Cyrille Bergerot1, Nathan Mewton2, Cécile Lacote-Roiron3, Laura Ernande3, Michel Ovize2, Pierre Croisille4, Hélène Thibault5, Geneviève Derumeaux5. 1. Centre d'Investigation Clinique de Lyon (CIC) et Service d'Explorations Fonctionnelles Cardiovasculaires, Groupement Hospitalier Est, Lyon, France; INSERM UMR-1060, CarMeN Laboratory, Université Claude Bernard Lyon 1, Lyon, France. Electronic address: cyrille.bergerot@chu-lyon.fr. 2. Centre d'Investigation Clinique de Lyon (CIC) et Service d'Explorations Fonctionnelles Cardiovasculaires, Groupement Hospitalier Est, Lyon, France; INSERM UMR-1060, CarMeN Laboratory, Université Claude Bernard Lyon 1, Lyon, France. 3. Centre d'Investigation Clinique de Lyon (CIC) et Service d'Explorations Fonctionnelles Cardiovasculaires, Groupement Hospitalier Est, Lyon, France. 4. CREATIS-LRMN, CNRS UMR 5220 - INSERM U630 - Université Claude Bernard Lyon 1, Lyon, France. 5. INSERM UMR-1060, CarMeN Laboratory, Université Claude Bernard Lyon 1, Lyon, France.
Abstract
BACKGROUND: In the acute phase of myocardial infarction (MI), infarct size and microvascular obstruction (MVO) are important prognostic factors for cardiovascular outcome. MI size is a major determinant of myocardial function, but the specific effect of MVO is less documented. The aim of this study was to evaluate the impact of MVO on longitudinal myocardial strain assessed by speckle-tracking echocardiography. METHOD: Speckle-tracking echocardiography and contrast-enhanced cardiac magnetic resonance studies were performed in 69 patients 72 hours after first acute MI. Segmental and global longitudinal systolic strain (εL) was measured using speckle-tracking echocardiography. Transmural extent of MI, MI size, and the presence or absence of MVO were assessed using contrast-enhanced cardiac magnetic resonance. Left ventricular (LV) ejection fraction was assessed at 6 months using echocardiography. RESULTS: The mean infarct size was 23 ± 13% of LV mass. MVO was present in 64% of patients. MVO was significantly associated with εL impairment (-7.8 ± 4.9% vs -16.3 ± 6.4%, P < .001), and εL remained significantly worse in MVO-positive segments after adjustment for transmural extent of MI. A εL value > -12.5% predicted the presence of MVO with 83% sensitivity and 75% specificity. On multivariate analysis, global εL and MI size, but not MVO, were identified as independent predictors of LV ejection fraction at follow-up (β = -0.9, P = .023, and β = -0.2, P = .034, respectively). CONCLUSION: In the acute phase of MI, segmental and global εL is significantly altered by the presence of MVO, in addition to MI size. However, MI size but not MVO independently predicts LV ejection fraction at follow-up.
BACKGROUND: In the acute phase of myocardial infarction (MI), infarct size and microvascular obstruction (MVO) are important prognostic factors for cardiovascular outcome. MI size is a major determinant of myocardial function, but the specific effect of MVO is less documented. The aim of this study was to evaluate the impact of MVO on longitudinal myocardial strain assessed by speckle-tracking echocardiography. METHOD: Speckle-tracking echocardiography and contrast-enhanced cardiac magnetic resonance studies were performed in 69 patients 72 hours after first acute MI. Segmental and global longitudinal systolic strain (εL) was measured using speckle-tracking echocardiography. Transmural extent of MI, MI size, and the presence or absence of MVO were assessed using contrast-enhanced cardiac magnetic resonance. Left ventricular (LV) ejection fraction was assessed at 6 months using echocardiography. RESULTS: The mean infarct size was 23 ± 13% of LV mass. MVO was present in 64% of patients. MVO was significantly associated with εL impairment (-7.8 ± 4.9% vs -16.3 ± 6.4%, P < .001), and εL remained significantly worse in MVO-positive segments after adjustment for transmural extent of MI. A εL value > -12.5% predicted the presence of MVO with 83% sensitivity and 75% specificity. On multivariate analysis, global εL and MI size, but not MVO, were identified as independent predictors of LV ejection fraction at follow-up (β = -0.9, P = .023, and β = -0.2, P = .034, respectively). CONCLUSION: In the acute phase of MI, segmental and global εL is significantly altered by the presence of MVO, in addition to MI size. However, MI size but not MVO independently predicts LV ejection fraction at follow-up.
Authors: Jaroslaw Zalewski; Piet Claus; Jan Bogaert; Nina Vanden Driessche; Ronald B Driesen; Diogo T Galan; Karin R Sipido; Piotr Buszman; Krzysztof Milewski; Frans Van de Werf Journal: Basic Res Cardiol Date: 2015-02-27 Impact factor: 17.165
Authors: Pankaj Garg; Ananth Kidambi; James R J Foley; Tarique Al Musa; David P Ripley; Peter P Swoboda; Bara Erhayiem; Laura E Dobson; Adam K McDiarmid; John P Greenwood; Sven Plein Journal: Open Heart Date: 2016-05-02
Authors: Henk Everaars; Lourens F H J Robbers; Marco Götte; Pierre Croisille; Alexander Hirsch; Paul F A Teunissen; Peter M van de Ven; Niels van Royen; Felix Zijlstra; Jan J Piek; Albert C van Rossum; Robin Nijveldt Journal: Eur Radiol Date: 2018-06-08 Impact factor: 5.315