Volume 59, Issue 5 pp. 1820-1831

Research Article

MR Uniformity Ratio Estimates to Evaluate Ventricular Mechanical Dyssynchrony and Prognosis After ST-Segment Elevation Myocardial Infarction

Jian-Xun Dong MD,

Jian-Xun Dong MD

orcid.org/0009-0006-4798-0925

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Lai Wei MD,

Lai Wei MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Li-Xing Jin MBBS,

Li-Xing Jin MBBS

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Jie He MD,

Jie He MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Chen-Xu Zhao MBBS,

Chen-Xu Zhao MBBS

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Song Ding MD,

Song Ding MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Ling-Cong Kong MD,

Ling-Cong Kong MD

orcid.org/0000-0002-1405-163X

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Fan Yang MD,

Fan Yang MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Dong-Ao-Lei An MD,

Dong-Ao-Lei An MD

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Chong-Wen Wu MD,

Chong-Wen Wu MD

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Bing-Hua Chen MD,

Bing-Hua Chen MD

orcid.org/0000-0002-2718-8416

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Hu-Wen Wang MD,

Hu-Wen Wang MD

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

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Yi-Ning Yang MD,

Yi-Ning Yang MD

People's Hospital of Xinjiang Uygur Autonomous Region, Wulumuqi, China

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Heng Ge MD,

Corresponding Author

Heng Ge MD

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Address reprint requests to: H.G., Shanghai, China. E-mail: [email protected], or J.P., Shanghai, China. E-mail: [email protected]

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Jun Pu MD, FACC, FSCAI,

Corresponding Author

Jun Pu MD, FACC, FSCAI

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Address reprint requests to: H.G., Shanghai, China. E-mail: [email protected], or J.P., Shanghai, China. E-mail: [email protected]

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Jian-Xun Dong MD,

Jian-Xun Dong MD

orcid.org/0009-0006-4798-0925

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Lai Wei MD,

Lai Wei MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Li-Xing Jin MBBS,

Li-Xing Jin MBBS

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Jie He MD,

Jie He MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Chen-Xu Zhao MBBS,

Chen-Xu Zhao MBBS

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Song Ding MD,

Song Ding MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Ling-Cong Kong MD,

Ling-Cong Kong MD

orcid.org/0000-0002-1405-163X

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Fan Yang MD,

Fan Yang MD

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Dong-Ao-Lei An MD,

Dong-Ao-Lei An MD

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Chong-Wen Wu MD,

Chong-Wen Wu MD

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

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Bing-Hua Chen MD,

Bing-Hua Chen MD

orcid.org/0000-0002-2718-8416

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Search for more papers by this author

Hu-Wen Wang MD,

Hu-Wen Wang MD

Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China

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Yi-Ning Yang MD,

Yi-Ning Yang MD

People's Hospital of Xinjiang Uygur Autonomous Region, Wulumuqi, China

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Heng Ge MD,

Corresponding Author

Heng Ge MD

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Address reprint requests to: H.G., Shanghai, China. E-mail: [email protected], or J.P., Shanghai, China. E-mail: [email protected]

Search for more papers by this author

Jun Pu MD, FACC, FSCAI,

Corresponding Author

Jun Pu MD, FACC, FSCAI

[email protected]

Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

Address reprint requests to: H.G., Shanghai, China. E-mail: [email protected], or J.P., Shanghai, China. E-mail: [email protected]

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First published: 13 October 2023

https://doi.org/10.1002/jmri.28998

Citations: 1

Jian-Xun Dong, Lai Wei, and Li-Xing Jin contributed equally to this work.

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Abstract

Background

The impact of left ventricular mechanical dyssynchrony (LVMD) on the long-term prognosis of ST-segment elevation myocardial infarction (STEMI) is unclear.

Hypothesis

MR uniformity ratio estimates (URE) can detect LVMD and assess STEMI prognosis.

Study Type

Retrospective analysis of a prospective multicenter registry (EARLY-MYO trial, NCT 03768453).

Population

Overall, 450 patients (50 females) with first-time STEMI were analyzed, as well as 40 participants without cardiovascular disease as controls.

Field Strength/Sequence

3.0-T, balanced steady-state free precession cine and late gadolinium enhancement imaging.

Assessment

MRI data were acquired within 1 week of symptom onset. Major adverse cardiovascular events (MACEs), including cardiovascular death, nonfatal re-infarction, hospitalization for heart failure, and stroke, were the primary clinical outcomes. LVMD was represented by circumferential URE (CURE) and radial URE (RURE) calculated using strain measurements. The patients were grouped according to clinical outcomes or URE values. Patients' clinical characteristics and MR indicators were compared.

Statistical Tests

The Student's t-test, Mann–Whitney U test, chi-square test, Fisher's exact test, receiver operating characteristic curve analysis with area under the curve, Kaplan–Meier analysis, Cox regression, logistic regression, intraclass correlation coefficient, c-index, and integrated discrimination improvement were used. P < 0.05 was considered statistically significant.

Results

CURE and RURE were significantly lower in patients with STEMI than in controls. The median follow-up was 60.5 months. Patients with both lower CURE and RURE values experienced a significantly higher incidence of MACEs by 3.525-fold. Both CURE and RURE were independent risk factors for MACEs. The addition of UREs improved diagnostic efficacy and risk stratification based on infarct size and left ventricular ejection fraction (LVEF). The indicators associated with LVMD included male sex, serum biomarkers (peak creatine phosphokinase and cardiac troponin I), infarct size, and LVEF.

Data Conclusion

CURE and RURE may be useful to evaluate long-term prognosis after STEMI.

Evidence Level

Technical Efficacy

Stage 2

Supporting Information

References

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Citing Literature

Volume59, Issue5

May 2024

Pages 1820-1831

MR Uniformity Ratio Estimates to Evaluate Ventricular Mechanical Dyssynchrony and Prognosis After ST-Segment Elevation Myocardial Infarction

Abstract

Background

Hypothesis

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

Supporting Information

References

Citing Literature

References

Information

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MR Uniformity Ratio Estimates to Evaluate Ventricular Mechanical Dyssynchrony and Prognosis After ST-Segment Elevation Myocardial Infarction

Abstract

Background

Hypothesis

Study Type

Population

Field Strength/Sequence

Assessment

Statistical Tests

Results

Data Conclusion

Evidence Level

Technical Efficacy

Supporting Information

References

Citing Literature

References

Related

Information