Predictive Value of Cardiac Magnetic Resonance Feature Tracking after Acute Myocardial Infarction: A Comparison with Dobutamine Stress Echocardiography

In acute ST-segment elevation myocardial infarction (STEMI) late gadolinium enhancement (LGE) may underestimate segmental functional recovery. We evaluated the predictive value of cardiac magnetic resonance (CMR) feature-tracking (FT) for functional recovery and whether it incremented the value of LGE compared to low-dose dobutamine stress echocardiography (LDDSE) and speckle-tracking echocardiography (STE). Eighty patients underwent LDDSE and CMR within 5–7 days after STEMI and segmental functional recovery was defined as improvement in wall-motion at 6-months CMR. Optimal conventional and FT parameters were analyzed and then also applied to an external validation cohort of 222 STEMI patients. Circumferential strain (CS) was the strongest CMR-FT predictor and addition to LGE increased the overall accuracy to 74% and was especially relevant in segments with 50–74% LGE (AUC 0.60 vs. 0.75, p = 0.001). LDDSE increased the overall accuracy to 71%, and in the 50–74% LGE subgroup improved the AUC from 0.60 to 0.69 (p = 0.039). LGE + CS showed similar value as LGE + LDDSE. In the validation cohort, CS was also the strongest CMR-FT predictor of recovery and addition of CS to LGE improved overall accuracy to 73% although this difference was not significant (AUC 0.69, p = 0.44). Conclusion: CS is the strongest CMR-FT predictor of segmental functional recovery after STEMI. Its incremental value to LGE is comparable to that of LDDSE whilst avoiding an inotropic stress agent. CS is especially relevant in segments with 50–74% LGE where accuracy is lower and further testing is frequently required to clarify the potential for recovery.

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Prediction of functional recovery by cardiac magnetic resonance feature tracking imaging in first time ST-elevation myocardial infarction. Comparison to infarct size and transmurality by late gadolinium enhancement

International Journal of Cardiology ◽

10.1016/j.ijcard.2015.01.022 ◽

2015 ◽

Vol 183 ◽

pp. 162-170 ◽

Cited By ~ 31

Author(s):

Sebastian J. Buss ◽

Birgit Krautz ◽

Nina Hofmann ◽

Yannick Sander ◽

Lukas Rust ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiac Magnetic Resonance ◽

Late Gadolinium Enhancement ◽

Magnetic Resonance ◽

Infarct Size ◽

Functional Recovery ◽

Feature Tracking ◽

Gadolinium Enhancement ◽

St Elevation ◽

First Time

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Assessment of myocardial viability after acute myocardial infarction by global longitudinal 2d strain at rest and during low dose dobutamine stress echocardiography: Comparison with cardiac magnetic resonance imaging

Archives of Cardiovascular Diseases ◽

10.1016/j.acvd.2013.03.026 ◽

2013 ◽

Vol 106 (4) ◽

pp. 254

Author(s):

F. Levy ◽

S. Abouth ◽

C. Renard ◽

C. Szymanski ◽

D. Malaquin ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiac Magnetic Resonance ◽

Stress Echocardiography ◽

Low Dose ◽

Dobutamine Stress Echocardiography ◽

Dobutamine Stress ◽

Resonance Imaging ◽

2D Strain

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789-1 Dobutamine Stress Echocardiography and Rest Thallium-201 Scintigraphy in Patients with Previous Myocardial Infarction and Single Coronary Lesion: Prediction of Functional Recovery After Revascularization

Journal of the American College of Cardiology ◽

10.1016/0735-1097(95)92869-7 ◽

1995 ◽

Vol 25 (2) ◽

pp. 340A ◽

Cited By ~ 1

Author(s):

Salvatore Pirelli ◽

Wilma Crivellaro ◽

Francesco Faletra ◽

Manlio Cipriani ◽

Livia Ruffini ◽

...

Keyword(s):

Myocardial Infarction ◽

Functional Recovery ◽

Stress Echocardiography ◽

Dobutamine Stress Echocardiography ◽

Dobutamine Stress ◽

Thallium 201 ◽

Previous Myocardial Infarction ◽

Coronary Lesion ◽

Thallium 201 Scintigraphy

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P6183Diagnostic performance of coronary computed tomography angiography-derived fractional flow reserve in patients with acute myocardial infarction and moderate non-culprit coronary stenosis

European Heart Journal ◽

10.1093/eurheartj/ehz746.0789 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

B Jablonkai ◽

A Ahres ◽

G Ruboczky ◽

B Nagybaczoni ◽

A Oze ◽

...

Keyword(s):

Myocardial Infarction ◽

Diagnostic Accuracy ◽

Fractional Flow Reserve ◽

Predictive Value ◽

Stress Echocardiography ◽

Dobutamine Stress Echocardiography ◽

Prospective Trial ◽

Dobutamine Stress ◽

Fractional Flow ◽

Flow Reserve

Abstract Background Revascularisation of significant non-culprit coronary lesions (NCL) may improve clinical outcome in patients with myocardial infarction and multi vessel disease, however management of moderate NCLs is still controversial. Dobutamine stress echocardiography (DSE) and invasive fractional flow reserve (FFR) are accepted methods to detect myocardial ischemia, nevertheless coronary CT angiography-derived fractional flow reserve (CT-FFR) is a new modality, which has not been widely investigated to date in patients with NCLs. Purpose Our aim was to determine the diagnostic performance of CT-FFR compared to DSE and invasive FFR. Methods In this prospective trial, DSE, FFR and CT-FFR were performed in every patient with MI and at least one moderate NCL (30–70% diameter stenosis by visual assessment). New or worsening wall motion abnormality in at least two contiguous myocardial segments on DSE, and FFR value<0.8 in invasive FFR and CT-FFR as well were determined as abnormal. In comparison, DSE and FFR were regarded as reference standard methods. Results Between March of 2017 and December of 2018, 51 patients (58.2±10.4 years, 74.5% male) were enrolled and 71 NCLs (40 LAD, 13 LCx, 18 RCA) were investigated. Dobutamine stress echocardiography, FFR and CT-FFR were positive in 30.9%, 32.3% and 22.5% of all lesions, respectively. FFR values were higher with CT-FFR compared to invasive FFR (0.85±0.11 vs. 0.83±0.08, p<0.05). Compared to DSE, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of CT-FFR were 40.9%, 85.7%, 56.2%, 76.3% and 71.8%, respectively. The same values were 39.1%, 85.4%, 56.2%, 74.5% and 70.4% compared to invasive FFR, respectively. Correspondence of CT-FFR with DSE (k=0.29) and with FFR (k=0.27) was weak. Conclusion This is the first study that compares the three modalities in the evaluation of moderate NCLs. Our results demonstrated moderate diagnostic accuracy, excellent specificity, poor sensitivity and PPV and acceptable NPV of CT-FFR compared to DSE and FFR. At this stage, CT-FFR is probably not accurate enough to determine revascularisation strategy of moderate NCLs as a single non-invasive method.

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