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17-06-2024 | CSF Drainage | Original Paper

Association between cardiac magnetic resonance ventricular strain and left ventricular thrombus in patients with ST-segment elevation myocardial infarction

Authors: Qing Chen, Zeqing Zhang, Lei Chen, Ziyu Zhou, Yuan Lu, Chaoqun Zhang, Chengzong Li, Zhuoqi Zhang, Wensu Chen

Published in: The International Journal of Cardiovascular Imaging

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Abstract

Background

Myocardial strain can analyze early myocardial dysfunction after myocardial infarction (MI). However, the correlation between left ventricular (LV) strain (including regional and global strain) obtained by cardiac magnetic resonance (CMR) imaging and left ventricular thrombus (LVT) after ST-segment elevation myocardial infarction (STEMI) is unclear.

Methods

The retrospective clinical observation study included patients with LVT (n = 20) and non-LVT (n = 195) who underwent CMR within two weeks after STEMI. CMR images were analyzed using CVI 42 (Circle Cardiovascular Imaging, Canada) to obtain LV strain values. Logistic regression analysis identified risk factors for LVT among baseline characteristics, CMR ventricular strain, and left ventricular ejection fraction (LVEF). Considering potential correlations between strains, the ability of LV strain to identify LVT was evaluated using 9 distinct models. Receiver operating characteristic curves were generated with GraphPad Prism, and the area under the curve (AUC) of LVEF, apical longitudinal strain (LS), and circumferential strain (CS) was calculated to determine their capacity to distinguish LVT.

Results

Among 215 patients, 9.3% developed LVT, with a 14.5% incidence in those with anterior MI. Univariate regression indicated associations of LAD infarct-related artery, lower NT-proBNP, lower LVEF, and reduced global, midventricular, and apical strain with LVT. Further multivariable regression analysis showed that apical LS, LVEF and NT-proBNP were still independently related to LVT (Apical LS: OR = 1.14, 95%CI (1.01, 1.30), P = 0.042; LVEF: OR = 0.91, 95%CI (0.85, 0.97), P = 0.005; NT-proBNP: OR = 2.35, 95%CI (1.04, 5.31) ).

Conclusion

Reduced apical LS on CMR is independently associated with LVT after STEMI.
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Literature
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go back to reference O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr., Chung MK, de Lemos JA et al (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice guidelines. Circulation 127(4):e362–425. https://doi.org/10.1161/CIR.0b013e3182742cf6CrossRefPubMed O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr., Chung MK, de Lemos JA et al (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice guidelines. Circulation 127(4):e362–425. https://​doi.​org/​10.​1161/​CIR.​0b013e3182742cf6​CrossRefPubMed
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Metadata
Title
Association between cardiac magnetic resonance ventricular strain and left ventricular thrombus in patients with ST-segment elevation myocardial infarction
Authors
Qing Chen
Zeqing Zhang
Lei Chen
Ziyu Zhou
Yuan Lu
Chaoqun Zhang
Chengzong Li
Zhuoqi Zhang
Wensu Chen
Publication date
17-06-2024
Publisher
Springer Netherlands
Published in
The International Journal of Cardiovascular Imaging
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-024-03163-2
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