Abstract
Aim: Scarce data are available regarding the prognostic impact of left ventricular (LV) dyssynchrony among patients with recent ST-segment elevation myocardial infarction (STEMI). Aim of the present study was to investigate the long-term prognostic value of LV dyssynchrony as assessed by feature-tracking CMR (FT-CMR) in patients with a first STEMI.
Methods: 107 patients with a first STEMI (mean age 59±12 years, 82% male) were included. All patients underwent primary PCI. After a median of 8 days (IQ range 4-18) following admission, CMR with LGE imaging was performed to assess LV function and infarct size (IS). In addition, feature-tracking analysis was applied to cine CMR basal, mid and apical short-axis images to assess LV dyssynchrony, defined as the standard deviation of the time-to-peak radial strain of the LV segments expressed as per cent cardiac cycle (systolic dyssynchrony index [SDI]). Patients were followed-up for a median of 97 months (IQ range 32-101); the primary endpoint was defined as a composite of death, myocardial infarction and hospitalisation due to heart failure.
Results: Median IS was 14% of the LV mass (IQ range 5-30) while median SDI was 16.7% (IQ range 9.6-21.2%). The outcome event occurred in 22% of patients. At multivariate Cox proportional-hazards analysis, after correction for the traditional clinical prognostic parameters, IS (HR 1.05, IC 1.01-1.08; p=0.007) and SDI (HR 1.08, IC 1.01-1.17; p=0.031) were the only variables significantly and independently related to the primary endpoint.
Conclusion: CMR assessment of SDI after a first STEMI provides significant and independent long-term prognostic information
Methods: 107 patients with a first STEMI (mean age 59±12 years, 82% male) were included. All patients underwent primary PCI. After a median of 8 days (IQ range 4-18) following admission, CMR with LGE imaging was performed to assess LV function and infarct size (IS). In addition, feature-tracking analysis was applied to cine CMR basal, mid and apical short-axis images to assess LV dyssynchrony, defined as the standard deviation of the time-to-peak radial strain of the LV segments expressed as per cent cardiac cycle (systolic dyssynchrony index [SDI]). Patients were followed-up for a median of 97 months (IQ range 32-101); the primary endpoint was defined as a composite of death, myocardial infarction and hospitalisation due to heart failure.
Results: Median IS was 14% of the LV mass (IQ range 5-30) while median SDI was 16.7% (IQ range 9.6-21.2%). The outcome event occurred in 22% of patients. At multivariate Cox proportional-hazards analysis, after correction for the traditional clinical prognostic parameters, IS (HR 1.05, IC 1.01-1.08; p=0.007) and SDI (HR 1.08, IC 1.01-1.17; p=0.031) were the only variables significantly and independently related to the primary endpoint.
Conclusion: CMR assessment of SDI after a first STEMI provides significant and independent long-term prognostic information
| Original language | English |
|---|---|
| Journal | Heart Lung and Circulation |
| Volume | 25 |
| Issue number | Supplement 2 |
| Publication status | Published or Issued - Aug 2016 |
| Event | Cardiac Society of Australia and New Zealand ASM 2016 - Adelaide Convention Centre, Adelaide, Australia Duration: 4 Aug 2016 → 7 Aug 2016 |