Left atrial function with MRI enables prediction of cardiovascular events after myocardial infarction: Insights from the AIDA STEMI and TatorT NSTEMI trials

Andreas Schuster, Sören J. Backhaus, Thomas Stiermaier, Jenny Lou Navarra, Johannes Uhlig, Karl Philipp Rommel, Alexander Koschalka, Johannes T. Kowallick, Joachim Lotz, Matthias Gutberlet, Boris Bigalke, Shelby Kutty, Gerd Hasenfuss, Holger Thiele, Ingo Eitel

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The role of left atrial (LA) performance in acute myocardial infarction (AMI) remains controversial. Cardiac MRI myocardial feature tracking (hereafter, MRI-FT) is a method used to quantify myocardial function that enables reliable assessment of atrial function. Purpose: To assess the relationship between LA function assessed with MRI-FT and major adverse cardiovascular events (MACE) after AMI. Materials and Methods: This secondary analysis of two prospective multicenter cardiac MRI studies (AIDA STEMI [NCT00712101] and TATORT NSTEMI [NCT01612312]) included 1235 study participants with ST-elevation myocardial infarction (n = 795) or non–ST-elevation myocardial infarction (n = 440) between July 2008 and June 2013. All study participants underwent primary percutaneous coronary intervention. MRI-FT analyses were performed in a core laboratory by researchers blinded to clinical status to determine LA performance using LA reservoir function peak systolic strain (´s), LA conduit strain (´e), and LA booster pump function active strain (´a). The relationship of LA performance to a MACE within 12 months after AMI was evaluated by using Cox proportional hazards models and area under the receiver operating characteristic curve (AUC). Results: Study participants with MACE had worse LA performance parameters compared with study participants without MACE (´s = 21.2% vs 16.2%, ´e = 8.8% vs 6.9%, ´a = 11.8% vs 10%; P , .001 for all). All atrial parameters were strongly associated with MACE (hazard ratio [HR], ´s = 0.9, ´e = 0.88, ´a = 0.89; P , .001 for all). For ´s, a cutoff of 18.8% was identified as the only independent atrial parameter with which to predict MACE after accounting for confounders and established prognostic markers in adjusted analysis (HR, 0.95; P = .02). The ´s yielded incremental prognostic value above left ventricular ejection fraction, global longitudinal strain, microvascular obstruction, and infarct size (AUC comparisons, P , .04 for all). Conclusion: Feature tracking of cardiac MRI to derive left atrial peak reservoir strain provided incremental prognostic value for major adverse cardiovascular events prediction versus established cardiac risk factors after acute myocardial infarction.

Original languageEnglish (US)
Pages (from-to)292-302
Number of pages11
JournalRadiology
Volume293
Issue number2
DOIs
StatePublished - Jan 1 2019

Fingerprint

Left Atrial Function
Myocardial Infarction
Area Under Curve
Atrial Function
Percutaneous Coronary Intervention
Proportional Hazards Models
ROC Curve
Stroke Volume
Research Personnel
Non-ST Elevated Myocardial Infarction
ST Elevation Myocardial Infarction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Left atrial function with MRI enables prediction of cardiovascular events after myocardial infarction : Insights from the AIDA STEMI and TatorT NSTEMI trials. / Schuster, Andreas; Backhaus, Sören J.; Stiermaier, Thomas; Navarra, Jenny Lou; Uhlig, Johannes; Rommel, Karl Philipp; Koschalka, Alexander; Kowallick, Johannes T.; Lotz, Joachim; Gutberlet, Matthias; Bigalke, Boris; Kutty, Shelby; Hasenfuss, Gerd; Thiele, Holger; Eitel, Ingo.

In: Radiology, Vol. 293, No. 2, 01.01.2019, p. 292-302.

Research output: Contribution to journalArticle

Schuster, A, Backhaus, SJ, Stiermaier, T, Navarra, JL, Uhlig, J, Rommel, KP, Koschalka, A, Kowallick, JT, Lotz, J, Gutberlet, M, Bigalke, B, Kutty, S, Hasenfuss, G, Thiele, H & Eitel, I 2019, 'Left atrial function with MRI enables prediction of cardiovascular events after myocardial infarction: Insights from the AIDA STEMI and TatorT NSTEMI trials', Radiology, vol. 293, no. 2, pp. 292-302. https://doi.org/10.1148/radiol.2019190559
Schuster, Andreas ; Backhaus, Sören J. ; Stiermaier, Thomas ; Navarra, Jenny Lou ; Uhlig, Johannes ; Rommel, Karl Philipp ; Koschalka, Alexander ; Kowallick, Johannes T. ; Lotz, Joachim ; Gutberlet, Matthias ; Bigalke, Boris ; Kutty, Shelby ; Hasenfuss, Gerd ; Thiele, Holger ; Eitel, Ingo. / Left atrial function with MRI enables prediction of cardiovascular events after myocardial infarction : Insights from the AIDA STEMI and TatorT NSTEMI trials. In: Radiology. 2019 ; Vol. 293, No. 2. pp. 292-302.
@article{d6e53b58b32147eb8a571fc1d2213756,
title = "Left atrial function with MRI enables prediction of cardiovascular events after myocardial infarction: Insights from the AIDA STEMI and TatorT NSTEMI trials",
abstract = "Background: The role of left atrial (LA) performance in acute myocardial infarction (AMI) remains controversial. Cardiac MRI myocardial feature tracking (hereafter, MRI-FT) is a method used to quantify myocardial function that enables reliable assessment of atrial function. Purpose: To assess the relationship between LA function assessed with MRI-FT and major adverse cardiovascular events (MACE) after AMI. Materials and Methods: This secondary analysis of two prospective multicenter cardiac MRI studies (AIDA STEMI [NCT00712101] and TATORT NSTEMI [NCT01612312]) included 1235 study participants with ST-elevation myocardial infarction (n = 795) or non–ST-elevation myocardial infarction (n = 440) between July 2008 and June 2013. All study participants underwent primary percutaneous coronary intervention. MRI-FT analyses were performed in a core laboratory by researchers blinded to clinical status to determine LA performance using LA reservoir function peak systolic strain (´s), LA conduit strain (´e), and LA booster pump function active strain (´a). The relationship of LA performance to a MACE within 12 months after AMI was evaluated by using Cox proportional hazards models and area under the receiver operating characteristic curve (AUC). Results: Study participants with MACE had worse LA performance parameters compared with study participants without MACE (´s = 21.2{\%} vs 16.2{\%}, ´e = 8.8{\%} vs 6.9{\%}, ´a = 11.8{\%} vs 10{\%}; P , .001 for all). All atrial parameters were strongly associated with MACE (hazard ratio [HR], ´s = 0.9, ´e = 0.88, ´a = 0.89; P , .001 for all). For ´s, a cutoff of 18.8{\%} was identified as the only independent atrial parameter with which to predict MACE after accounting for confounders and established prognostic markers in adjusted analysis (HR, 0.95; P = .02). The ´s yielded incremental prognostic value above left ventricular ejection fraction, global longitudinal strain, microvascular obstruction, and infarct size (AUC comparisons, P , .04 for all). Conclusion: Feature tracking of cardiac MRI to derive left atrial peak reservoir strain provided incremental prognostic value for major adverse cardiovascular events prediction versus established cardiac risk factors after acute myocardial infarction.",
author = "Andreas Schuster and Backhaus, {S{\"o}ren J.} and Thomas Stiermaier and Navarra, {Jenny Lou} and Johannes Uhlig and Rommel, {Karl Philipp} and Alexander Koschalka and Kowallick, {Johannes T.} and Joachim Lotz and Matthias Gutberlet and Boris Bigalke and Shelby Kutty and Gerd Hasenfuss and Holger Thiele and Ingo Eitel",
year = "2019",
month = "1",
day = "1",
doi = "10.1148/radiol.2019190559",
language = "English (US)",
volume = "293",
pages = "292--302",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Left atrial function with MRI enables prediction of cardiovascular events after myocardial infarction

T2 - Insights from the AIDA STEMI and TatorT NSTEMI trials

AU - Schuster, Andreas

AU - Backhaus, Sören J.

AU - Stiermaier, Thomas

AU - Navarra, Jenny Lou

AU - Uhlig, Johannes

AU - Rommel, Karl Philipp

AU - Koschalka, Alexander

AU - Kowallick, Johannes T.

AU - Lotz, Joachim

AU - Gutberlet, Matthias

AU - Bigalke, Boris

AU - Kutty, Shelby

AU - Hasenfuss, Gerd

AU - Thiele, Holger

AU - Eitel, Ingo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The role of left atrial (LA) performance in acute myocardial infarction (AMI) remains controversial. Cardiac MRI myocardial feature tracking (hereafter, MRI-FT) is a method used to quantify myocardial function that enables reliable assessment of atrial function. Purpose: To assess the relationship between LA function assessed with MRI-FT and major adverse cardiovascular events (MACE) after AMI. Materials and Methods: This secondary analysis of two prospective multicenter cardiac MRI studies (AIDA STEMI [NCT00712101] and TATORT NSTEMI [NCT01612312]) included 1235 study participants with ST-elevation myocardial infarction (n = 795) or non–ST-elevation myocardial infarction (n = 440) between July 2008 and June 2013. All study participants underwent primary percutaneous coronary intervention. MRI-FT analyses were performed in a core laboratory by researchers blinded to clinical status to determine LA performance using LA reservoir function peak systolic strain (´s), LA conduit strain (´e), and LA booster pump function active strain (´a). The relationship of LA performance to a MACE within 12 months after AMI was evaluated by using Cox proportional hazards models and area under the receiver operating characteristic curve (AUC). Results: Study participants with MACE had worse LA performance parameters compared with study participants without MACE (´s = 21.2% vs 16.2%, ´e = 8.8% vs 6.9%, ´a = 11.8% vs 10%; P , .001 for all). All atrial parameters were strongly associated with MACE (hazard ratio [HR], ´s = 0.9, ´e = 0.88, ´a = 0.89; P , .001 for all). For ´s, a cutoff of 18.8% was identified as the only independent atrial parameter with which to predict MACE after accounting for confounders and established prognostic markers in adjusted analysis (HR, 0.95; P = .02). The ´s yielded incremental prognostic value above left ventricular ejection fraction, global longitudinal strain, microvascular obstruction, and infarct size (AUC comparisons, P , .04 for all). Conclusion: Feature tracking of cardiac MRI to derive left atrial peak reservoir strain provided incremental prognostic value for major adverse cardiovascular events prediction versus established cardiac risk factors after acute myocardial infarction.

AB - Background: The role of left atrial (LA) performance in acute myocardial infarction (AMI) remains controversial. Cardiac MRI myocardial feature tracking (hereafter, MRI-FT) is a method used to quantify myocardial function that enables reliable assessment of atrial function. Purpose: To assess the relationship between LA function assessed with MRI-FT and major adverse cardiovascular events (MACE) after AMI. Materials and Methods: This secondary analysis of two prospective multicenter cardiac MRI studies (AIDA STEMI [NCT00712101] and TATORT NSTEMI [NCT01612312]) included 1235 study participants with ST-elevation myocardial infarction (n = 795) or non–ST-elevation myocardial infarction (n = 440) between July 2008 and June 2013. All study participants underwent primary percutaneous coronary intervention. MRI-FT analyses were performed in a core laboratory by researchers blinded to clinical status to determine LA performance using LA reservoir function peak systolic strain (´s), LA conduit strain (´e), and LA booster pump function active strain (´a). The relationship of LA performance to a MACE within 12 months after AMI was evaluated by using Cox proportional hazards models and area under the receiver operating characteristic curve (AUC). Results: Study participants with MACE had worse LA performance parameters compared with study participants without MACE (´s = 21.2% vs 16.2%, ´e = 8.8% vs 6.9%, ´a = 11.8% vs 10%; P , .001 for all). All atrial parameters were strongly associated with MACE (hazard ratio [HR], ´s = 0.9, ´e = 0.88, ´a = 0.89; P , .001 for all). For ´s, a cutoff of 18.8% was identified as the only independent atrial parameter with which to predict MACE after accounting for confounders and established prognostic markers in adjusted analysis (HR, 0.95; P = .02). The ´s yielded incremental prognostic value above left ventricular ejection fraction, global longitudinal strain, microvascular obstruction, and infarct size (AUC comparisons, P , .04 for all). Conclusion: Feature tracking of cardiac MRI to derive left atrial peak reservoir strain provided incremental prognostic value for major adverse cardiovascular events prediction versus established cardiac risk factors after acute myocardial infarction.

UR - http://www.scopus.com/inward/record.url?scp=85073576948&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073576948&partnerID=8YFLogxK

U2 - 10.1148/radiol.2019190559

DO - 10.1148/radiol.2019190559

M3 - Article

C2 - 31526253

AN - SCOPUS:85073576948

VL - 293

SP - 292

EP - 302

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -