Document Detail

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.
MedLine Citation:
PMID:  20846606     Owner:  NLM     Status:  MEDLINE    
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 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).
Mirja Neizel; Grigorios Korosoglou; Dirk Lossnitzer; Harald Kühl; Rainer Hoffmann; Christina Ocklenburg; Evangelos Giannitsis; Nael F Osman; Hugo A Katus; Henning Steen
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2010-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1056-62     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Department of Cardiology, University Hospital Heidelberg, Heidelberg, Germany.
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MeSH Terms
Case-Control Studies
Follow-Up Studies
Gadolinium / diagnostic use
Magnetic Resonance Imaging / methods*
Magnetic Resonance Imaging, Cine
Myocardial Infarction / complications,  diagnosis*
Predictive Value of Tests
Prospective Studies
Radiopharmaceuticals / diagnostic use
Ventricular Dysfunction, Left / diagnosis*,  etiology
Grant Support
Reg. No./Substance:
0/Radiopharmaceuticals; 7440-54-2/Gadolinium

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