Comparison of Left Ventricular Global Strain in Anterior and Non-anterior Wall Myocardial Infarction With CMR Tissue Tracking.

Shuhao Li,Jie Tian,Aijia Lu,Lianggeng Gong,Xiaohai Ma,Lei Zhao

doi:10.3389/fphys.2020.530108

Abstract

Left ventricular (LV) myocardial dysfunction occurs after myocardial infarction (MI) is associated with the location, infarct size, and transmurality degrees of MI. The myocardial strain is a sensitive index used for the quantification of myocardium dysfunction. This study used Tissue-Tracking to evaluate whether the different location of MI would result in different myocardial dysfunction. One hundred patients diagnosed with MI who underwent cardiovascular magnetic resonance examination were included. The tissue-tracking indices, LV global radial strain (GRS), global circumferential strain (GCS), global longitudinal strain (GLS), and the infarct size (IS,% of LV mass) were quantified. There were 42 cases of anterior wall MI (AWMI) and 58 cases of non-anterior wall MI (NAWMI). The GCS of AWMI was significantly lower than that of NAWMI (P = 0.036). In the same level of infarct size, the myocardial strain of AWMI was not significantly different from NAWMI group (P > 0.05). The GRS and GCS were significantly different between transmurality > 50% group with transmurality ≤ 50% group (P < 0.05). The present study demonstrated that LV MI is associated with reduced myocardial strain, and the infarct size and degrees of transmurality were both related to the decline of myocardial strain in patients with MI.

Highlights

According to the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction, anterior wall myocardial infarction (AWMI) is a risk assessment index of Major Adverse Cardiovascular Events (MACE) (O’Gara et al, 2013)
The infarct size of the AWMI group was larger than the nonanterior wall MI (NAWMI) group (22 ± 9 vs. 14 ± 9, P < 0.001) (Table 2 and Figure 4)
The present study indicated that: (1) There is no relationship between post infarction myocardial strain reduction and infarction location; (2) Post-infarction strain reduction is related to transmurality or infarct size

Summary

Introduction

According to the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction, anterior wall myocardial infarction (AWMI) is a risk assessment index of Major Adverse Cardiovascular Events (MACE) (O’Gara et al, 2013). MI most likely occurs in the domain of the left anterior descending artery (LAD) (Park et al, 2014; Postma et al, 2015; Stone et al, 2016), which supplies nearly two-thirds of the whole heart blood (Bastiany et al, 2017). Previous studies have suggested that the prognosis of patients with AWMI is significantly worse compared to patients with inferior wall MI (Geltman et al, 1979; Thanavaro et al, 1982; Hands et al, 1986; Bourke et al, 1988; Stone et al, 1988).

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Conclusion