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Open Access 01-12-2018 | Cardiac

Strain analysis is superior to wall thickening in discriminating between infarcted myocardium with and without microvascular obstruction

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

Published in: European Radiology | Issue 12/2018

Abstract

Objectives

The aim of the present study was to evaluate the diagnostic performances of strain and wall thickening analysis in discriminating among three types of myocardium after acute myocardial infarction: non-infarcted myocardium, infarcted myocardium without microvascular obstruction (MVO) and infarcted myocardium with MVO.

Methods

Seventy-one patients with a successfully treated ST-segment elevation myocardial infarction underwent cardiovascular magnetic resonance imaging at 2-6 days after reperfusion. The imaging protocol included conventional cine imaging, myocardial tissue tagging and late gadolinium enhancement. Regional circumferential and radial strain and associated strain rates were analyzed in a 16-segment model as were the absolute and relative wall thickening.

Results

Hyperenhancement was detected in 418 (38%) of 1096 segments and was accompanied by MVO in 145 (35%) of hyperenhanced segments. Wall thickening, circumferential and radial strain were all significantly diminished in segments with hyperenhancement and decreased even further if MVO was also present (all p < 0.001). Peak circumferential strain (CS) surpassed all other strain and wall thickening parameters in its ability to discriminate between hyperenhanced and non-enhanced myocardium (all p < 0.05). Furthermore, CS was superior to both absolute and relative wall thickening in differentiating infarcted segments with MVO from infarcted segments without MVO (p = 0.02 and p = 0.001, respectively).

Conclusions

Strain analysis is superior to wall thickening in differentiating between non-infarcted myocardium, infarcted myocardium without MVO and infarcted myocardium with MVO. Peak circumferential strain is the most accurate marker of regional function.

Key Points

• CMR can quantify regional myocardial function by analysis of wall thickening on cine images and strain analysis of tissue tagged images.

• Strain analysis is superior to wall thickening in differentiating between different degrees of myocardial injury after acute myocardial infarction.

• Peak circumferential strain is the most accurate marker of regional function.

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Title: Strain analysis is superior to wall thickening in discriminating between infarcted myocardium with and without microvascular obstruction
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
Publication date: 01-12-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 12/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5493-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Strain analysis is superior to wall thickening in discriminating between infarcted myocardium with and without microvascular obstruction

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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