Left atrial mechanics in patients with acute STEMI and secondary mitral regurgitation: A prospective pilot CMR feature tracking study
Abstract
:1. Introduction
2. Materials and methods
2.1. Study population
2.2. Cardiac magnetic resonance
2.3. Volumetric analysis
2.4. Feature tracking
2.5. Statistical analysis
3. Results
4. Discussion
- LV volumes are significantly larger in patients with MR, whereas LV ejection fraction is similar when compared with those without MR.
- LA volumes and emptying fractions are similar in both groups and do not show early changes in LA myocardial deformation in patients with acute STEMI and secondary MR.
- LA reservoir, passive and active strain are significantly higher in patients with MR, but only peak early negative strain rate exhibits substantial augmentation.
- Study demonstrates excellent interobserver and intraobserver reproducibility for all LA strain and strain rate values.
4.1. Limitations
5. Conclusions
Conflict of interest
Appendix A. Supplementary data
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Phasic function | Equation |
---|---|
LA reservoir function | |
LAEVtotal, mL | LAmaximal–LAminimal |
LAEFtotal, % | (LAmaximal–LAminimal)/LAmaximal |
LA conduit function | |
LAEVpassive, mL | LAmaximal–LAprecontraction |
LAEFpassive (%) | (LAmaximal–LAprecontraction)/ |
LAmaximal | |
LA contratile function | |
LAEVactive, mL | LAprecontraction–LAminimal |
LAEFactive, % | (LAprecontraction–LAminimal)/ |
LAprecontraction |
Characteristic | MR(−) | MR(+) | P |
---|---|---|---|
group | group | ||
(n = 10) | (n = 10) | ||
Demographics | |||
Age | 62.90 ± 8.62 | 59.70 ± 11.17 | 0.48 |
Male gender, n (%) | 5 (50) | 7 (70) | 0.39 |
BMI, kg/m2 | 29.50 ± 4.49 | 28.14 ± 5.49 | 0.55 |
Left ventricular volumetric parameters | |||
LVEDV, mL/m2 | 64.70 ± 13.78 | 86.22 ± 20.50 | 0.01 |
LVESV, mL/m2 | 24.28 ± 5.08 | 34.87 ± 9.52 | 0.01 |
LVSV, ml/m2 | 40.42 ± 9.12 | 51.36 ± 11.81 | 0.03 |
LVEF, % | 62.34 ± 2.94 | 59.69 ± 3.20 | 0.07 |
Left atrial volumetric parameters | |||
LAEVtotal, mL/m2 | 19.91 ± 7.52 | 26.26 ± 8.94 | 0.17 |
LAEVpassive, mL/m2 | 9.54 ± 6.06 | 15.04 ± 6.89 | 0.11 |
LAEVactive, mL/m2 | 10.37 ± 4.05 | 11.22 ± 4.48 | 0.65 |
LAEFtotal, % | 55.27 ± 9.64 | 55.91 ± 11.47 | 0.90 |
LAEFpassive, % | 24.92 ± 8.93 | 30.91 ± 7.93 | 0.13 |
LAEFactive, % | 40.21 ± 12.77 | 36.28 ± 14.51 | 0.53 |
Parameter | MR(−) group | MR(+) group | P |
---|---|---|---|
εs, % | 27.67 ± 10.25 | 32.80 ± 6.95 | 0.01 |
εe, % | 15.29 ± 7.30 | 19.22 ± 6.04 | 0.01 |
εa, % | 12.38 ± 4.23 | 14.44 ± 5.19 | 0.03 |
SRs, s−1 | 1.10 ± 0.39 | 1.12 ± 0.28 | 0.55 |
SRe, s−1 | −0.57 ± 0.24 | −0.70 ± 0.20 | 0.01 |
SRa, s−1 | –1.15 ± 0.35 | –1.09 ± 0.38 | 0.56 |
Parameter | Mean | Limits of | ICC |
---|---|---|---|
difference ± SD | agreement | (95% CI) | |
εs, % | −0.05 ± 3.12 | −6.17 to 6.07 | 0.97 (0.94 to 0.98) |
εe, % | −0.11 ± 2.90 | −5.80 to 5.57 | 0.96 (0.92 to 0.98) |
εa, % | −0.84 ± 4.24 | −9.14 to 7.46 | 0.76 (0.54 to 0.87) |
SRs, s−1 | 0.00 ± 0.20 | −0.38 to 0.39 | 0.91 (0.83 to 0.95) |
SRe, s−1 | 0.00 ± 0.13 | −0.25 to 0.26 | 0.92 (0.84 to 0.96) |
SRa, s−1 | 0.00 ± 0.13 | −0.26 to 0.26 | 0.97 (0.94 to 0.98) |
Parameter | Mean | Limits of | ICC |
---|---|---|---|
difference ± SD | agreement | (95% CI) | |
εs, % | −0.29 ± 1.39 | −3.01 to 2.44 | 0.99 (0.99 to 1.00) |
εe, % | −0.07 ± 1.68 | −3.37 to 3.23 | 0.99 (0.97 to 1.00) |
εa, % | −0.23 ± 1.10 | −2.39 to 1.94 | 0.98 (0.95 to 0.99) |
SRs, s−1 | −0.02 ± 0.09 | −0.19 to 0.16 | 0.98 (0.95 to 0.99) |
SRe, s−1 | 0.01 ± 0.08 | −0.14 to 0.15 | 0.97 (0.93 to 0.99) |
SRa, s−1 | 0.00 ± 0.22 | –0.43 to 0.44 | 0.79 (0.47 to 0.92) |
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Lapinskas, T.; Bučius, P.; Urbonaitė, L.; Stabinskaitė, A.; Valuckienė, Ž.; Jankauskaitė, L.; Benetis, R.; Žaliūnas, R. Left atrial mechanics in patients with acute STEMI and secondary mitral regurgitation: A prospective pilot CMR feature tracking study. Medicina 2017, 53, 11-18. https://doi.org/10.1016/j.medici.2017.02.001
Lapinskas T, Bučius P, Urbonaitė L, Stabinskaitė A, Valuckienė Ž, Jankauskaitė L, Benetis R, Žaliūnas R. Left atrial mechanics in patients with acute STEMI and secondary mitral regurgitation: A prospective pilot CMR feature tracking study. Medicina. 2017; 53(1):11-18. https://doi.org/10.1016/j.medici.2017.02.001
Chicago/Turabian StyleLapinskas, Tomas, Paulius Bučius, Laura Urbonaitė, Agnieta Stabinskaitė, Živilė Valuckienė, Lina Jankauskaitė, Rimantas Benetis, and Remigijus Žaliūnas. 2017. "Left atrial mechanics in patients with acute STEMI and secondary mitral regurgitation: A prospective pilot CMR feature tracking study" Medicina 53, no. 1: 11-18. https://doi.org/10.1016/j.medici.2017.02.001