P876Cardiac magnetic resonance based feature-tracking myocardial strain analysis in MINOCA patients

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Szabo ◽  
V Horvath ◽  
Z Dohy ◽  
C Czimbalmos ◽  
A Toth ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Feature Tracking ◽  
Acute Myocarditis ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Healthy Controls ◽  
Regional Heterogeneity ◽  
Significant Difference

Abstract The diagnostic performance of cardiac magnetic resonance (CMR) based deformation imaging (feature tracking - FT) has been demonstrated in various groups of patients including acute myocardial infarction and acute myocarditis. However, the capability of this method to distinguish between patients with the working diagnosis of MINOCA is yet to be tested. We aimed to compare standard CMR parameters and investigate the differential diagnostic value of CMR-FT myocardial strain in pts with the working diagnosis of MINOCA. From our consecutive register of pts with troponin positive acute coronary syndrome (n=234 pts) we enrolled 100 pts (47.7±14 y; 51 male) in this study.Twenty-five pts were selected randomly from each group of acute myocardial infarction (MI), acute myocarditis, Tako-Tsubo cardiomyopathy (TTC) and pts without structural alteration on CMR, and an additional group of healthy control (n=20, 46±8.2 y; 12 male). Standard CMR parameters such as left ventricular ejection fraction (LVEF), end-diastolic (LVEDVi) and end-systolic (LVESVi) volumes, myocardial mass were assessed and compared between the groups. We performed CMR-FT analysis of the left ventricle, including: global longitudinal (GLS), circumferential (GCS), standard deviation (SD) of the peak circumferential (CS) strain furthermore mechanical dispersion (MD), defined as the SD of the time-to-peak circumferential (MDC) strain of the LV segments expressed as percent of the cardiac cycle. LVEF was lower (44±9.1%) and LVESVi (52.5±12.9ml/m2) was higher in TTC pts compared to all other groups (p<0.001). The LVEF, LVEDVi and LVESVi parameters did not show significant difference between MI and myocarditis pts (LVEF 56.5±7% vs 55±6.6%; LVEDVi 85.4±14.8 vs 92.7±10.7ml/m2; LVESVi 37.7±11.4 vs 41.5±9.1ml/m2). GLS and GRS were significantly reduced in TTC pts (−11.4±4.8%; 43.09±12.5%) compared to all other groups (p<0.001). GCS was impaired in pts with TTC, acute myocarditis and MI compared to healthy controls (−14±3.7 vs −18.7±3.7 vs −19.1±3.8 vs −23.2±3.1%, p<0.001), however there was no significant difference between myocarditis and MI pts. SD of the peak CS was lower in myocarditis compared to other groups (p<0.001). MDC was elevated in TTC and MI compared to myocarditis and healthy controls (16.3±5 vs 13.3±3.4 vs 8.1±3.3 vs 9.46±3.5% p<0.05). There was no significant difference between healthy controls and patients without structural alterations in any strain parameter. Strain analysis of a TTC patient Feature tracking analysis may enable differentiation between patients with MINOCA. TTC reduces global myocardial strain of the left ventricle and causes regional heterogeneity of the left ventricular contraction. Although standard volumetric CMR parameters and CMR based global strain values have limited capability to distinguish between MI and myocarditis with preserved ejection fraction, regional heterogeneity, expressible in MDC is significantly elevated in MI compared to myocarditis and healthy controls. Acknowledgement/Funding Project no. NVKP_16-1-2016-0017 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary

Feature-tracking myocardial strain analysis in acute myocarditis: diagnostic value and association with myocardial oedema

2017 ◽  
Vol 27 (11) ◽  
pp. 4661-4671 ◽  
Author(s):  
Julian A. Luetkens ◽  
Ulrike Schlesinger-Irsch ◽  
Daniel L. Kuetting ◽  
Darius Dabir ◽  
Rami Homsi ◽  
...  
Keyword(s):  
Feature Tracking ◽  
Acute Myocarditis ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Diagnostic Value ◽  
Myocardial Oedema ◽  
Myocardial Strain Analysis

P5253Does regional myocardial strain by cardiac magnetic resonance feature tracking reflect scar in ischemic heart disease?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Stathogiannis ◽  
V Mor-Avi ◽  
R Lang ◽  
A R Patel
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Feature Tracking ◽  
Circumferential Strain ◽  
Myocardial Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Lv Function ◽  
Regional Strain ◽  
The Relationship

Abstract Background Cardiac magnetic resonance (CMR) late gadolinium enhancement (LGE) is the gold standard for detection of myocardial scar. We hypothesized that CMR Feature Tracking (FT)-derived regional myocardial strain may reflect the presence of scar and could thus potentially be used instead of LGE imaging. Purpose The aim of this study was to determine the relationship between FT-derived regional myocardial strain and LGE in patients with coronary artery disease (CAD). Methods Seventy-five patients with CAD and typical ischemic LGE patterns on CMR (1.5T) were included (mean age 60±12 years, 70% males). Myocardial strain analysis and LGE identification were performed using dedicated commercial software. Scar was defined by presence of LGE in the same area of the myocardium in both short- and long-axis views. Peak systolic regional longitudinal and circumferential strain (RLS, RCS) values were calculated in the region of interest corresponding to the LGE area and also in a non-LGE myocardial region as a reference in each patient. These comparisons were repeated for a subgroup of 36 patients with left ventricular (LV) ejection fraction (EF) <40% to determine whether the relationship between strain and LGE holds in the presence of reduced LV function, when strain measurements may be altered as a reflection of reduced LVEF itself. Results Both global longitudinal and circumferential strain values were abnormal (−12.8±5.1% and −11.4±4.1%, respectively), reflecting LV dysfunction in this CAD cohort (EF = 40±16%). The magnitude of both RLS and RCS was significantly reduced in areas of LGE, compared to those without LGE: RLS −10.0±5.8% versus −20.4±7.5% (p<0.001); RCS −10.1±5.3±% versus −18.9±7.5%, respectively (p<0.001). Same pattern was noted in the reduced EF subgroup: RLS −8.0±4.7% versus −16.9±6.6% (p<0.001), RCS −7.7±4.3±% versus −16.0±7.9%, respectively (p<0.001). The figure depicts 2 representative cases in long and short axis views, LGE detection and concomitant regional strain analysis. LGE and regional strain analysis. Conclusion Reduced magnitude of regional longitudinal and circumferential strain by CMR-FT correlates with presence of LGE. Pending further validation, this finding may constitute the basis for detection of scar without contrast enhanced imaging, and would result in reduced cost, scan time and risk associated with gadolinium. Acknowledgement/Funding ARP: Research support (software) from Neosoft and Philips

Abstract 4305: Long-term Follow-up Of Left Ventricular Function After Acute Myocardial Infarction Treated With Intracoronary Injection Of Autologous Bone Marrow Cells. The ASTAMI Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Jan Otto Beitnes ◽  
Einar Hopp ◽  
Ketil Lunde ◽  
Hans-Jørgen Smith ◽  
Svein Solheim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Bone Marrow ◽  
Left Ventricular Function ◽  
Bone Marrow Cells ◽  
Left Ventricular ◽  
Intracoronary Injection ◽  
Significant Difference

Background: Long-term effects of cardiac autologous cell therapy are not well known. We performed a 3 year follow-up of the ASTAMI study. Patients with acute ST-elevation anterior wall myocardial infarctions were initially randomized to either intracoronary injection of autologous mononuclear bone marrow cells (mBMCs) (n=50) or control (n=50). At 6 months, LV ejection fraction improved in both groups, with no significant difference between groups. Methods: All eligible patients underwent MRI with a 1,5 T scanner (Siemens) 2–3 weeks, 6 months and mean(SD) 3,2 (0,2) years after myocardial infarction and stem cell injection. Infarct size was determined from gadolinium late-enhancement MR images. All images were analyzed by experienced observers blinded for treatment assignment. Left ventricular volumes were calculated by the area-length method. Results: There was no significant difference in EDV, ESV or LVEF between baseline and 3 years in neither group. Infarction volume was reduced at 3 years in both groups (p<0,001). No significant effects of mBMC treatment could be identified on LV volumes, LVEF or infarct size. Thus intracoronary injection of mBMCs in acute myocardial infarction does not improve global LV function over a 3 year follow-up. Left ventricular function after mBMC-treatment

scholarly journals CMR feature tracking remote myocardial strain analyses for optimized risk prediction following acute myocardial infarction

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T Lange ◽  
T Stiermaier ◽  
SJ Backhaus ◽  
P Boom ◽  
JT Kowallick ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
High Risk ◽  
Feature Tracking ◽  
Circumferential Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
High Risk Patients ◽  
Risk Patients

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiac magnetic resonance myocardial feature tracking (CMR-FT) derived global strain assessments provide incremental prognostic information in patients following acute myocardial infarction (AMI). Functional analyses of the remote myocardium (RM) are scarce and whether they provide an additional prognostic value in these patients is unknown. Methods 1052 patients following acute myocardial infarction were included. CMR imaging and strain analyses as well as scar size quantification were performed after reperfusion by primary percutaneous coronary intervention. The occurrence of major adverse cardiac events (MACE) within 12 months after the index event was defined as primary clinical endpoint. Results Patients with MACE had significantly lower RM circumferential strain (CS) compared to those without MACE. A cut-off value for RM CS of -25.8% best identified high-risk patients (p &lt; 0.001 on log-rank testing) and impaired RM CS was a strong predictor of MACE (HR 1.05, 95% CI 1.07-1.14, p = 0.003). RM CS provided further risk stratification amongst patients considered at risk according to established CMR parameters for 1.) patients with reduced left ventricular ejection fraction (LVEF) ≤ 35 % (p = 0.002 on log-rank testing), 2.) patients with reduced global circumferential strain (GCS) &gt; -18,3 % (p = 0.015 on log-rank testing), and 3.) patients with large microvascular obstruction ≥ 1.46 % (p = 0.038 on log-rank testing). Conclusion CMR-FT derived RM CS is a useful parameter to characterize the response of RM and allows improved stratification following AMI beyond commonly used parameters, especially of high-risk patients.

scholarly journals High triglyceride-glucose index is associated with adverse cardiovascular outcomes in patients with acute myocardial infarction

2020 ◽  
Author(s):  
Yue Zhang ◽  
Xiaosong Ding ◽  
Bing Hua ◽  
Qingbo Liu ◽  
Hui Gao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Cardiovascular Outcomes ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Tyg Index ◽  
Significant Difference

Abstract Background Triglyceride glucose (TyG) index is considered a new marker for metabolic disorders. Although recent studies have found an association between TyG index level and vascular disease development, the prognostic value of TyG index in patients with acute myocardial infarction (AMI) remains unclear. Methods A total of 3181 patients with AMI, who underwent coronary angiography, were identified from the Cardiovascular Center of Beijing Friendship Hospital Database Bank and included in the analysis. Patients were stratified into 2 groups according to their baseline TyG index levels: the TyG index < 8.88 group and the TyG index ≥ 8.88 group. Clinical characteristics,biochemical parameters, and the incidence of major adverse cardiovascular events (MACEs) during a median of 33.3-month follow-up were recorded. The TyG index was calculated using the following formula: ln [fasting triglycerides (mg/dL) × fasting plasma glucose (mg/dL)/2]. Results Kaplan-Meier analysis revealed no significant difference in the incidence of all-cause death and cardiac death between the 2 groups. Compared with the TyG index < 8.88 group, the TyG index ≥ 8.88 group had significantly higher incidences of non-fatal MI, revascularization, cardiac rehospitalization and composite MACEs. Multivariable Cox regression models revealed that the TyG index was positively associated with all-cause death [HR (95% CI): 1.51 (1.10,2.06), P = 0.010], cardiac death [HR (95%CI): 1.68 (1.19,2.38), P = 0.004], revascularization [HR (95%CI): 1.50 (1.16,1.94), P = 0.002], cardiac rehospitalization [HR (95%CI): 1.25 (1.05,1.49), P = 0.012], and composite MACEs [HR (95%CI): 1.19 (1.01,1.41), P = 0.046] in patients with AMI. The independent predictive effect of TyG index on all-cause death and cardiac death was mainly reflected in the subgroups of male gender, body mass index ≥ 25 kg/m2, smoker, diabetes mellitus, estimated glomerular filtration rate (eGFR) ≥ 60 ml/min/1.73 m2, high-density lipoprotein cholesterol ≥ 1.01 mmol/L and left ventricular ejection fraction (LVEF) ≥ 0.50. The results also revealed that diabetes mellitus, previous AMI, eGFR, LVEF, and multi-vessel/left main coronary artery lesions were independent predictors of MACEs in patients with AMI (all P < 0.05). Conclusions High TyG index levels appeared to be associated with an increased risk of MACEs in patients with AMI. The TyG index might be a valid predictor of cardiovascular outcomes of patients with AMI. Trial registration: retrospectively registered

scholarly journals CMR-derived myocardial strain analysis differentiates ischemic and dilated cardiomyopathy - A propensity score-matched study

2021 ◽  
Author(s):  
Julia Vietheer ◽  
Lehmann Lena ◽  
Claudia Unbehaun ◽  
Ullrich Fischer-Rasokat ◽  
Jan Sebastian Wolter ◽  
...  
Keyword(s):  
Propensity Score ◽  
Dilated Cardiomyopathy ◽  
Propensity Score Matching ◽  
Feature Tracking ◽  
Global Longitudinal Strain ◽  
Myocardial Strain ◽  
Radial Strain ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Myocardial Strain Analysis

Abstract Purpose Left ventricular (LV) longitudinal, circumferential, and radial motion can be measured using feature tracking of cardiac magnetic resonance (CMR) images. The aim of our study was to detect differences in LV mechanics between patients with dilated cardiomyopathy (DCM) and ischemic cardiomyopathy (ICM) who were matched using a propensity score-based model. Methods Between April 2017 and October 2019, 1224 patients were included in our CMR registry, among them 141 with ICM and 77 with DCM. Propensity score matching was used to pair patients based on their indexed end-diastolic volume (EDVi), ejection fraction (EF), and septal T1 relaxation time. Feature tracking provided six parameters for global longitudinal, circumferential, and radial strain with corresponding strain rates. Results Propensity score matching yielded 72 patients in each group (DCM mean age 58.6 ± 11.6 years, 15 females; ICM mean age 62.6 ± 13.2 years, 11 females, p = 0.084 and 0.44 respectively; LV-EF 32.2 ± 13.5% vs. 33.8 ± 12.1%, p = 0.356; EDVi 127.2 ± 30.7 ml/m² vs. 121.1 ± 41.8 ml/m², p = 0.251; native T1 values 1165 ± 58 ms vs. 1167 ± 70 ms, p = 0.862). There was no difference in global longitudinal strain between DCM and ICM patients (-10.9 ± 5.5% vs. -11.2 ± 4.7%, p = 0.72), whereas in DCM patients there was a significant reduction in global circumferential strain (-10.0 ± 4.5% vs. -12.2 ± 4.7%, p = 0.002) and radial strain (17.1 ± 8.51 vs. 21.2 ± 9.7%, p = 0.039). Conclusion Our data suggest that ICM and DCM patients have inherently different myocardial mechanics, even if phenotypes are similar. The ability to discriminate these two conditions may aid in developing additional prognostic and therapeutic strategies in the future.

Abstract 215: Effect of Adipose Tissue-derived Stromal Cell Transplantation in Mouse Model of Acute Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Long-Hao Yu ◽  
Moo H Kim ◽  
Dong S Kum ◽  
Tae H Park ◽  
Kwang S Cha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adipose Tissue ◽  
Mouse Model ◽  
Cell Transplantation ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Favorable Effect ◽  
Intramyocardial Injection ◽  
Significant Difference

Background: Adipose tissue has been identified as a source of multipotent cells that have the capacity to differentiate into cardiac myocytes, endothelial cells, similar to bone marrow cells. We sought to investigate the effect of adipose tissue-derived stromal cells (ADSCs) therapy on cardiac contractility and remodeling in C57BL/6 mouse model of acute myocardial infarction (AMI). Materials and Methods: Total 30 adult male C58BL/6 mice (12 weeks of age, 28~30g body weight) were used for the study. Mice were randomized into two groups (MI + media, n = 15 and MI + ADSCs, n= 15) after producing AMI by ligation of left anterior descending coronary artery. Intramyocardial injection of 1 × 10 6 ADSCs cells was compared to the injection of media alone. Ten animals were excluded from further analyses because of death. Most of them died 7 to 10 days after AMI, a mouse died duing surgical procedure following LAD ligation. All survived mice (n = 20) were received echocardiograpic analysis before and 2 weeks after cell transplantation, and then sacrificed for histologic analysis. Results: The fractional shortening and left ventricular ejection fraction improved significantly in ADSCs transplant group at 2 weeks compared to control group ( 20.9 ± 3.48% vs 29.9 ± 8.6%, p = 0.006 and 46.4 ± 7.6% vs 63.1 ± 12.8%, p = 0.002 ). Left ventricular end dialstolic dimension in ADSCs transplant group showed a little decrease from 4.65 ± 0.63 mm (control) to 4.14 ± 0.53 mm (ADSC), but there was no statistical difference ( p < 0.072), whereas left ventricle end-systolic diameter decreased significantly in cell transplantation group ( p < 0.05). Also, there were significant difference in injury size, infarct area, wall thickness or scar formation in ADSC group. In histochemical analysis, ADSCs have been shown to migrate into the injured sites and to integrate into the scar areas with some of transplanted ADSCs expressing endothelial marker. Conclusion: ADSCs improved left ventricular function and showed favorable effect on remodeling. They could be a good candidate for the source of cell therapy after myocardial injury.

scholarly journals ADP-induced platelet reactivity and bleeding events in patients with acute myocardial infarction complicated by cardiogenic shock

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
C Scherer ◽  
E Luesebrink ◽  
S Massberg ◽  
D Sibbing ◽  
M Orban
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Platelet Aggregation ◽  
Cardiogenic Shock ◽  
Platelet Reactivity ◽  
Bleeding Risk ◽  
Left Ventricular ◽  
Severe Bleeding ◽  
Bleeding Events ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Background While previous reports showed ADP-induced platelet reactivity to be an independent predictor of bleeding after PCI in stable patients, this has never been investigated in patients with cardiogenic shock (CS). Methods The association of bleeding events with respect to ADP-induced platelet aggregation was investigated in patients undergoing primary PCI for acute myocardial infarction complicated by cardiogenic shock (AMI-CS) and with available on-treatment ADP-induced platelet aggregation measurements. Results Out of 233 patients, 74 suffered from a severe BARC 3 or higher bleed. ADP-induced platelet aggregation was significantly lower in patients with BARC≥3 bleedings (10 AU [IQR 3 - 13] vs. 15 AU [IQR 9 - 25], p &lt; 0.001). Multivariate analysis identified on-treatment ADP-induced platelet aggregation as an independent risk factor for bleeding (HR = 0.968 per AU, 95% confidence interval (CI) 0.942-0.994). An optimal cut-off value of &lt;12 AU for ADP-induced platelet aggregation to predict BARC≥3 bleedings was identified via ROC analysis. Moreover, use of VA-ECMO (HR 1.972, 95% CI 1.003-3.879) or coaxial left ventricular pump (HR 2.593, 95% CI 1.509-4.455), first lactate (HR 1.093 per mmol/l, 95% CI 1.037-1.152) and thrombocyte count (HR 0.994 per G/l, 95% CI 0.990-0.998) were independent predictors of BARC≥3 bleedings. There was no significant difference in survival nor ischemic events between patients with low and high on-treatment platelet reactivity. Conclusion: Lower on-treatment ADP-induced platelet aggregation was independently associated with severe bleeding events in patients with AMI-CS. The value of platelet function testing for bleeding risk prediction and guidance of anti-thrombotic treatment in CS warrants further investigation.

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