Predictive value of global longitudinal strain measured by cardiac magnetic resonance imaging for left ventricular remodeling after acute ST-segment elevation myocardial infarction:a multi-centered prospective study
10.12122/j.issn.1673-4254.2024.06.03
- VernacularTitle:心脏磁共振成像整体纵向应变对急性ST段抬高型心肌梗死后左心室重构的预测价值:403例前瞻性研究
- Author:
Ke LIU
1
,
2
;
Zhenyan MA
;
Lei FU
;
Liping ZHANG
;
Xin A
;
Shaobo XIAO
;
Zhen ZHANG
;
Hongbo ZHANG
;
Lei ZHAO
;
Geng QIAN
Author Information
1. 解放军医学院,北京 100853
2. 中国人民解放军总医院第六医学中心心血管病医学部,北京 100048
- Keywords:
acute ST-segment elevation myocardial infarction;
cardiac magnetic resonance feature tracking;
myocardial strain;
left ventricular remodeling
- From:
Journal of Southern Medical University
2024;44(6):1033-1039
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the predictive value of global longitudinal strain(GLS)measured by cardiac magnetic resonance(CMR)feature-tracking technique for left ventricular remodeling(LVR)after percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 403 patients undergoing PCI for acute STEMI were prospectively recruited from multiple centers in China.CMR examinations were performed one week(7±2 days)and 6 months after myocardial infarction to obtain GLS,global radial strain(GRS),global circumferential strain(GCS),ejection fraction(LVEF)and infarct size(IS).The primary endpoint was LVR,defined as an increase of left ventricle end-diastolic volume by≥20%or an increase of left ventricle end-systolic volume by≥15%from the baseline determined by CMR at 6 months.Logistic regression analysis was performed to evaluate the predictive value of CMR parameters for LVR.Results LVR occurred in 101 of the patients at 6 months after myocardial infarction.Compared with those without LVR(n=302),the patients in LVR group exhibited significantly higher GLS and GCS(P<0.001)and lower GRS and LVEF(P<0.001).Logistic regression analysis indicated that both GLS(OR=1.387,95%CI:1.223-1.573;P<0.001)and LVEF(OR=0.951,95%CI:0.914-0.990;P=0.015)were independent predictors of LVR.ROC curve analysis showed that at the optimal cutoff value of-10.6%,GLS had a sensitivity of 74.3%and a specificity of 71.9%for predicting LVR.The AUC of GLS was similar to that of LVEF for predicting LVR(P=0.146),but was significantly greater than those of other parameters such as GCS,GRS and IS(P<0.05);the AUC of LVEF did not differ significantly from those of the other parameters(P>0.05).Conclusion In patients receiving PCI for STEMI,GLS measured by CMR is a significant predictor of LVR occurrence with better performance than GRS,GCS,IS and LVEF.
