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Updated: Jun 25, 2026
Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Prognostic Value of Strain by Tissue Tracking Cardiac Magnetic Resonance in Myocardial Infarction With Nonobstructive
Lei Chen1, Bowen Qiu2, Fuad A Abdu1
1Department of Cardiology Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai China.
Insights
Cardiac magnetic resonance (CMR) strain analysis reveals that left atrial (LA) and left ventricular strain predict major adverse cardiovascular events (MACEs) in myocardial infarction with nonobstructive coronary arteries (MINOCA). Combining these strain measures enhances MACE prediction in true MINOCA patients.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Strain assessed by cardiac magnetic resonance (CMR) is a key prognostic indicator in myocardial infarction.
- Strain characteristics and prognostic value in myocardial infarction with nonobstructive coronary arteries (MINOCA) with different causes are unclear.
- This study investigates left atrial (LA) and left ventricular strain in MINOCA patients.
Purpose of the Study:
- To describe LA and left ventricular strain in MINOCA patients.
- To evaluate the predictive value of these strains for major adverse cardiovascular events (MACEs) in "true MINOCA" cases.
Main Methods:
- Single-center retrospective study of 386 patients suspected of myocardial infarction.
- CMR imaging with feature tracking to obtain LA and left ventricular strain.
- True MINOCA defined by evidence of ischemia or infarction on CMR.
Main Results:
- LA and left ventricular strains varied by pathogenesis, with lowest strain in cardiomyopathy.
- Global longitudinal strain (GLS) and LA reservoir strain (LARS) independently predicted MACEs in true MINOCA patients.
- Integrating GLS and LARS improved MACE prediction.
Conclusions:
- LA and left ventricular strains differ across MINOCA causes.
- GLS and LARS are independent predictors of MACE risk in true MINOCA.
- Combined strain analysis enhances MACE prediction in MINOCA.
Background:
Strain assessed by cardiac magnetic resonance (CMR) is a key prognostic indicator in myocardial infarction. However, the strain characteristics and prognostic value in myocardial infarction with nonobstructive coronary arteries (MINOCA) with different causes are unclear. This study aims to describe left atrial (LA) and left ventricular strain in patients with MINOCA and evaluate their predictive value for major adverse cardiovascular events (MACEs) in "true MINOCA" cases.
Methods And Results:
This single-center retrospective study included patients suspected of myocardial infarction who completed CMR during hospitalization. CMR images were used to obtain LA and left ventricular strain via CMR feature tracking. True MINOCA was defined by evidence of ischemia or infarction on CMR. MACEs included all-cause death, recurrent myocardial infarction, stroke, heart failure, atrial fibrillation, and angina pectoris. This study included 386 patients, with a median time from admission to CMR of 4 days. LA and left ventricular strains varied by pathogenesis, with the lowest strain in patients with cardiomyopathy. For patients with true MINOCA, Cox regression showed that global longitudinal strain (hazard ratio [HR], 0.90 [95% CI, 0.82-0.99]; P=0.022) and LA reservoir strain (HR, 0.95 [95% CI, 0.91-0.99]; P=0.014) were independently associated with MACEs. Kaplan-Meier analysis indicated that patients with LA reservoir strain ≤21.25% or global longitudinal strain ≤16.4% had a significantly higher MACE risk (P<0.001). Integrating global longitudinal strain and LA reservoir strain improved MACE prediction.
Conclusions:
LA and left ventricular strains vary among MINOCA pathogeneses. In true MINOCA patients, global longitudinal strain and LA reservoir strains independently predict MACE risk. Integrating these strains enhances MACE prediction.
Registration:
URL: https://www.clinicaltrials.gov; Unique Identifier: NCT06502899.
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