Evaluation of left atrial myocardial deformation in patients with acute MR after STEMI using CMR feature tracking

  • Tomas Lapinskas
  • Laura Urbonaite
  • Paulius Bucius
  • Augustinas P Fedaravicius
  • Agnieta Stabinskaite
  • Marta Ejsmont
  • Antanas Jankauskas
  • Remigijus Zaliunas
Open Access
Poster presentation

Keywords

Cardiac Magnetic Resonance Left Atrium Feature Tracking Active Strain Myocardial Deformation 

Background

Left atrium (LA) is an important predictor of cardiovascular morbidity and mortality. Data related to LA functional changes during acute MR after ST-segment elevation myocardial infarction (STEMI) are limited. CMR is rapidly evolving imaging modality and feature tracking becomes very promising technique for assessment of myocardial deformation. The aim of this study was to investigate LA functional changes during acute MR in patients with STEMI using cardiac magnetic resonance (CMR) feature tracking.

Methods

A total of 30 participants (mean age 59 years; 70% male) were enrolled into the study and underwent CMR at 1.5 Tesla (Siemens Magnetom Aera). LA volumetric and myocardial deformation parameters were obtained from two- and four-chamber b-SSFP cine images. LA strain (passive strain (εe), corresponding to atrial conduit phase, active strain (εa), corresponding to atrial booster pump phase and total strain (εs), corresponding to atrial reservoir phase) and SR (peak positive strain rate (SRs), corresponding to atrial reservoir phase, peak early negative strain rate (SRe), corresponding to atrial conduit phase and peak late negative strain rate (SRa), corresponding to atrial booster pump phase) were calculated.

Results

All LA strain parameters were significantly increased in mild MR patients, but not in moderate MR or controls (total strain (εs): mild MR 34.1% ± 6.6, moderate MR 25.7% ± 6.7, controls 25.0% ± 8.1, p < 0.01; passive strain (εe): mild MR 18.1% ± 3.8, moderate MR 13.8% ± 5.5, controls 12.6% ± 5.7, p < 0.05; and active strain (εa): mild MR 16.0% ± 4.7, moderate MR 11.8% ± 3.7, controls 12.3% ± 3.2, p < 0.05). LA strain rate parameters did not reach statistical significance. Intraclass correlation coefficient analysis revealed strong interobserver agreement for all LA strain and strain rate parameters.

Conclusions

LA longitudinal deformation is enhanced during acute MR in patients with STEMI, but only when MR is mild. CMR feature tracking is highly reproducible, less time consuming and potentially valuable tool for clinical and research applications.
Table 1

Comparison of LA strain (ε) and strain rate (SR) parameters MR population and controls

  

Controls (n = 10)

Mild MR (n = 10)

Moderate MR (n = 10)

P value

Left atrial function

Left atrial strain (%)

    

Reservoir

εs

25.0 (8.1)

34.1 (6.6)

25.7 (6.7)

0.009

Conduit

εe

12.6 (5.7)

18.1 (3.8)

13.8 (5.5)

0.026

Booster pump

εa

12.3 (3.2)

16.0 (4.7)

11.8 (3.7)

0.041

 

Left atrial strain rate (s-1)

    

Reservoir

SRs

1.1 (0.2)

1.2 (0.1)

1.0 (0.2)

0.093

Conduit

SRe

-0.5 (0.2)

-0.7 (0.1)

-0.6 (0.2)

0.104

Booster pump

SRa

-1.0 (0.2)

-1.1 (0.4)

-0.9 (0.3)

0.738

ε, strain; SR, strain rate; MR, mitral regurgitation. Bold p values indicate a significance level <0.05.

Copyright information

© Lapinskas et al. 2016

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • Tomas Lapinskas
    • 1
  • Laura Urbonaite
    • 1
  • Paulius Bucius
    • 2
  • Augustinas P Fedaravicius
    • 2
  • Agnieta Stabinskaite
    • 1
  • Marta Ejsmont
    • 2
  • Antanas Jankauskas
    • 3
  • Remigijus Zaliunas
    • 1
  1. 1.Department of CardiologyLithuanian University of Health SciencesKaunasLithuania
  2. 2.Faculty of MedicineLithuanian University of Health SciencesKaunasLithuania
  3. 3.Department of RadiologyLithuanian University of Health SciencesKaunasLithuania

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