Circumferential strain acquired by CMR early after acute myocardial infarction adds incremental predictive value to late gadolinium enhancement imaging to predict late myocardial remodeling and subsequent risk of sudden cardiac death

• Published in: Journal of interventional cardiac electrophysiology 2017-12, Vol.50 (3), p.211-218
• Main Authors: Holmes, Anthony A., Romero, Jorge, Levsky, Jeffrey M., Haramati, Linda B., Phuong, Newton, Rezai-Gharai, Leila, Cohen, Stuart, Restrepo, Lina, Ruiz-Guerrero, Luis, Fisher, John D., Taub, Cynthia C., Di Biase, Luigi, Garcia, Mario J.
• Format: Article
• Language: English
• Subjects: Accuracy; Cardiology; Defibrillators; Echocardiography; Gadolinium; Heart; Heart attacks; Heart diseases; Magnetic resonance; Medicine; Medicine & Public Health; Microvasculature; Multimedia Report; Myocardial infarction; Patients; Segments
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1007/s10840-017-0296-9

Purpose Late adverse myocardial remodeling after acute myocardial infarction (AMI) is strongly associated with sudden cardiac death (SCD). Cardiac magnetic resonance (CMR) performed early after AMI can predict late remodeling and SCD risk with moderate accuracy. This study assessed the ability of CMR-measured circumferential strain (CS) to add incremental predictive information to late gadolinium enhancement (LGE). Methods Patients with an AMI and LVEF  1 measured by echocardiography 3 months after PCI. Results A total of 141 segments experienced the primary endpoint at 3 months. The mean LGE volume was higher in these segments, but LGE was also present in many segments with normal WMS (40 ± 28 versus 20 ± 26%, p   17% and impaired CS >− 7.2% on CMR were more likely to experience late adverse remodeling (73%) as compared to segments with neither (9%, p   17% for predicting late adverse remodeling (AUC 0.81 from 0.70, p