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Updated: Dec 19, 2025
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Longitudinal strain in remote non-infarcted myocardium by tissue tracking CMR: characterization, dynamics, structural
Jose Gavara1,2, Jose F Rodriguez-Palomares3, Cesar Rios-Navarro4
1Hospital Clínico Universitario de Valencia, Department of Cardiology, Instituto de Investigación Sanitaria del Hospital Clínico Universitario de Valencia (INCLIVA), University of Valencia, Blasco Ibanez 17, 46010, Valencia, Spain.
Insights
Reduced longitudinal strain in remote non-infarcted myocardium (RNM-LS) after ST-segment elevation myocardial infarction (STEMI) is common and linked to worse outcomes. However, RNM-LS can recover, paralleling improvements in left ventricular ejection fraction.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Myocardial Infarction Research
Background:
- Longitudinal strain (LS) in remote non-infarcted myocardium (RNM) is not well-characterized in ST-segment elevation myocardial infarction (STEMI) using tissue tracking (TT) cardiovascular magnetic resonance (CMR).
- Understanding RNM-LS dynamics and implications is crucial for STEMI patient management.
Purpose of the Study:
- To characterize RNM-LS by TT-CMR in STEMI patients.
- To assess the dynamics of RNM-LS.
- To evaluate the structural and prognostic implications of RNM-LS.
Main Methods:
- Recruited 271 STEMI patients for TT-CMR at 1 week post-infarction.
- 145 patients underwent follow-up TT-CMR at 6 months to assess RNM-LS dynamics and structural changes.
- RNM areas were defined based on culprit coronary artery anatomy.
Main Results:
- Reduced RNM-LS at 1 week was associated with larger infarct size and lower LVEF at 1 week and 6 months (p < 0.001).
- 40% of patients with reduced RNM-LS showed late normalization, which independently correlated with late LVEF recovery (p = 0.002).
- Reduced RNM-LS at 1 week predicted major adverse cardiac events in both the primary (26% vs. 11%, p = 0.002) and validation cohorts (57% vs. 13%, p < 0.001).
Conclusions:
- Reduced RNM-LS after STEMI is prevalent and indicates more severe short- and long-term cardiac damage.
- RNM-LS shows a tendency towards recovery, mirroring late LVEF improvement.
- Patients with reduced RNM-LS face a higher risk of adverse cardiac events.
Purpose:
In ST-segment elevation myocardial infarction (STEMI) patients, longitudinal strain (LS) in remote non-infarcted myocardium (RNM) has not yet been characterized by tissue tracking (TT) cardiovascular magnetic resonance (CMR). In STEMI patients, we aimed to characterize RNM-LS by TT-CMR and to assess both its dynamics and its structural and prognostic implications.
Methods:
We recruited 271 patients with a first STEMI studied with TT-CMR 1 week after infarction. Of these patients, 145 underwent 1-week and 6-month TT-CMR and were used to characterize both the dynamics and the short-term and long-term structural implications of RNM-LS. Based on previously validated data, RNM areas were defined depending on the culprit coronary artery.
Results:
Reduced RNM-LS at 1 week (n = 70, 48%) was associated with larger infarct size and more depressed left ventricular ejection fraction (LVEF) at both the 1-week and 6-month TT-CMR (p value < 0.001). Late normalization of RNM-LS was frequent (28/70, 40%) and independently related to late recovery of LVEF (p value = 0.002). Patients with reduced RNM-LS at 1-week TT-CMR had more major adverse cardiac events (death, heart failure or re-infarction) in both the 271 patients included in the study group (26% vs. 11%, p value = 0.002) and in an external validation cohort made up of 177 STEMI patients (57% vs. 13%, p value < 0.001).
Conclusion:
After STEMI, reduced RNM-LS by TT-CMR is common and is associated with more severe short- and long-term structural damage. There is a beneficial tendency towards recovery of RNM-LS that parallels late recovery of LVEF. More events occur in patients with reduced RNM-LS.
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