany. Electronic address: grigorios.korosoglou@med.uni-heidelberg.de.
authors: Grigorios
authors: G
authors: Korosoglou
mesh_terms: D000368:Aged; D003287:Contrast Media; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology*; D012372:ROC Curve; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D020107:Troponin T / Q000032:analysis; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D003287:Contrast Media; D020107:Troponin T; D005682:Gadolinium
keywords: Cardiac magnetic resonance; FTI; Late gadolinium enhancement; Left ventricular function; Myocardial infarction; STEMI; Two dimensional strain imaging