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Cardiac magnetic resonance for the early prediction of reverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction

  • Cardiac
  • Published:
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Abstract

Objectives

To evaluate the changes in cardiac magnetic resonance (CMR) characteristics and investigate the predictors of reverse left ventricular remodeling (r-LVR) in ST-segment elevation myocardial infarction (STEMI) patients.

Materials and methods

Eighty-six STEMI patients (median 56 years) were retrospectively studied. The patients were divided into r-LVR and without r-LVR groups. CMR analysis included LV volume, infarct characteristics, and global and regional myocardial function. The strain and displacement were assessed by CMR-feature tracking. The predictors of r-LVR were analyzed by the logistic regression method.

Results

There were 37 patients in the r-LVR group and 49 patients in the without r-LVR group. At initial CMR, there was no difference in LV volume and global cardiac function between the two groups. However, the infarct zone radial and longitudinal displacements were higher in the r-LVR group (p < 0.05, respectively). At the second CMR, the r-LVR group showed higher LVEF, lower LV volume, and total enhanced mass (all p < 0.05). The infarct zone radial and circumferential strains and radial displacement were higher in the r-LVR group (all p < 0.05). The r-LVR group had better recovery of myocardial injury and function. Of note, microvascular obstruction (MVO) mass (odds ratio: 0.779 (0.613–0.989), p = 0.041) and infarct zone peak longitudinal displacement (PLD) (odds ratio: 1.448 (1.044–2.008), p = 0.026) were independent predictors of r-LVR.

Conclusions

At initial CMR, there were no differences in global cardiac function between the two groups, but infarct zone displacements were higher in the r-LVR group. The r-LVR group had better recovery of cardiac function. In addition, MVO mass and infarct zone PLD were independent predictors of r-LVR.

Clinical relevance statement

Our study assessed changes in cardiac structure, function, and tissue characteristics after STEMI by CMR, investigated the best predictors of r-LVR in STEMI patients, and laid the foundation for the development of new parameter-guided treatment strategies for STEMI patients.

Key Points

• At initial CMR, the reverse left ventricular remodeling (r-LVR) group had less myocardial damage and higher infarct zone displacement, but there were no differences in global function between the two groups.

• Both groups showed recovery of myocardial injury and cardiac function over time, but the r-LVR group had less enhanced mass and better cardiac function compared to the without r-LVR group at the second CMR.

• Microvascular obstruction mass and infarct zone peak longitudinal displacement by cardiac magnetic resonance feature-tracking were significant predictors of r-LVR in STEMI patients.

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Abbreviations

AUC:

Area under the curve

CMR:

Cardiac magnetic resonance

CMR-FT:

Cardiac magnetic resonance- feature tracking

EMR:

Electronic medical record

LGE:

Late gadolinium enhancement

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

LVESV:

Left ventricular end-systolic volume

MVO:

Microvascular obstruction

PCI:

Percutaneous coronary intervention

PLD:

Peak longitudinal displacement

R-LVR:

Reverse left ventricular remodeling

STEMI:

ST-segment elevation myocardial infarction

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Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, the First Medical center, PLA General Hospital, Beijing, China

    Jianing Cui, Yanan Zhao, Chuncai Luo & Tao Li

  2. Department of Cardiology, The Six Medical Center, PLA General Hospital, Beijing, China

    Geng Qian

  3. Philips Healthcare, Beijing, China

    Xiuzheng Yue

Authors
  1. Jianing Cui
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  2. Yanan Zhao
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  3. Geng Qian
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  4. Xiuzheng Yue
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  5. Chuncai Luo
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  6. Tao Li
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Corresponding author

Correspondence to Tao Li.

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Guarantor

The scientific guarantor of this publication is Tao Li.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because this is a retrospective study.

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Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

Study subjects and cohorts have not been reported elsewhere.

Methodology

  • Retrospective

  • Observational

  • Performed at one institution

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Cui, J., Zhao, Y., Qian, G. et al. Cardiac magnetic resonance for the early prediction of reverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction. Eur Radiol 33, 8501–8512 (2023). https://doi.org/10.1007/s00330-023-09907-3

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  • DOI: https://doi.org/10.1007/s00330-023-09907-3

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