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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
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Myocardial strain characteristics in ST-segment elevation myocardial infarction patients with left ventricular

Yanhe Ma1, Yufan Gao1, Jiwei Sun1

  • 1Department of Radiology, Tianjin Chest Hospital, Tianjin University, Tianjin, China.

Quantitative Imaging in Medicine and Surgery
|April 16, 2025
PubMed

Insights

Left ventricular thrombus (LVT) occurs frequently in ST-segment elevation myocardial infarction (STEMI) patients without aneurysm. Cardiac magnetic resonance (CMR) myocardial strain analysis aids in LVT diagnosis by revealing reduced strain patterns.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Left ventricular thrombus (LVT) is a significant complication following ST-segment elevation myocardial infarction (STEMI).
  • Investigating LVT in STEMI patients without left ventricular aneurysm is crucial for understanding disease progression and management.
  • Myocardial strain characteristics assessed via magnetic resonance (MR) imaging offer potential insights into LVT development.

Purpose of the Study:

  • To investigate the magnetic resonance (MR) myocardial strain characteristics associated with left ventricular thrombus (LVT) in ST-segment elevation myocardial infarction (STEMI) patients.
  • To compare cardiac function and myocardial strain parameters between STEMI patients with and without LVT.
  • To determine the diagnostic value of myocardial strain on cardiac MR (CMR) imaging for LVT detection.

Main Methods:

  • A cohort of 199 STEMI patients underwent cardiac MR (CMR) examination.
  • Patients were categorized into two groups: 41 with LVT and 158 without LVT.
  • Clinical data, including B-type natriuretic peptide (BNP) levels, left ventricular ejection fraction (LVEF), and volumes, were compared alongside myocardial strain parameters (circumferential, radial, longitudinal).

Main Results:

  • STEMI patients with LVT exhibited significantly elevated BNP levels and reduced LVEF compared to those without LVT.
  • Left ventricular volumes (end-diastolic and end-systolic) were significantly increased in the LVT group.
  • Global circumferential, radial, and longitudinal strain were significantly reduced in the LVT group, indicating impaired myocardial function.

Conclusions:

  • Left ventricular thrombus (LVT) remains a common complication in STEMI patients, even in the absence of left ventricular aneurysm.
  • Cardiac MR (CMR) imaging, particularly myocardial strain analysis, provides valuable information for the diagnosis and assessment of LVT.
  • Understanding these strain characteristics can improve the early detection and management of LVT in STEMI patients.
Abstract

Keywords:
Left ventricular thrombus (LVT)ST-segment elevation myocardial infarction (STEMI)cardiac magnetic resonance imaging (CMR imaging)myocardial strainstrain analysis

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