Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction
Background: The exact mechanism underlying myocardial maladaptive changes post ST-elevation myocardial infarction (STEMI) remains unclear. We sought to assess the impact of the tissue=flow interaction on the development of adverse cardiac remodeling 12 months(M) after acute STEMI. Materials and meth...
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Elsevier
2025-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664725000675 |
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| author | Christel H. Kamani May Lwin Ioannis Botis Mehak Asad Noor Sharrack Hadar Schapira Arka Das Peter P. Swoboda Sven Plein Rob J. Van der Geest Erica Dall’Armellina |
| author_facet | Christel H. Kamani May Lwin Ioannis Botis Mehak Asad Noor Sharrack Hadar Schapira Arka Das Peter P. Swoboda Sven Plein Rob J. Van der Geest Erica Dall’Armellina |
| author_sort | Christel H. Kamani |
| collection | DOAJ |
| description | Background: The exact mechanism underlying myocardial maladaptive changes post ST-elevation myocardial infarction (STEMI) remains unclear. We sought to assess the impact of the tissue=flow interaction on the development of adverse cardiac remodeling 12 months(M) after acute STEMI. Materials and methods: Forty-nine first-STEMI patients (M:F = 26:13; mean age = 58 ± 10) prospectively underwent 3T cardiovascular magnetic resonance (CMR) acutely, at 3 months (3M) and 12M post-STEMI. The CMR protocol included left ventricular (LV) cine-images for LV end-diastolic (LVEDV) and end-systolic volumes, stroke volume (SV), and ejection fraction (LVEF); four-dimensional (4D)-flow and late gadolinium enhancement imaging. The 3M outcome measures included 4D-flow derived LV flow kinetic energy indexed to EDV (KEiEDV) and functional flow components [LV-KEiEDV, minimal- KEiEDV, diastolic- KEiEDV, and residual volume (RV), retained inflow, delayed ejection, direct flow (DF)]; global radial, circumferential, and longitudinal strain (GRS, GCS, GLS) by feature tracking (FT); infarct size (IS). Adverse LV remodeling (LVremod) was defined by a ≥20% increase in LVEDVi at 12M from baseline, in opposition to the non-remodeling group (LVnon-remod). Association between SV, FT-strain, KE, and 4D flow parameters was assessed, as well as predictors of adverse remodeling at 12M post-STEMI. Results: There were 23 LVremod patients. At 3M post-STEMI, LVremod patients had significantly reduced LVEF, increased IS, abnormal FT-strain, systolic KEiEDV, DF, and RV compared to LVnon-remod patients. There was no significant difference in SV between the two groups. FT-strain parameters significantly correlated with DF (GRS: r = 0.62; GCS: r = −0.67; GLS: r = −0.58, all p < 0.001); RV (GRS: r = −0.56; GCS: r = 0.51; GLS: r = 0.53, all p < 0.001); peak-A-wave KEiEDV (GRS: r = 0.38, p = 0.008; GCS: r = −0.30, p = 0.038; GLS: r = −0.29, p = 0.04); systolic KEiEDV (GRS: r = 0.31, p = 0.033, GLS: r = −0.35, p = 0.012). DF outperformed conventional LV function parameters (SV and LVEF) in the LVremod prediction. DF and IS were the only independent predictors of 12M adverse remodeling after adjustment for LVEF, SV, FT-strain, and KEiEDV parameters. Conclusions: Our study suggests a potential early interaction between FT-strain and 4D-flow parameters post-STEMI leading to the development of adverse remodeling. Within the limitations of our sample size, DF and IS were independent predictors of LV remodeling after adjustment for LVEF, SV, FT-strain, and KE parameters. These findings suggest that these parameters may contribute to further risk stratification at 3M for the development of adverse remodeling at 12M post-STEMI, above conventional LV function parameters. Larger studies are needed to confirm these results. |
| format | Article |
| id | doaj-art-abb698be51794e84924cd3652d1971b1 |
| institution | DOAJ |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-abb698be51794e84924cd3652d1971b12025-08-20T03:09:55ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127210190510.1016/j.jocmr.2025.101905Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarctionChristel H. Kamani0May Lwin1Ioannis Botis2Mehak Asad3Noor Sharrack4Hadar Schapira5Arka Das6Peter P. Swoboda7Sven Plein8Rob J. Van der Geest9Erica Dall’Armellina10Department of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UK; Department of Cardiology, Lausanne University Teaching Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland; Department of Nuclear Medicine and Molecular Imaging , Lausanne University Teaching Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UKDepartment of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The NetherlandsDepartment of Biomedical Imaging Science, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds LS2 9JT, UK; Corresponding author.Background: The exact mechanism underlying myocardial maladaptive changes post ST-elevation myocardial infarction (STEMI) remains unclear. We sought to assess the impact of the tissue=flow interaction on the development of adverse cardiac remodeling 12 months(M) after acute STEMI. Materials and methods: Forty-nine first-STEMI patients (M:F = 26:13; mean age = 58 ± 10) prospectively underwent 3T cardiovascular magnetic resonance (CMR) acutely, at 3 months (3M) and 12M post-STEMI. The CMR protocol included left ventricular (LV) cine-images for LV end-diastolic (LVEDV) and end-systolic volumes, stroke volume (SV), and ejection fraction (LVEF); four-dimensional (4D)-flow and late gadolinium enhancement imaging. The 3M outcome measures included 4D-flow derived LV flow kinetic energy indexed to EDV (KEiEDV) and functional flow components [LV-KEiEDV, minimal- KEiEDV, diastolic- KEiEDV, and residual volume (RV), retained inflow, delayed ejection, direct flow (DF)]; global radial, circumferential, and longitudinal strain (GRS, GCS, GLS) by feature tracking (FT); infarct size (IS). Adverse LV remodeling (LVremod) was defined by a ≥20% increase in LVEDVi at 12M from baseline, in opposition to the non-remodeling group (LVnon-remod). Association between SV, FT-strain, KE, and 4D flow parameters was assessed, as well as predictors of adverse remodeling at 12M post-STEMI. Results: There were 23 LVremod patients. At 3M post-STEMI, LVremod patients had significantly reduced LVEF, increased IS, abnormal FT-strain, systolic KEiEDV, DF, and RV compared to LVnon-remod patients. There was no significant difference in SV between the two groups. FT-strain parameters significantly correlated with DF (GRS: r = 0.62; GCS: r = −0.67; GLS: r = −0.58, all p < 0.001); RV (GRS: r = −0.56; GCS: r = 0.51; GLS: r = 0.53, all p < 0.001); peak-A-wave KEiEDV (GRS: r = 0.38, p = 0.008; GCS: r = −0.30, p = 0.038; GLS: r = −0.29, p = 0.04); systolic KEiEDV (GRS: r = 0.31, p = 0.033, GLS: r = −0.35, p = 0.012). DF outperformed conventional LV function parameters (SV and LVEF) in the LVremod prediction. DF and IS were the only independent predictors of 12M adverse remodeling after adjustment for LVEF, SV, FT-strain, and KEiEDV parameters. Conclusions: Our study suggests a potential early interaction between FT-strain and 4D-flow parameters post-STEMI leading to the development of adverse remodeling. Within the limitations of our sample size, DF and IS were independent predictors of LV remodeling after adjustment for LVEF, SV, FT-strain, and KE parameters. These findings suggest that these parameters may contribute to further risk stratification at 3M for the development of adverse remodeling at 12M post-STEMI, above conventional LV function parameters. Larger studies are needed to confirm these results.http://www.sciencedirect.com/science/article/pii/S1097664725000675CMR post MIGlobal FT strain parameters4D flow parametersInteraction of FT strain and 4D flow parametersPrediction of LV adverse remodeling at 12 months post STEMI |
| spellingShingle | Christel H. Kamani May Lwin Ioannis Botis Mehak Asad Noor Sharrack Hadar Schapira Arka Das Peter P. Swoboda Sven Plein Rob J. Van der Geest Erica Dall’Armellina Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction Journal of Cardiovascular Magnetic Resonance CMR post MI Global FT strain parameters 4D flow parameters Interaction of FT strain and 4D flow parameters Prediction of LV adverse remodeling at 12 months post STEMI |
| title | Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction |
| title_full | Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction |
| title_fullStr | Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction |
| title_full_unstemmed | Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction |
| title_short | Left ventricular flow kinetics and myocardial deformation following acute infarction: Additional predictive value of cardiac magnetic resonance four-dimensional flow for left ventricular remodeling post-ST-elevation myocardial infarction |
| title_sort | left ventricular flow kinetics and myocardial deformation following acute infarction additional predictive value of cardiac magnetic resonance four dimensional flow for left ventricular remodeling post st elevation myocardial infarction |
| topic | CMR post MI Global FT strain parameters 4D flow parameters Interaction of FT strain and 4D flow parameters Prediction of LV adverse remodeling at 12 months post STEMI |
| url | http://www.sciencedirect.com/science/article/pii/S1097664725000675 |
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