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Left atrial and ventricular longitudinal strain by cardiac magnetic resonance feature tracking improves prognostic stratification of patients with ST-segment elevation myocardial infarction

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Abstract

We aimed to investigate the predictive value of left atrium (LA) and left ventricle (LV) longitudinal strain derived by CMR-FT early after ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Patients with STEMI who received pPCI and completed CMR within the following week were enrolled. LA and LV longitudinal strain parameters were derived from cine CMR by FT; conventional CMR indexes were also performed. The primary endpoint was the occurrence of major cardiovascular adverse events (MACE), defined as a composite of death, reinfarction, and congestive heart failure (HF). 276 participants (median age, 57 years, IQR, 48–66 years; 85% men) were included in this study. CMR was usually completed on the 5 (IQR,4–7) days after pPCI. During a median follow-up of 16 months, MACE occurred in 35 (12.7%) participants. Multivariable Cox regression analysis showed that LA conduit strain (HR 0.91, 95%CI: 0.84, 0.98, p = 0.013) and LV global longitudinal strain (HR 1.17, 95%CI: 1.03, 1.34, p = 0.016) remained independently associated with MACE. Participants with impaired LA conduit strain (≤ 12.8%) and LV global longitudinal strain (> -13.1%) had a higher risk of MACE than those with preserved. Longitudinal strain of LA and LV could provide independent prognostic information in STEMI patients, and comprehensive assessment of Left atrial and ventricular longitudinal strain significantly improved the prognosis.

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Fig. 1
Fig. 2

Data availability

No datasets were generated or analysed during the current study.

Abbreviations

GLS:

global longitudinal strain

BSA:

body surface area, LA: left atrial, LV: left ventricle

LAEF:

left atrial ejection fraction

εs :

reservoir strain

εe :

conduit strain

εa :

booster strain

SRs :

reservoir strain rate

SRe :

conduit strain rate

SRa :

booster strain rate

CMR:

cardiac magnetic resonance

FT:

feature tracking

MVO:

microvascular obstruction

STEMI:

ST elevation myocardial infarction

CE-SSFP:

contrast-enhanced steady-state free precession

MACE:

major cardiovascular adverse events

pPCI:

primary percutaneous coronary intervention

CI:

confidence interval

HR:

hazard ratio

LGE:

late gadolinium enhancement

LVEF:

left ventricle ejection fraction

EDV:

end diastolic volume

ESV:

end systolic volume

SV:

stroke volume

LVMM:

LV myocardial mass

Hs-cTnT:

high-sensitivity cardiac troponin T

IQR:

interquartile ranges

LAD:

left anterior descending coronary artery

LCX:

left circumflex coronary artery

RCA:

right coronary artery

BSA:

body surface area

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Author notes

  1. Min Zhang and Zhi Li contributed equally to this work.

Authors and Affiliations

  1. Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99#, Huaihai West Road, Xuzhou, 221002, China

    Min Zhang, Zhi Li, Yiwen Wang, Lei Chen, Yanfei Ren, Yixuan Wu & Yuan Lu

  2. Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, 99#, Huaihai West Road, Xuzhou, China

    Jiali Wang

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Contributions

MZ and ZL significantly contributed to the research design, data interpretation, manuscript writing, and modification. YXW and LC were involved in data collection and analysis. YWW and YFC performed the patient studies; JLW performed CMR image acquisition and postprocessing analysis. YL directed the entire research work and corrected the articles. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Yuan Lu.

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Ethics approval and consent to participate

This study complied with the Declaration of Helsinki and was approved by the Ethics Committee of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China. The patients provided their written informed consent to participate in this study.

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The authors declare no competing interests.

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Zhang, M., Li, Z., Wang, Y. et al. Left atrial and ventricular longitudinal strain by cardiac magnetic resonance feature tracking improves prognostic stratification of patients with ST-segment elevation myocardial infarction. Int J Cardiovasc Imaging (2024). https://doi.org/10.1007/s10554-024-03174-z

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