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Riffel, Johannes H.; Siry, Deborah; Salatzki, Janek; Andre, Florian; Ochs, Marco; Weberling, Lukas D.; Giannitsis, Evangelos; Katus, Hugo A.; Friedrich, Matthias G.

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

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  • Media type: E-Article
  • Title: Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain
  • Contributor: Riffel, Johannes H.; Siry, Deborah; Salatzki, Janek; Andre, Florian; Ochs, Marco; Weberling, Lukas D.; Giannitsis, Evangelos; Katus, Hugo A.; Friedrich, Matthias G.
  • Published: Public Library of Science (PLoS), 2021
  • Published in: PLOS ONE, 16 (2021) 5, Seite e0251040
  • Language: English
  • DOI: 10.1371/journal.pone.0251040
  • ISSN: 1932-6203
  • Origination:
  • Footnote:
  • Description: <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methods and results</jats:title> <jats:p>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&lt;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&lt;0.05 for all comparisons).</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Conclusion</jats:title> <jats:p>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.</jats:p> </jats:sec>
  • Access State: Open Access