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European Radiology
Published in: European Radiology 1/2020

Open Access 01-01-2020 | Myocardial Infarction | Cardiac

Mitral annular plane systolic excursion by cardiac MR is an easy tool for optimized prognosis assessment in ST-elevation myocardial infarction

Authors: Agnes Mayr, Mathias Pamminger, Martin Reindl, Simon Greulich, Sebastian J. Reinstadler, Christina Tiller, Magdalena Holzknecht, Timo Nalbach, David Plappert, Christof Kranewitter, Gert Klug, Bernhard Metzler

Published in: European Radiology | Issue 1/2020

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Abstract

Objectives

The purpose of this study was to assess the comparative prognostic value of mitral annular plane systolic excursion (MAPSE) versus left ventricular ejection fraction (LVEF), measured by cardiac magnetic resonance (CMR) imaging in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI).

Methods

CMR was performed in 255 STEMI patients within 2 days (interquartile range (IQR) 2–4 days) after infarction. CMR included MAPSE measurement on CINE 4-chamber view. Patients were followed for major adverse cardiovascular events (MACE)—death, non-fatal myocardial re-infarction, stroke, and new congestive heart failure.

Results

Patients with MACE (n = 35, 14%, median follow-up 3 years [IQR 1–4 years]) showed significantly lower MAPSE (8 mm [7–8.8] vs. 9.6 mm [8.1–11.5], p < 0.001). The association between decreased MAPSE (< 9 mm, optimal cut-off value by c-statistics) remained significant after adjustment for independent clinical and CMR predictors of MACE. The AUC of MAPSE for the prediction of MACE was 0.74 (CI 95% 0.65–0.82), significantly higher than that of LVEF (0.61 [CI 95% 0.50–0.71]; p < 0.001).

Conclusions

Reduced long-axis function assessed with MAPSE measurement using CINE CMR independently predicts long-term prognosis following STEMI. Moreover, MAPSE provided significantly higher prognostic implication in comparison with conventional LVEF measurement.

Key Points

• MAPSE determined by CMR independently predicts long-term prognosis following STEMI.
• MACE-free survival is significantly higher in patients with MAPSE ≥ 9 mm than < 9 mm.
• MAPSE provides significantly higher prognostic implication than conventional LVEF.
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Metadata
Title
Mitral annular plane systolic excursion by cardiac MR is an easy tool for optimized prognosis assessment in ST-elevation myocardial infarction
Authors
Agnes Mayr
Mathias Pamminger
Martin Reindl
Simon Greulich
Sebastian J. Reinstadler
Christina Tiller
Magdalena Holzknecht
Timo Nalbach
David Plappert
Christof Kranewitter
Gert Klug
Bernhard Metzler
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 1/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06393-4

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