Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus
Background Myocardial strain provides a novel means of quantifying subtle alterations in contractile function; incremental utility post‐MI is unknown. Objectives To test longitudinal—quantified by postprocessing routine echo—for assessment of MI size measured by cardiac magnetic resonance (CMR) and...
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| Veröffentlicht in: | Echocardiography (Mount Kisco, N.Y.) N.Y.), 2017-11, Vol.34 (11), p.1623-1632 |
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| creator | Kim, Jiwon Rodriguez‐Diego, Sara Srinivasan, Aparna Brown, Rachel‐Maria Pollie, Meridith P. Di Franco, Antonino Goldburg, Samantha R. Siden, Jonathan Y. Ratcliffe, Mark B. Levine, Robert A. Devereux, Richard B. Weinsaft, Jonathan W. |
| description | Background
Myocardial strain provides a novel means of quantifying subtle alterations in contractile function; incremental utility post‐MI is unknown.
Objectives
To test longitudinal—quantified by postprocessing routine echo—for assessment of MI size measured by cardiac magnetic resonance (CMR) and conventional methods, and assess regional and global strain (GLS) as markers of LV thrombus.
Methods
The population comprised of patients with anterior ST‐segment MI who underwent echo and CMR prospectively. Preexisting echoes were retrieved, re‐analyzed for strain, and compared to conventional MI markers as well as CMR‐evidenced MI, function, and thrombus.
Results
Seventy‐four patients underwent echo and CMR 4 ± 1 weeks post‐MI; 72% had abnormal GLS. CMR‐quantified MI size was 2.5‐fold larger and EF lower among patients with abnormal GLS, paralleling 2.6–3.1 fold differences in Q‐wave size and CPK (all P ≤ .002). GLS correlated with CMR‐quantified MI (r = .66), CPK (r = .52) and Q‐wave area (r = .44; all P ≤ .001): Regional strain was lower in the base, mid, and apical LV among patients with CMR‐defined transmural MI in each territory (P |
| doi_str_mv | 10.1111/echo.13668 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5985969</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1932167000</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3358-2bbd8fb36bff56d8e6532d1f7ae43cad9d8f103e2657e67ed68b6c6843d72bb53</originalsourceid><addsrcrecordid>eNp9kUFu1DAYhS0EokNhwwGQlwgpJbYTx9kgodFAkSp1A2vLsX9PTJ14aidFw6pHYIE4YE-CZ1Iq2OCNZb3vPf_2Q-glKc9IXm9B9-GMMM7FI7QidVUWgjT1Y7Qqm4oWVFB6gp6l9LUsy4aQ6ik6oUIwVpN2hX5tslmraFzYRrXr93e3P65nNU7OOjB42C-i8jhNUbnx7vanwoOKVxBxsHjrQ5c1NRocYevCmA9utCrqCSf3HfDUq-loPQYm7N0VeNeHYA52D3bCNzBO0enZq5jxGIZuTs_RE6t8ghf3-yn68mHzeX1eXFx-_LR-f1HoPL8oaNcZYTvGO2trbgTwmlFDbKOgYlqZNqukZEB53QBvwHDRcc1FxUyTvTU7Re-W3N3cDWD0YRTl5S66_Ma9DMrJf5XR9XIbbmTdirrlbQ54fR8Qw_UMaZKDSxq8VyOEOUnSMkp4k78-o28WVMeQUgT7cA0p5aFIeShSHovM8Ku_B3tA_zSXAbIA35yH_X-i5GZ9frmE_gZZFbEa</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1932167000</pqid></control><display><type>article</type><title>Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus</title><source>Wiley Online Library - AutoHoldings Journals</source><creator>Kim, Jiwon ; Rodriguez‐Diego, Sara ; Srinivasan, Aparna ; Brown, Rachel‐Maria ; Pollie, Meridith P. ; Di Franco, Antonino ; Goldburg, Samantha R. ; Siden, Jonathan Y. ; Ratcliffe, Mark B. ; Levine, Robert A. ; Devereux, Richard B. ; Weinsaft, Jonathan W.</creator><creatorcontrib>Kim, Jiwon ; Rodriguez‐Diego, Sara ; Srinivasan, Aparna ; Brown, Rachel‐Maria ; Pollie, Meridith P. ; Di Franco, Antonino ; Goldburg, Samantha R. ; Siden, Jonathan Y. ; Ratcliffe, Mark B. ; Levine, Robert A. ; Devereux, Richard B. ; Weinsaft, Jonathan W.</creatorcontrib><description>Background
Myocardial strain provides a novel means of quantifying subtle alterations in contractile function; incremental utility post‐MI is unknown.
Objectives
To test longitudinal—quantified by postprocessing routine echo—for assessment of MI size measured by cardiac magnetic resonance (CMR) and conventional methods, and assess regional and global strain (GLS) as markers of LV thrombus.
Methods
The population comprised of patients with anterior ST‐segment MI who underwent echo and CMR prospectively. Preexisting echoes were retrieved, re‐analyzed for strain, and compared to conventional MI markers as well as CMR‐evidenced MI, function, and thrombus.
Results
Seventy‐four patients underwent echo and CMR 4 ± 1 weeks post‐MI; 72% had abnormal GLS. CMR‐quantified MI size was 2.5‐fold larger and EF lower among patients with abnormal GLS, paralleling 2.6–3.1 fold differences in Q‐wave size and CPK (all P ≤ .002). GLS correlated with CMR‐quantified MI (r = .66), CPK (r = .52) and Q‐wave area (r = .44; all P ≤ .001): Regional strain was lower in the base, mid, and apical LV among patients with CMR‐defined transmural MI in each territory (P < .05) and correlated with cine‐CMR regional EF (r = .53–.71; P < .001) and echo wall motion (r = .45–.71; P < .001). GLS and apical strain were ~2‐fold lower among patients with LV thrombus (P ≤ .002): Apical strain yielded higher diagnostic performance for thrombus (AUC: 0.83 [0.72–0.93], P = .001) than wall motion (0.73 [0.58–0.88], P = .02), as did global strain (0.78 [0.65–0.90], P = .005) compared to LVEF (0.58 [0.45–0.72], P = .41).
Conclusions
Echo‐quantified longitudinal strain provides a marker of MI size and improves stratification for post‐MI LV thrombus beyond conventional indices.</description><identifier>ISSN: 0742-2822</identifier><identifier>EISSN: 1540-8175</identifier><identifier>DOI: 10.1111/echo.13668</identifier><identifier>PMID: 28833519</identifier><language>eng</language><publisher>United States</publisher><subject>cardiac magnetic resonance imaging ; echocardiography ; strain</subject><ispartof>Echocardiography (Mount Kisco, N.Y.), 2017-11, Vol.34 (11), p.1623-1632</ispartof><rights>2017, Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3358-2bbd8fb36bff56d8e6532d1f7ae43cad9d8f103e2657e67ed68b6c6843d72bb53</citedby><cites>FETCH-LOGICAL-c3358-2bbd8fb36bff56d8e6532d1f7ae43cad9d8f103e2657e67ed68b6c6843d72bb53</cites><orcidid>0000-0002-8420-8604</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecho.13668$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecho.13668$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28833519$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Jiwon</creatorcontrib><creatorcontrib>Rodriguez‐Diego, Sara</creatorcontrib><creatorcontrib>Srinivasan, Aparna</creatorcontrib><creatorcontrib>Brown, Rachel‐Maria</creatorcontrib><creatorcontrib>Pollie, Meridith P.</creatorcontrib><creatorcontrib>Di Franco, Antonino</creatorcontrib><creatorcontrib>Goldburg, Samantha R.</creatorcontrib><creatorcontrib>Siden, Jonathan Y.</creatorcontrib><creatorcontrib>Ratcliffe, Mark B.</creatorcontrib><creatorcontrib>Levine, Robert A.</creatorcontrib><creatorcontrib>Devereux, Richard B.</creatorcontrib><creatorcontrib>Weinsaft, Jonathan W.</creatorcontrib><title>Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus</title><title>Echocardiography (Mount Kisco, N.Y.)</title><addtitle>Echocardiography</addtitle><description>Background
Myocardial strain provides a novel means of quantifying subtle alterations in contractile function; incremental utility post‐MI is unknown.
Objectives
To test longitudinal—quantified by postprocessing routine echo—for assessment of MI size measured by cardiac magnetic resonance (CMR) and conventional methods, and assess regional and global strain (GLS) as markers of LV thrombus.
Methods
The population comprised of patients with anterior ST‐segment MI who underwent echo and CMR prospectively. Preexisting echoes were retrieved, re‐analyzed for strain, and compared to conventional MI markers as well as CMR‐evidenced MI, function, and thrombus.
Results
Seventy‐four patients underwent echo and CMR 4 ± 1 weeks post‐MI; 72% had abnormal GLS. CMR‐quantified MI size was 2.5‐fold larger and EF lower among patients with abnormal GLS, paralleling 2.6–3.1 fold differences in Q‐wave size and CPK (all P ≤ .002). GLS correlated with CMR‐quantified MI (r = .66), CPK (r = .52) and Q‐wave area (r = .44; all P ≤ .001): Regional strain was lower in the base, mid, and apical LV among patients with CMR‐defined transmural MI in each territory (P < .05) and correlated with cine‐CMR regional EF (r = .53–.71; P < .001) and echo wall motion (r = .45–.71; P < .001). GLS and apical strain were ~2‐fold lower among patients with LV thrombus (P ≤ .002): Apical strain yielded higher diagnostic performance for thrombus (AUC: 0.83 [0.72–0.93], P = .001) than wall motion (0.73 [0.58–0.88], P = .02), as did global strain (0.78 [0.65–0.90], P = .005) compared to LVEF (0.58 [0.45–0.72], P = .41).
Conclusions
Echo‐quantified longitudinal strain provides a marker of MI size and improves stratification for post‐MI LV thrombus beyond conventional indices.</description><subject>cardiac magnetic resonance imaging</subject><subject>echocardiography</subject><subject>strain</subject><issn>0742-2822</issn><issn>1540-8175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kUFu1DAYhS0EokNhwwGQlwgpJbYTx9kgodFAkSp1A2vLsX9PTJ14aidFw6pHYIE4YE-CZ1Iq2OCNZb3vPf_2Q-glKc9IXm9B9-GMMM7FI7QidVUWgjT1Y7Qqm4oWVFB6gp6l9LUsy4aQ6ik6oUIwVpN2hX5tslmraFzYRrXr93e3P65nNU7OOjB42C-i8jhNUbnx7vanwoOKVxBxsHjrQ5c1NRocYevCmA9utCrqCSf3HfDUq-loPQYm7N0VeNeHYA52D3bCNzBO0enZq5jxGIZuTs_RE6t8ghf3-yn68mHzeX1eXFx-_LR-f1HoPL8oaNcZYTvGO2trbgTwmlFDbKOgYlqZNqukZEB53QBvwHDRcc1FxUyTvTU7Re-W3N3cDWD0YRTl5S66_Ma9DMrJf5XR9XIbbmTdirrlbQ54fR8Qw_UMaZKDSxq8VyOEOUnSMkp4k78-o28WVMeQUgT7cA0p5aFIeShSHovM8Ku_B3tA_zSXAbIA35yH_X-i5GZ9frmE_gZZFbEa</recordid><startdate>201711</startdate><enddate>201711</enddate><creator>Kim, Jiwon</creator><creator>Rodriguez‐Diego, Sara</creator><creator>Srinivasan, Aparna</creator><creator>Brown, Rachel‐Maria</creator><creator>Pollie, Meridith P.</creator><creator>Di Franco, Antonino</creator><creator>Goldburg, Samantha R.</creator><creator>Siden, Jonathan Y.</creator><creator>Ratcliffe, Mark B.</creator><creator>Levine, Robert A.</creator><creator>Devereux, Richard B.</creator><creator>Weinsaft, Jonathan W.</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8420-8604</orcidid></search><sort><creationdate>201711</creationdate><title>Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus</title><author>Kim, Jiwon ; Rodriguez‐Diego, Sara ; Srinivasan, Aparna ; Brown, Rachel‐Maria ; Pollie, Meridith P. ; Di Franco, Antonino ; Goldburg, Samantha R. ; Siden, Jonathan Y. ; Ratcliffe, Mark B. ; Levine, Robert A. ; Devereux, Richard B. ; Weinsaft, Jonathan W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3358-2bbd8fb36bff56d8e6532d1f7ae43cad9d8f103e2657e67ed68b6c6843d72bb53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>cardiac magnetic resonance imaging</topic><topic>echocardiography</topic><topic>strain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Jiwon</creatorcontrib><creatorcontrib>Rodriguez‐Diego, Sara</creatorcontrib><creatorcontrib>Srinivasan, Aparna</creatorcontrib><creatorcontrib>Brown, Rachel‐Maria</creatorcontrib><creatorcontrib>Pollie, Meridith P.</creatorcontrib><creatorcontrib>Di Franco, Antonino</creatorcontrib><creatorcontrib>Goldburg, Samantha R.</creatorcontrib><creatorcontrib>Siden, Jonathan Y.</creatorcontrib><creatorcontrib>Ratcliffe, Mark B.</creatorcontrib><creatorcontrib>Levine, Robert A.</creatorcontrib><creatorcontrib>Devereux, Richard B.</creatorcontrib><creatorcontrib>Weinsaft, Jonathan W.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Jiwon</au><au>Rodriguez‐Diego, Sara</au><au>Srinivasan, Aparna</au><au>Brown, Rachel‐Maria</au><au>Pollie, Meridith P.</au><au>Di Franco, Antonino</au><au>Goldburg, Samantha R.</au><au>Siden, Jonathan Y.</au><au>Ratcliffe, Mark B.</au><au>Levine, Robert A.</au><au>Devereux, Richard B.</au><au>Weinsaft, Jonathan W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus</atitle><jtitle>Echocardiography (Mount Kisco, N.Y.)</jtitle><addtitle>Echocardiography</addtitle><date>2017-11</date><risdate>2017</risdate><volume>34</volume><issue>11</issue><spage>1623</spage><epage>1632</epage><pages>1623-1632</pages><issn>0742-2822</issn><eissn>1540-8175</eissn><abstract>Background
Myocardial strain provides a novel means of quantifying subtle alterations in contractile function; incremental utility post‐MI is unknown.
Objectives
To test longitudinal—quantified by postprocessing routine echo—for assessment of MI size measured by cardiac magnetic resonance (CMR) and conventional methods, and assess regional and global strain (GLS) as markers of LV thrombus.
Methods
The population comprised of patients with anterior ST‐segment MI who underwent echo and CMR prospectively. Preexisting echoes were retrieved, re‐analyzed for strain, and compared to conventional MI markers as well as CMR‐evidenced MI, function, and thrombus.
Results
Seventy‐four patients underwent echo and CMR 4 ± 1 weeks post‐MI; 72% had abnormal GLS. CMR‐quantified MI size was 2.5‐fold larger and EF lower among patients with abnormal GLS, paralleling 2.6–3.1 fold differences in Q‐wave size and CPK (all P ≤ .002). GLS correlated with CMR‐quantified MI (r = .66), CPK (r = .52) and Q‐wave area (r = .44; all P ≤ .001): Regional strain was lower in the base, mid, and apical LV among patients with CMR‐defined transmural MI in each territory (P < .05) and correlated with cine‐CMR regional EF (r = .53–.71; P < .001) and echo wall motion (r = .45–.71; P < .001). GLS and apical strain were ~2‐fold lower among patients with LV thrombus (P ≤ .002): Apical strain yielded higher diagnostic performance for thrombus (AUC: 0.83 [0.72–0.93], P = .001) than wall motion (0.73 [0.58–0.88], P = .02), as did global strain (0.78 [0.65–0.90], P = .005) compared to LVEF (0.58 [0.45–0.72], P = .41).
Conclusions
Echo‐quantified longitudinal strain provides a marker of MI size and improves stratification for post‐MI LV thrombus beyond conventional indices.</abstract><cop>United States</cop><pmid>28833519</pmid><doi>10.1111/echo.13668</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-8420-8604</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0742-2822 |
| ispartof | Echocardiography (Mount Kisco, N.Y.), 2017-11, Vol.34 (11), p.1623-1632 |
| issn | 0742-2822 1540-8175 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5985969 |
| source | Wiley Online Library - AutoHoldings Journals |
| subjects | cardiac magnetic resonance imaging echocardiography strain |
| title | Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus |
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