Usefulness of Left Ventricular Dyssynchrony After Acute Myocardial Infarction, Assessed by a Tagging Magnetic Resonance Image Derived Metric, as a Determinant of Ventricular Remodeling

Sung A. Chang, Hyuk-Jae Chang, Sang Il Choi, Eun Ju Chun, Yeonyee E. Yoon, Hyung Kwan Kim, Yong Jin Kim, Dong Ju Choi, Dae Won Sohn, Robert H. Helm, Albert C. Lardo

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Development of left ventricular (LV) remodeling after acute myocardial infarction (AMI) is a serious medical complication. We investigated the correlation of LV dyssynchrony after AMI with LV remodeling using magnetic resonance-myocardial tagging (MR-MT) derived dyssynchrony index (circumferential uniformity ratio estimate [CURE]). Forty-three patients diagnosed with ST-elevation AMI were analyzed. After treatment with primary percutaneous intervention, cardiac magnetic resonance imaging was performed to obtain a cine image, a delayed enhancement image, and an MR-MT image. CURE as a dyssynchrony index was calculated from the MR-MT image using HARP software (CURE 0 to 1 = dyssynchrony to synchrony). After 6 months, follow-up cardiac magnetic resonance imaging was performed to assess degree of LV remodeling. Sixteen patients (37%) had an increased LV end-systolic volume (ESV) >15% compared with baseline. The baseline LV dyssynchrony index, CURE, was significantly associated with ESV at 6 months (r = -0.49, p <0.001) and weakly correlated with change in ESV (percentage) compared with baseline values (r = -0.26, p = 0.08). Multivariate analysis showed that CURE was associated only with change in ESV (beta -0.39, p = 0.03). Subgroup analysis for patients with nonviable myocardium (infarct thickness >75%, n = 31) showed that this correlation was stronger (beta -0.52, p = 0.006), suggesting that CURE could predict progression of LV remodeling in patients with AMI and nonviable myocardium. LV dyssynchrony immediately after AMI is an important determinant of LV remodeling. In conclusion, the MR-MT dyssynchrony index, CURE, might be useful for prediction of LV remodeling in patients with AMI.

Original languageEnglish
Pages (from-to)19-23
Number of pages5
JournalAmerican Journal of Cardiology
Volume104
Issue number1
DOIs
Publication statusPublished - 2009 Jul 1

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Ventricular Remodeling
Magnetic Resonance Spectroscopy
Myocardial Infarction
Magnetic Resonance Imaging
Image Enhancement
Stroke Volume
Myocardium
Software

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Chang, Sung A. ; Chang, Hyuk-Jae ; Choi, Sang Il ; Chun, Eun Ju ; Yoon, Yeonyee E. ; Kim, Hyung Kwan ; Kim, Yong Jin ; Choi, Dong Ju ; Sohn, Dae Won ; Helm, Robert H. ; Lardo, Albert C. / Usefulness of Left Ventricular Dyssynchrony After Acute Myocardial Infarction, Assessed by a Tagging Magnetic Resonance Image Derived Metric, as a Determinant of Ventricular Remodeling. In: American Journal of Cardiology. 2009 ; Vol. 104, No. 1. pp. 19-23.
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abstract = "Development of left ventricular (LV) remodeling after acute myocardial infarction (AMI) is a serious medical complication. We investigated the correlation of LV dyssynchrony after AMI with LV remodeling using magnetic resonance-myocardial tagging (MR-MT) derived dyssynchrony index (circumferential uniformity ratio estimate [CURE]). Forty-three patients diagnosed with ST-elevation AMI were analyzed. After treatment with primary percutaneous intervention, cardiac magnetic resonance imaging was performed to obtain a cine image, a delayed enhancement image, and an MR-MT image. CURE as a dyssynchrony index was calculated from the MR-MT image using HARP software (CURE 0 to 1 = dyssynchrony to synchrony). After 6 months, follow-up cardiac magnetic resonance imaging was performed to assess degree of LV remodeling. Sixteen patients (37{\%}) had an increased LV end-systolic volume (ESV) >15{\%} compared with baseline. The baseline LV dyssynchrony index, CURE, was significantly associated with ESV at 6 months (r = -0.49, p <0.001) and weakly correlated with change in ESV (percentage) compared with baseline values (r = -0.26, p = 0.08). Multivariate analysis showed that CURE was associated only with change in ESV (beta -0.39, p = 0.03). Subgroup analysis for patients with nonviable myocardium (infarct thickness >75{\%}, n = 31) showed that this correlation was stronger (beta -0.52, p = 0.006), suggesting that CURE could predict progression of LV remodeling in patients with AMI and nonviable myocardium. LV dyssynchrony immediately after AMI is an important determinant of LV remodeling. In conclusion, the MR-MT dyssynchrony index, CURE, might be useful for prediction of LV remodeling in patients with AMI.",
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Usefulness of Left Ventricular Dyssynchrony After Acute Myocardial Infarction, Assessed by a Tagging Magnetic Resonance Image Derived Metric, as a Determinant of Ventricular Remodeling. / Chang, Sung A.; Chang, Hyuk-Jae; Choi, Sang Il; Chun, Eun Ju; Yoon, Yeonyee E.; Kim, Hyung Kwan; Kim, Yong Jin; Choi, Dong Ju; Sohn, Dae Won; Helm, Robert H.; Lardo, Albert C.

In: American Journal of Cardiology, Vol. 104, No. 1, 01.07.2009, p. 19-23.

Research output: Contribution to journalArticle

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T1 - Usefulness of Left Ventricular Dyssynchrony After Acute Myocardial Infarction, Assessed by a Tagging Magnetic Resonance Image Derived Metric, as a Determinant of Ventricular Remodeling

AU - Chang, Sung A.

AU - Chang, Hyuk-Jae

AU - Choi, Sang Il

AU - Chun, Eun Ju

AU - Yoon, Yeonyee E.

AU - Kim, Hyung Kwan

AU - Kim, Yong Jin

AU - Choi, Dong Ju

AU - Sohn, Dae Won

AU - Helm, Robert H.

AU - Lardo, Albert C.

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AB - Development of left ventricular (LV) remodeling after acute myocardial infarction (AMI) is a serious medical complication. We investigated the correlation of LV dyssynchrony after AMI with LV remodeling using magnetic resonance-myocardial tagging (MR-MT) derived dyssynchrony index (circumferential uniformity ratio estimate [CURE]). Forty-three patients diagnosed with ST-elevation AMI were analyzed. After treatment with primary percutaneous intervention, cardiac magnetic resonance imaging was performed to obtain a cine image, a delayed enhancement image, and an MR-MT image. CURE as a dyssynchrony index was calculated from the MR-MT image using HARP software (CURE 0 to 1 = dyssynchrony to synchrony). After 6 months, follow-up cardiac magnetic resonance imaging was performed to assess degree of LV remodeling. Sixteen patients (37%) had an increased LV end-systolic volume (ESV) >15% compared with baseline. The baseline LV dyssynchrony index, CURE, was significantly associated with ESV at 6 months (r = -0.49, p <0.001) and weakly correlated with change in ESV (percentage) compared with baseline values (r = -0.26, p = 0.08). Multivariate analysis showed that CURE was associated only with change in ESV (beta -0.39, p = 0.03). Subgroup analysis for patients with nonviable myocardium (infarct thickness >75%, n = 31) showed that this correlation was stronger (beta -0.52, p = 0.006), suggesting that CURE could predict progression of LV remodeling in patients with AMI and nonviable myocardium. LV dyssynchrony immediately after AMI is an important determinant of LV remodeling. In conclusion, the MR-MT dyssynchrony index, CURE, might be useful for prediction of LV remodeling in patients with AMI.

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