Author + information
- Received May 31, 2017
- Revision received November 15, 2017
- Accepted November 27, 2017
- Published online February 14, 2018.
- Ingo Eitel, MDa,b,∗ (, )
- Thomas Stiermaier, MDa,b,
- Torben Lange, BScc,d,
- Karl-Philipp Rommel, MDe,
- Alexander Koschalka, BScc,d,
- Johannes T. Kowallick, MDd,f,
- Joachim Lotz, MDd,f,
- Shelby Kutty, MD, PhD, MHCMg,
- Matthias Gutberlet, MDh,
- Gerd Hasenfuß, MDc,d,
- Holger Thiele, MDa,b and
- Andreas Schuster, MD, PhD, MBAc,d,i,∗∗ ()
- aUniversity Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Hospital Schleswig-Holstein, Lübeck, Germany
- bGerman Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany
- cUniversity Medical Center Göttingen, Department of Cardiology and Pneumology, Georg-August University, Göttingen, Germany
- dGerman Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany
- eUniversity of Leipzig Heart Center, Department of Internal Medicine/Cardiology, University of Leipzig, Leipzig, Germany
- fUniversity Medical Center Göttingen, Institute for Diagnostic and Interventional Radiology, Georg-August University, Göttingen, Germany
- gChildren's Hospital and Medical Center, University of Nebraska College of Medicine, Omaha, Nebraska
- hDepartment of Diagnostic and Interventional Radiology, University of Leipzig Heart Center, Leipzig, Germany
- iDepartment of Cardiology, Royal North Shore Hospital, the Kolling Institute, Northern Clinical School, University of Sydney, Sydney, Australia
- ↵∗Address for correspondence:
Dr. Ingo Eitel, University Heart Center Lübeck, University Hospital Schleswig-Holstein, Medical Clinic II, Ratzeburger Allee 160, 23538 Lübeck, Germany.
- ↵∗∗Dr. Andreas Schuster, University Medical Center, Georg-August-University Göttingen, Department of Cardiology and Pneumology, Robert-Koch-Straße 40, 37099 Göttingen, Germany.
Objectives The aims of the study were to assess the prognostic significance of cardiac magnetic resonance myocardial feature tracking (CMR-FT) in a large multicenter study and to evaluate the most potent CMR-FT predictor of hard clinical events following myocardial infarction (MI).
Background CMR-FT is a new method that allows accurate assessment of global and regional circumferential, radial, and longitudinal myocardial strain. The prognostic value of CMR-FT in patients with reperfused MI is unknown.
Methods The study included 1,235 MI patients (n = 795 with ST-segment elevation MI and 440 with non–ST-elevation MI) at 15 centers. All patients were reperfused by primary percutaneous coronary intervention. Central core laboratory–masked analyses were performed to determine left ventricular (LV) circumferential, radial, and longitudinal strain. The primary clinical endpoint of the study was the occurrence of major adverse cardiac events within 12 months after infarction.
Results Patients with cardiovascular events had significantly impaired CMR-FT strain values (p < 0.001 for all). Global longitudinal strain was identified as the strongest CMR-FT parameter of future cardiovascular events and emerged as an independent predictor of poor prognosis following MI even after adjustment for established prognostic markers. Global longitudinal strain provided an incremental prognostic value for all-cause mortality above LV ejection fraction (c-index increase from 0.65 to 0.73; p = 0.04) and infarct size (c-index increase from 0.60 to 0.78; p = 0.002).
Conclusions CMR-FT is a superior measure of LV function and performance early after reperfused MI with incremental prognostic value for mortality over and above LV ejection fraction and infarct size. (Abciximab i.v. Versus i.c. in ST-segment elevation Myocardial Infarction [AIDA STEMI]; NCT00712101; Thrombus Aspiration in ThrOmbus Containing culpRIT Lesions in Non-ST-Elevation Myocardial Infarction [TATORT-NSTEMI]; NCT01612312).
Dr. Gutberlet has received speaker honoraria from Siemens, Philips, Bayer, and Bracco. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Eitel and Stiermaier contributed equally to this work and are joint first authors.
- Received May 31, 2017.
- Revision received November 15, 2017.
- Accepted November 27, 2017.
- 2018 American College of Cardiology Foundation
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