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The International Journal of Cardiovascular Imaging

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Open Access 01-07-2019 | ST-Segment Elevation Myocardial Infarction | Original Paper

Combined T1-mapping and tissue tracking analysis predicts severity of ischemic injury following acute STEMI—an Oxford Acute Myocardial Infarction (OxAMI) study

Authors: Malgorzata Wamil, Alessandra Borlotti, Dan Liu, André Briosa e Gala, Alessia Bracco, Mohammad Alkhalil, Giovanni Luigi De Maria, Stefan K. Piechnik, Vanessa M. Ferreira, Adrian P. Banning, Rajesh K. Kharbanda, Stefan Neubauer, Robin P. Choudhury, Keith M. Channon, Erica Dall’Armellina

Published in: The International Journal of Cardiovascular Imaging | Issue 7/2019

Abstract

Early risk stratification after ST-segment–elevation myocardial infarction (STEMI) is of major clinical importance. Strain quantifies myocardial deformation and can demonstrate abnormal global and segmental myocardial function in acute ischaemia. Native T1-mapping allows assessment of the severity of acute ischemic injury, however its clinical applicability early post MI is limited by the complex dynamic changes happening in the myocardium post MI. We aimed to explore relationship between T1-mapping and feature tracking imaging, to establish whether combined analysis of these parameters could predict recovery after STEMI. 96 STEMI patients (aged 60 ± 11) prospectively recruited in the Oxford Acute Myocardial Infarction (OxAMI) study underwent 3T-CMR scans acutely (within 53 ± 32 h from primary percutaneous coronary intervention) and at 6 months (6M). The imaging protocol included: cine, ShMOLLI T1-mapping and late gadolinium enhancement (LGE). Segments were divided in the infarct, adjacent and remote zones based on the presence of LGE. Peak circumferential (Ecc) and radial (Err) strain was assessed using cvi42 software. Acute segmental strain correlated with segmental T1-mapping values (T1 vs. Err − 0.75 ± 0.25, p < 0.01; T1 vs. Ecc 0.72 ± 0.32, p < 0.01) and with LGE segmental injury (LGE vs. Err − 0.56 ± 0.29, p < 0.01; LGE vs. Ecc 0.54 ± 0.35, p < 0.01). Moreover, acute segmental T1 and strain predicted segmental LGE transmurality on 6M scans (p < 0.001, r = 0.5). Multiple regression analysis confirmed combined analysis of global Ecc and T1-mapping was significantly better than either method alone in predicting final infarct size at 6M (r = 0.556 vs r = 0.473 for global T1 only and r = 0.476 for global Ecc only, p < 0.001). This novel CMR method combining T1-mapping and feature tracking analysis of acute CMR scans predicts LGE transmurality and infarct size at 6M following STEMI.

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Title: Combined T1-mapping and tissue tracking analysis predicts severity of ischemic injury following acute STEMI—an Oxford Acute Myocardial Infarction (OxAMI) study
Authors: Malgorzata Wamil
Alessandra Borlotti
Dan Liu
André Briosa e Gala
Alessia Bracco
Mohammad Alkhalil
Giovanni Luigi De Maria
Stefan K. Piechnik
Vanessa M. Ferreira
Adrian P. Banning
Rajesh K. Kharbanda
Stefan Neubauer
Robin P. Choudhury
Keith M. Channon
Erica Dall’Armellina
Publication date: 01-07-2019
Publisher: Springer Netherlands
Keywords: ST-Segment Elevation Myocardial Infarction
Myocardial Infarction
Published in: The International Journal of Cardiovascular Imaging / Issue 7/2019
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-019-01542-8

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