Mitral annular plane systolic excursion by cardiac MRI versus Global longitudinal strain analysis by speckle tracking echocardiography for prognostic assessment in ST-elevation myocardial infarction patients

Abstract

Background: Mitral annular plane systolic excursion (MAPSE) determined by Cardiac Magnetic Resonance (CMR) can predict poor outcomes following STEMI. Objectives: This study was performed to investigate the feasibility of CMR-derived MAPSE to predict major adverse cardiovascular events (MACE) in first time reperfused STEMI patients by primary percutaneous coronary intervention (pPCI) and to Compare its predictive value with speckle-tracking echocardiography- derived LV global longitudinal strain. Methods: LV Global longitudinal strain analysis by speckle tracking echocardiography and MAPSE assessment by cardiac MRI were performed in 70 reperfused first time STEMI patients by (pPCI) within 2 days after infarction. One year follow up registration for MACE was done. Results: Patients with MACE (n = 12, 17.1%, median follow-up 1 year) showed significantly lower MAPSE and lower LV GLS in comparison to those without MACE (6.25±1.1 mm vs. 9.67±1.6 mm, p < 0.001) , (10.4 ±1.1% vs. 13.6±1.9 %, p < 0.001) respectively .Reduced MAPSE (<7 mm, optimal cut-off value by c-statistics) and reduced LV GLS (< 11%, optimal cut-off value by c-statistics) was associated with increased incidence of MACE The MAPSE AUC for the MACE prediction was 0.96 that was significantly higher than that of LV GLS Conclusions Reduced MAPSE measured by CINE CMR independently predicts long term prognosis following STEMI. Additionally, MAPSE had a greater predictive value compared to GLS analysis by speckle tracking echocardiography. Key Points: •After STEMI, the longterm prognosis is independently predicted by MAPSE assessed by CMR.