Impact of Concomitant Impairments of the Left and Right Ventricular Myocardial Strain on the Prognoses of Patients With ST-Elevation Myocardial Infarction

Frontiers in Cardiovascular Medicine

article

Wei Lai¹  He Jie¹  Dong Jian-Xun¹  Kong Ling-Cong¹  Zeng Jun-Tong¹  Shi Bo-Zhong¹  An Dong-Ao-Lei²  Chen Bing-Hua²  Ding Song¹  Li Zheng¹  Yang Fan¹  Yang Yi-Ning³  Yan Fu-Hua⁴  Xiu Jian-Cheng⁵  Wang Hu-Wen⁶  Xu Jian-Rong²  Ge Heng¹  Pu Jun¹ 

[1] Department of Cardiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University;Department of Radiology, School of Medicine, Renji Hospital, Shanghai Jiao Tong University;The First Affiliated Hospital, Xinjiang Medical University;Department of Radiology, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University;Nanfang Hospital, Southern Medical University;School of Public Health, Shanghai Jiaotong University

关键词: ST-elevation myocardial infarction;    cardiac magnetic resonance;    myocardial strain analysis;    right ventricle;    prognostic implications;   

DOI  :  10.3389/fcvm.2021.659364

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Background: The impact of concomitant impairments of left and right ventricular (LV and RV) strain on the long-term prognosis of acute ST-elevation myocardial infarction (STEMI) is not clear. Methods: We analyzed CMR images and followed up 420 first STEMI patients from the EARLY Assessment of MYOcardial Tissue Characteristics by CMR in STEMI (EARLY-MYO-CMR) registry ( {"type":"clinical-trial","attrs":{"text":"NCT03768453","term_id":"NCT03768453"}} NCT03768453 ). These patients received timely primary percutaneous coronary intervention (PCI) within 12 h and CMR examination within 1 week (median, 5 days; range, 2–7 days) after infarction. Global longitudinal strain (GLS), global radial strain (GRS), and global circumferential strain (GCS) of both ventricles were measured based on CMR cine images. Conventional CMR indexes were also assessed. Primary clinical outcome was composite major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, re-hospitalization for heart failure and stroke. In addition, CMR data from 40 people without apparent heart disease were used as control group. Results: Compared to controls, both LV and RV strains were remarkably reduced in STEMI patients. During follow-up (median: 52 months, interquartile range: 29–68 months), 80 patients experienced major adverse cardiac and cerebrovascular events (MACCEs) including cardiovascular death, re-infarction, heart failure, and stroke. LV-GCS > −11.20% was an independent predictor of MACCEs ( P −11.20% ( P = 0.012) was correlated with lower RV-GRS. Conclusions: The concomitant decrease of LV and RV strain is associated with a worse long-term prognosis than impaired LV strain alone. Combination assessment of both LV and RV strain indexes could improve risk stratification of patients with STEMI. Trial Registration:ClinicalTrials.gov , {"type":"clinical-trial","attrs":{"text":"NCT03768453","term_id":"NCT03768453"}} NCT03768453 . Registered 7 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/ {"type":"clinical-trial","attrs":{"text":"NCT03768453","term_id":"NCT03768453"}} NCT03768453 .

【 授权许可】

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