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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Validity of resting strain/strain rate in prediction of myocardial viability
Amr Hanafy1, Soliman Ghareb Ibrahim2, Hossam-Eldein Mohamed Mohamed Mansour3
1Cardiovascular Department, Aswan University, Aswân, Egypt. Amrhanafy75@yahoo.com.
Insights
Resting strain and strain rate measurements from echocardiography accurately predict myocardial viability after heart attack. These non-invasive measures show promise for assessing heart muscle health post-myocardial infarction.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Assessing myocardial viability after acute myocardial infarction (AMI) is crucial for guiding treatment decisions.
- Delayed enhancement cardiac magnetic resonance imaging (DE-CMR) is the gold standard but is costly and not widely accessible.
- Non-invasive echocardiography offers a potential alternative for evaluating myocardial viability.
Purpose of the Study:
- To determine if resting strain and strain rate measurements from echocardiography can accurately predict myocardial viability.
- To compare echocardiographic findings with DE-CMR in patients post-AMI.
Main Methods:
- Sixty patients, three months post-AMI, underwent resting echocardiography with offline deformation index analysis.
- Gadolinium contrast-enhanced cardiac magnetic resonance imaging (DE-CMR) was performed as the gold standard.
- 268 myocardial segments with resting wall motion abnormalities were analyzed.
Main Results:
- Resting longitudinal strain was significantly higher in viable segments compared to non-viable segments (p < 0.05).
- Resting longitudinal strain rate was also significantly higher in viable segments for most myocardial regions (p < 0.05).
- Specific segments showed non-significant differences in strain rate, but overall trends supported viability prediction.
Conclusions:
- Resting strain and strain rate measurements are accurate predictors of myocardial viability post-AMI.
- Echocardiography offers a valuable, accessible tool for assessing myocardial viability, complementing DE-CMR.
Abstract:
To evaluate the validity of the resting strain/strain rate measurements in predicting myocardial viability taking delayed enhancement cardiac magnetic resonance imaging as the gold standard. A cohort of 60 patients at three months followed up after acute myocardial infarction were recruited for this study. Resting echocardiography with offline analysis of deformation indices and gadolinium contrast enhanced cardiac magnetic resonance imaging were applied for all patients. For the final assessment, 268 segments with significant resting wall motion abnormalities were presented. Resting longitudinal strain was significantly (p < 0.05) higher in viable, compared with non-viable segments in all the studied individual myocardial segments (apical inferior, mid antro-lateral, mid-inferolateral, mid inferoseptum, and all other segments). Likewise, resting longitudinal strain rate was significantly (p < 0.05) higher in viable, compared with non-viable segments in almost all studied individual myocardial segments apart from apical inferior, mid inferolateral and basal antro-septum (p = 0.245, p = 0.098, p = 0.097 respectively). Resting Strain and Resting Strain rate could be used as accurate predictors of myocardia viability following acute myocardial infarction.
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