Early Cardiac Magnetic Resonance-derived Cardiac Strain as a Predictor of Adverse Events and Ventricular Remodeling in Patients with Reperfused STEMI: A Two-center Cohort Study

Abstract

Abstract Purpose The main purpose of this study was to investigate the predictive value of cardiac magnetic resonance (CMR)-derived strains for post-infarction left ventricular adverse remodeling (LVAR) and clinical events in an East Asian patient cohort of ST-segment elevation myocardial infarction (STEMI). Methods Patients diagnosed with STEMI and treated with primary percutaneous coronary intervention (PCI) comprising stent implantation at Chinese two centers were enrolled in this prospective cohort study. All participants underwent CMR imaging early after stenting. Feature tracking was used to assess left ventricular (LV) strains. The primary endpoints were major adverse cardiac events (MACE) and LVAR (defined as 15% increase in LV end-diastolic volume) in 6-month follow up. Results Among the 76 patients included (age 55.5 ± 10.7 years; 88% male), 18 (23.7%) experienced a MACE event. Global longitudinal strain (GLS) revealed by FT-CMR was confirmed to be the independent predictor of MACE (OR = 1.21 (1.07–1.36); P = 0.001). The area under the ROC curve was 0.763. The best cutoff value of GLS for predicting MACE was − 14.6%, with a diagnostic sensitivity of 72.2% and a diagnostic specificity of 74.2%. LVAR was found in 7 patients (29.2%) among the 24 patients underwent CMR imaging at 6-month follow-up time. GLS was an independent predictor of LVAR (OR = 2.06 (1.14–3.73); P = 0.017). Conclusion In STEMI patients treated with primary PCI, GLS determined on early CMR could be an independent predictor of MACE and LVAR.