Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain

• Verfasst von: Riffel, Johannes [VerfasserIn]
• Verfasst von: Siry, Deborah [VerfasserIn]
• Verfasst von: Salatzki, Janek [VerfasserIn]
• Verfasst von: André, Florian [VerfasserIn]
• Verfasst von: Ochs, Marco [VerfasserIn]
• Verfasst von: Weberling, Lukas D. [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Friedrich, Matthias [VerfasserIn]
• Titel: Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain
• Verf.angabe: Johannes H. Riffel, Deborah Siry, Janek Salatzki, Florian Andre, Marco Ochs, Lukas D. Weberling, Evangelos Giannitsis, Hugo A. Katus, Matthias G. Friedrich
• E-Jahr: 2021
• Jahr: May 3, 2021
• Umfang: 16 S.
• Fussnoten: Gesehen am 21.06.2021
• Titel Quelle: Enthalten in: PLOS ONE
• Ort Quelle: San Francisco, California, US : PLOS, 2006
• Jahr Quelle: 2021
• Band/Heft Quelle: 16(2021), 5, Artikel-ID e0251040, Seite 1-16
• ISSN Quelle: 1932-6203
• DOI: doi:10.1371/journal.pone.0251040
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Angiography
• Sach-SW: Coronary heart disease
• Sach-SW: Deformation
• Sach-SW: Electrocardiography
• Sach-SW: Medical risk factors
• Sach-SW: Myocardial infarction
• Sach-SW: Pain
• Sach-SW: Troponin
• K10plus-PPN: 1760906921

Abstract

Background Cardiovascular magnetic resonance (CMR) is the current reference standard for the quantitative assessment of ventricular function. Fast Strain-ENCoded (fSENC)-CMR imaging allows for the assessment of myocardial deformation within a single heartbeat. The aim of this pilot study was to identify obstructive coronary artery disease (oCAD) with fSENC-CMR in patients presenting with new onset of chest pain. Methods and results In 108 patients presenting with acute chest pain, we performed fSENC-CMR after initial clinical assessment in the emergency department. The final clinical diagnosis, for which cardiology-trained physicians used clinical information, serial high-sensitive Troponin T (hscTnT) values and—if necessary—further diagnostic tests, served as the standard of truth. oCAD was defined as flow-limiting CAD as confirmed by coronary angiography with typical angina or hscTnT dynamics. Diagnoses were divided into three groups: 0: non-cardiac, 1: oCAD, 2: cardiac, non-oCAD. The visual analysis of fSENC bull´s eye maps (blinded to final diagnosis) resulted in a sensitivity of 82% and specificity of 87%, as well as a negative predictive value of 96% for identification of oCAD. Both, global circumferential strain (GCS) and global longitudinal strain (GLS) accurately identified oCAD (area under the curve/AUC: GCS 0.867; GLS 0.874; p<0.0001 for both), outperforming ECG, hscTnT dynamics and EF. Furthermore, the fSENC analysis on a segmental basis revealed that the number of segments with impaired strain was significantly associated with the patient´s final diagnosis (p<0.05 for all comparisons). Conclusion In patients with acute chest pain, myocardial strain imaging with fSENC-CMR may serve as a fast and accurate diagnostic tool for ruling out obstructive coronary artery disease.