ISMRM - SCMR Workshop
Tomas Lapinskas, MD, PhD
Professor
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Sofija G. Cieskaite, N/A
Meidical student
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Arnoldas Leleika, MD
Resident doctor
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Agneta Virbickiene, MD
Cardiologist
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Neda Jonaitiene, MD
Cardiologist
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Justina Jureviciute, MD
Cardiologist
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Paulius Bucius, MD
Cardiologist
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Lina Padervinskiene, MD
Radiologist
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Olivija Dobiliene, PhD
Professor
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Tomas Lapinskas, MD, PhD
Professor
Lithuanian University of Health Sciences, Kaunas, Lithuania, Lithuania
Acute ST-elevation myocardial infarction (STEMI) remains a relevant healthcare issue in modern and developing societies [1][2]. Cardiac magnetic resonance imaging (CMR) is an excellent modality in assessing left ventricular (LV) structural and functional changes in STEMI patients [2]. The LV haemodynamic forces (HDF) may allow a more comprehensive understanding of LV functional (systolic and diastolic) alterations during acute STEMI [3].
Methods:
CMR was conducted during the acute phase in STEMI patients. LV volumes, ejection fraction (LVEF), myocardial mass, and global longitudinal strain (GLS) were analyzed using QMass 8.1 and QStrain 3.2. Infarct size (IS) was measured using late gadolinium enhancement. HDF parameters, expressed as root mean square (RMS) of force amplitude, were measured during different phases of cardiac cycles: entire heartbeat (RMSapex-base), systole (RMSsystolic), systole to diastole (RMSsuction), and diastolic deceleration (RMSdeceleration). Data were analyzed using SPSS, with significance at p < 0.05.
Results:
STEMI patients had significantly higher LV end-diastolic volume (LVEDV: 83.03 ± 11.58 ml vs. 70.37 ± 16.81 ml, p < 0.001) and LV end-diastolic volume index (LVEDVi: 38.78 ± 13.21 ml/m² vs. 30.78 ± 6.55 ml/m², p = 0.007). LV end-systolic volume (LVESV) and LV end-systolic volume index (LVESVi) were also elevated in STEMI patients (LVESV: 58.72 ± 14.76 ml vs. 78.83 ± 28.31 ml, p = 0.002; LVESVi: 30.78 ± 6.55 ml/m² vs. 38.78 ± 13.21 ml/m², p = 0.007). LVEF and GLS were significantly reduced in STEMI patients (LVEF: 44.86 ± 11.67% vs. 63.00 ± 5.06%, p < 0.001; GLS: -15.61 ± 6.54% vs. -29.11 ± 4.02%, p < 0.001).
HDF analysis indicated LV dysfunction in STEMI patients with lower RMS values across different cycles: RMSapex-base (15.50 ± 6.20 vs. 25.97 ± 13.11, p < 0.001), RMSsystolic (25.35 ± 11.59 vs. 42.22 ± 23.02, p < 0.001), RMSsuction (9.30 ± 4.95 vs. 16.02 ± 6.59, p < 0.001), and RMSdeceleration (10.99 ± 30.24 vs. 13.25 ± 6.16, p < 0.001). Correlations were found between LVEF and RMSsystolic (r = 0.395, p < 0.001), RMSsuction (r = 0.322, p = 0.003), and RMSdeceleration (r = 0.228, p = 0.035). GLS correlated with RMSapex-base (r = -0.552, p < 0.001), RMSsystolic (r = -0.533, p < 0.001), RMSsuction (r = -0.324, p = 0.002), and RMSdeceleration (r = -0.324, p = 0.002). IS was correlated with RMSapex-base (r = -0.347, p = 0.001), RMSsystolic (r = -0.251, p = 0.020), and relative IS with RMSapex-base (r = -0.347, p = 0.001) and RMSsystolic (r = -0.301, p = 0.005).
Conclusion:
Stronger HDF is associated with better cardiac function, with RMSapex-base and RMSsystolic correlating with LVEF and GLS. Our findings suggest that HDF allow a more detailed assessment of LV performance in patients with acute STEMI.
