The International Journal of Cardiovascular Imaging

, Volume 35, Issue 11, pp 2095–2102 | Cite as

Cardiac magnetic resonance-tissue tracking for the early prediction of adverse left ventricular remodeling after ST-segment elevation myocardial infarction

  • Min Jae Cha
  • Jeong Hyun Lee
  • Hye Na Jung
  • Yiseul Kim
  • Yeon Hyeon Choe
  • Sung Mok KimEmail author
Original Paper


Cardiac magnetic resonance-tissue tracking (CMR-TT)-derived myocardial strain after ST-elevation myocardial infarction (STEMI) is related to adverse cardiac events. We aimed to investigate the feasibility of CMR-TT for the early prediction of adverse left ventricular (LV) remodeling after STEMI. We retrospectively searched our institution’s STEMI registry for patients who underwent reperfusion therapy, post-reperfusion CMR within 1 week after STEMI, and follow-up CMR. CMR-TT analysis was performed using cine imaging of post-reperfusion CMR. Adverse LV remodeling was defined as an increase in end-diastolic LV volume by 20% or more on follow-up CMR (median interval between serial CMR exams, 197 days; interquartile, 174–241 days). A total of 82 patients (age, 59.2 ± 11.1 years; male:female = 73:9) were included and divided into two groups: STEMI without (n = 62) and with (n = 20) adverse LV remodeling. Patients with LV remodeling showed significantly higher peak creatine kinase-MB and troponin I levels and a larger infarct size compared with those without LV remodeling (p = 0.001, p = 0.001, and p = 0.010, respectively). Global circumferential, radial, and longitudinal strain (GLS) also differed significantly between the groups (p = 0.001, p = 0.004, and p < 0.001, respectively). Logistic regression and receiver operating characteristic curve analyses demonstrated that GLS was an independent predictor of LV remodeling [odds ratio (OR) = 1.282, 95% confidence interval (CI) = 1.060–1.55 p = 0.011] with an optimal cut-off of − 12.84 (AUC = 0.756, 95% CI = 0.636–0.887, p < 0.001). CMR-TT-derived GLS may aid the early prediction of adverse LV remodeling after reperfusion, within 1 week after STEMI.


Cardiac magnetic resonance imaging Ventricular remodeling ST-segment elevation myocardial infarction 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Informed consent

The institutional review board of our institution approved the study, and informed consent was waived.

Research involving human and animal participants

The ethical standards of the responsible committee on human experimentation (institutional and national) and Declaration of Helsinki of 1964 (revised in 2008) were followed.

Supplementary material

10554_2019_1659_MOESM1_ESM.docx (13 kb)
Electronic supplementary material 1 (DOCX 13 kb)
10554_2019_1659_MOESM2_ESM.avi (5.6 mb)
Electronic supplementary material 2 (AVI 5763 kb)
10554_2019_1659_MOESM3_ESM.avi (5.6 mb)
Electronic supplementary material 3 (AVI 5763 kb)
10554_2019_1659_MOESM4_ESM.avi (5.6 mb)
Electronic supplementary material 4 (AVI 5763 kb)
10554_2019_1659_MOESM5_ESM.avi (5.6 mb)
Electronic supplementary material 5 (AVI 5763 kb)


  1. 1.
    Abbate A (2017) Tackling the Problem of Adverse Ventricular Remodeling After Myocardial Infarction. In: Morrow David A (ed) Myocardial Infarction: A Companion to Braunwald's Heart Disease. Elsevier, Missouri, pp 449–461Google Scholar
  2. 2.
    Konstam MA, Kramer DG, Patel AR, Maron MS, Udelson JE (2011) Left ventricular remodeling in heart failure: current concepts in clinical significance and assessment. JACC Cardiovasc Imaging 4(1):98–108CrossRefGoogle Scholar
  3. 3.
    Park YH, Kang SJ, Song JK et al (2008) Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction. J Am Soc Echocardiogr 21(3):262–267CrossRefGoogle Scholar
  4. 4.
    Bochenek T, Wita K, Tabor Z et al (2011) Value of speckle-tracking echocardiography for prediction of left ventricular remodeling in patients with ST-elevation myocardial infarction treated by primary percutaneous intervention. J Am Soc Echocardiogr 24(12):1342–1348CrossRefGoogle Scholar
  5. 5.
    D'Andrea A, Cocchia R, Caso P et al (2011) Global longitudinal speckle-tracking strain is predictive of left ventricular remodeling after coronary angioplasty in patients with recent non-ST elevation myocardial infarction. Int J Cardiol 153(2):185–191CrossRefGoogle Scholar
  6. 6.
    Abate E, Hoogslag GE, Antoni ML et al (2012) Value of three-dimensional speckle-tracking longitudinal strain for predicting improvement of left ventricular function after acute myocardial infarction. Am J Cardiol 110(7):961–967CrossRefGoogle Scholar
  7. 7.
    Munk K, Andersen NH, Terkelsen CJ et al (2012) Global left ventricular longitudinal systolic strain for early risk assessment in patients with acute myocardial infarction treated with primary percutaneous intervention. J Am Soc Echocardiogr 25(6):644–651CrossRefGoogle Scholar
  8. 8.
    Altiok E, Tiemann S, Becker M et al (2014) Myocardial deformation imaging by two-dimensional speckle-tracking echocardiography for prediction of global and segmental functional changes after acute myocardial infarction: a comparison with late gadolinium enhancement cardiac magnetic resonance. J Am Soc Echocardiogr 27(3):249–257CrossRefGoogle Scholar
  9. 9.
    Bergerot C, Mewton N, Lacote-Roiron C et al (2014) Influence of microvascular obstruction on regional myocardial deformation in the acute phase of myocardial infarction: a speckle-tracking echocardiography study. J Am Soc Echocardiogr 27(1):93–100CrossRefGoogle Scholar
  10. 10.
    Kalam K, Otahal P, Marwick TH (2014) Prognostic implications of global LV dysfunction: a systematic review and meta-analysis of global longitudinal strain and ejection fraction. Heart 100(21):1673–1680CrossRefGoogle Scholar
  11. 11.
    Kandler D, Lucke C, Grothoff M et al (2014) The relation between hypointense core, microvascular obstruction and intramyocardial haemorrhage in acute reperfused myocardial infarction assessed by cardiac magnetic resonance imaging. Eur Radiol 24(12):3277–3288CrossRefGoogle Scholar
  12. 12.
    Symons R, Masci PG, Goetschalckx K, Doulaptsis K, Janssens S, Bogaert J (2015) Effect of infarct severity on regional and global left ventricular remodeling in patients with successfully reperfused ST segment elevation myocardial infarction. Radiology 274(1):93–102CrossRefGoogle Scholar
  13. 13.
    Bodi V, Monmeneu JV, Ortiz-Perez JT et al (2016) Prediction of Reverse Remodeling at Cardiac MR Imaging Soon after First ST-Segment-Elevation Myocardial Infarction: Results of a Large Prospective Registry. Radiology 278(1):54–63CrossRefGoogle Scholar
  14. 14.
    Kim EK, Song YB, Chang SA et al (2017) Is cardiac magnetic resonance necessary for prediction of left ventricular remodeling in patients with reperfused ST-segment elevation myocardial infarction? Int J Cardiovasc Imaging 33(12):2003–2012CrossRefGoogle Scholar
  15. 15.
    Shetye A, Nazir SA, Squire IB, McCann GP (2015) Global myocardial strain assessment by different imaging modalities to predict outcomes after ST-elevation myocardial infarction: a systematic review. World J Cardiol 7(12):948–960CrossRefGoogle Scholar
  16. 16.
    Hor KN, Baumann R, Pedrizzetti G et al (2011) Magnetic resonance derived myocardial strain assessment using feature tracking. J Vis Exp 48:e2356Google Scholar
  17. 17.
    Khan JN, Singh A, Nazir SA, Kanagala P, Gershlick AH, McCann GP (2015) Comparison of cardiovascular magnetic resonance feature tracking and tagging for the assessment of left ventricular systolic strain in acute myocardial infarction. Eur J Radiol 84(5):840–848CrossRefGoogle Scholar
  18. 18.
    Yoon YE, Kang SH, Choi HM et al (2018) Prediction of infarct size and adverse cardiac outcomes by tissue tracking-cardiac magnetic resonance imaging in ST-segment elevation myocardial infarction. Eur Radiol 28(8):3454–3463CrossRefGoogle Scholar
  19. 19.
    Bolognese L, Neskovic AN, Parodi G et al (2002) Left ventricular remodeling after primary coronary angioplasty: patterns of left ventricular dilation and long-term prognostic implications. Circulation 106(18):2351–2357CrossRefGoogle Scholar
  20. 20.
    Hamirani YS, Wong A, Kramer CM, Salerno M (2014) Effect of microvascular obstruction and intramyocardial hemorrhage by CMR on LV remodeling and outcomes after myocardial infarction: a systematic review and meta-analysis. JACC Cardiovasc Imaging 7(9):940–952CrossRefGoogle Scholar
  21. 21.
    Truong VT, Safdar KS, Kalra DK et al (2017) Cardiac magnetic resonance tissue tracking in right ventricle: Feasibility and normal values. Magn Reson Imaging 38:189–195CrossRefGoogle Scholar
  22. 22.
    Scatteia A, Baritussio A, Bucciarelli-Ducci C (2017) Strain imaging using cardiac magnetic resonance. Heart Fail Rev 22(4):465–476CrossRefGoogle Scholar
  23. 23.
    Claus P, Omar AMS, Pedrizzetti G, Sengupta PP, Nagel E (2015) Tissue tracking technology for assessing cardiac mechanics: principles, normal values, and clinical applications. JACC Cardiovasc Imaging 8(12):1444–1460CrossRefGoogle Scholar
  24. 24.
    Joyce E, Hoogslag GE, Leong DP et al (2014) Association between left ventricular global longitudinal strain and adverse left ventricular dilatation after ST-segment-elevation myocardial infarction. Circ Cardiovasc Imaging 7(1):74–81CrossRefGoogle Scholar
  25. 25.
    Lacalzada J, de la Rosa A, Izquierdo MM et al (2015) Left ventricular global longitudinal systolic strain predicts adverse remodeling and subsequent cardiac events in patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Int J Cardiovasc Imaging 31(3):575–584CrossRefGoogle Scholar
  26. 26.
    Biere L, Donal E, Terrien G et al (2014) Longitudinal strain is a marker of microvascular obstruction and infarct size in patients with acute ST-segment elevation myocardial infarction. PLoS ONE 9(1):e86959CrossRefGoogle Scholar
  27. 27.
    Perazzolo Marra M, Lima JA, Iliceto S (2011) MRI in acute myocardial infarction. Eur Heart J 32(3):284–293CrossRefGoogle Scholar
  28. 28.
    Hadamitzky M, Langhans B, Hausleiter J et al (2014) Prognostic value of late gadolinium enhancement in cardiovascular magnetic resonance imaging after acute ST-elevation myocardial infarction in comparison with single-photon emission tomography using Tc99m-Sestamibi. Eur Heart J Cardiovasc Imaging 15(2):216–225CrossRefGoogle Scholar
  29. 29.
    Reiter T, Ritter O, Prince MR et al (2012) Minimizing risk of nephrogenic systemic fibrosis in cardiovascular magnetic resonance. J Cardiovasc Magn Reson 14:31CrossRefGoogle Scholar
  30. 30.
    Gavara J, Rodriguez-Palomares JF, Valente F et al (2018) Prognostic value of strain by tissue tracking cardiac magnetic resonance after ST-segment elevation myocardial infarction. JACC Cardiovasc Imaging 11(10):1448–1457CrossRefGoogle Scholar
  31. 31.
    Shetye AM, Nazir SA, Razvi NA et al (2017) Comparison of global myocardial strain assessed by cardiovascular magnetic resonance tagging and feature tracking to infarct size at predicting remodelling following STEMI. BMC Cardiovasc Disord 17(1):7CrossRefGoogle Scholar
  32. 32.
    Garg P, Kidambi A, Swoboda PP et al (2017) The role of left ventricular deformation in the assessment of microvascular obstruction and intramyocardial haemorrhage. Int J Cardiovasc Imaging 33(3):361–370CrossRefGoogle Scholar
  33. 33.
    Sutton MG, Sharpe N (2000) Left ventricular remodeling after myocardial infarction: pathophysiology and therapy. Circulation 101(25):2981–2988CrossRefGoogle Scholar
  34. 34.
    Hendriks T, Hartman MHT, Vlaar PJJ et al (2017) Predictors of left ventricular remodeling after ST-elevation myocardial infarction. Int J Cardiovasc Imaging 33(9):1415–1423CrossRefGoogle Scholar
  35. 35.
    Gotte MJ, Germans T, Russel IK et al (2006) Myocardial strain and torsion quantified by cardiovascular magnetic resonance tissue tagging: studies in normal and impaired left ventricular function. J Am Coll Cardiol 48(10):2002–2011CrossRefGoogle Scholar
  36. 36.
    Onishi T, Saha SK, Delgado-Montero A et al (2015) Global longitudinal strain and global circumferential strain by speckle-tracking echocardiography and feature-tracking cardiac magnetic resonance imaging: comparison with left ventricular ejection fraction. J Am Soc Echocardiogr 28(5):587–596CrossRefGoogle Scholar
  37. 37.
    Hor KN, Gottliebson WM, Carson C et al (2010) Comparison of magnetic resonance feature tracking for strain calculation with harmonic phase imaging analysis. JACC Cardiovasc Imaging 3(2):144–151CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of RadiologyChung-Ang University Hospital, Chung-Ang University College of MedicineSeoulSouth Korea
  2. 2.Department of RadiologySamsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Cardiovascular Imaging CenterSamsung Medical Center, Sungkyunkwan University School of MedicineSeoulSouth Korea

Personalised recommendations