ArticleJACC. Cardiovascular imaging2023
Pathophysiology of LV Remodeling Following STEMI: A Longitudinal Diffusion Tensor CMR Study.
Article in JACC. Cardiovascular imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 23 citations in OpenAlex.
- Post-MI Remodeling Mechanics of Left Ventricle: Microstructure-Informed Models, Identifiability, and Uncertainty for Patient-Specific Prediction.Bioengineering (Basel, Switzerland) · 2026Review
- The Role of Inflammation and Immunity in Cardiovascular Disease: Molecular Mechanisms and Therapeutic Targets.MedComm · 2026Review
- Promises and challenges of AI-enabled methods for myocardial characterisation in cardiovascular magnetic resonance.Frontiers in cardiovascular medicine · 2026Review
- Prediction of adverse left ventricular remodeling by culprit lesion features in patients with LAD-related myocardial infarction.Scientific reports · 2025Article
- Trimethylamine N-Oxide as a Biomarker for Left Ventricular Diastolic Dysfunction and Functional Remodeling After STEMI.International journal of molecular sciences · 2025Observational
- Outlier detection in cardiac diffusion tensor imaging: Shot rejection or robust fitting?Medical image analysis · 2025Article
- Prognostic value of the BAB index and a machine learning model integrating the BAB index for predicting mortality in acute ST-segment elevation.Frontiers in nutrition · 2025Article
- Multi-center investigation of cardiac diffusion tensor imaging in healthy volunteers by the Society of Cardiovascular Magnetic Resonance Cardiac Diffusion Special Interest Group NETwork (SIGNET).Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025Observational
- Deep learning-based diffusion tensor cardiac magnetic resonance reconstruction: a comparison study.Scientific reports · 2024Article
- Development and validation of cardiac diffusion weighted magnetic resonance imaging for the diagnosis of myocardial injury in small animal models.Scientific reports · 2024Article
- Cardiovascular magnetic resonance imaging-derived intraventricular pressure gradients in ST-segment elevation myocardial infarction: a long-term follow-up study.European heart journal. Imaging methods and practice · 2024Article
- Potential utility of SPECT/CT with 99mTc-Tektrotyd for imaging of post-myocardial infarction inflammation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Motion-compensated spin-echo cardiac diffusion tensor imaging in multiple cardiac phases using an ultrahigh gradient strength scanner.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic ResonanceArticle
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11 authors at 2 institutions in 2 countries.
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Abstract
backgroundAdverse LV remodeling post-ST-segment elevation myocardial infarction (STEMI) is associated with a poor prognosis, but the underlying mechanisms are not fully understood. Diffusion tensor (DT)-cardiac magnetic resonance (CMR) allows in vivo characterization of myocardial architecture and provides unique mechanistic insight into pathophysiologic changes following myocardial infarction.
objectivesThis study evaluated the potential associations between DT-CMR performed soon after STEMI and long-term adverse left ventricular (LV) remodeling following STEMI.
methodsA total of 100 patients with STEMI underwent CMR at 5 days and 12 months post-reperfusion. The protocol included DT-CMR for assessing fractional anisotropy (FA), secondary eigenvector angle (E2A) and helix angle (HA), cine imaging for assessing LV volumes, and late gadolinium enhancement for calculating infarct and microvascular obstruction size. Adverse remodeling was defined as a 20% increase in LV end-diastolic volume at 12 months.
resultsA total of 32 patients experienced adverse remodeling at 12 months. Compared with patients without adverse remodeling, they had lower FA (0.23 ± 0.03 vs 0.27 ± 0.04; P < 0.001), lower E2A (37 ± 6° vs 51 ± 7°; P < 0.001), and, on HA maps, a lower proportion of myocytes with right-handed orientation (RHM) (8% ± 5% vs 17% ± 9%; P < 0.001) in their acutely infarcted myocardium. On multivariable logistic regression analysis, infarct FA (odds ratio [OR]: <0.01; P = 0.014) and E2A (OR: 0.77; P = 0.001) were independent predictors of adverse LV remodeling after adjusting for left ventricular ejection fraction (LVEF) and infarct size. There were no significant changes in infarct FA, E2A, or RHM between the 2 scans.
conclusionsExtensive cardiomyocyte disorganization (evidenced by low FA), acute loss of sheetlet angularity (evidenced by low E2A), and a greater loss of organization among cardiomyocytes with RHM, corresponding to the subendocardium, can be detected within 5 days post-STEMI. These changes persist post-injury, and low FA and E2A are independently associated with long-term adverse remodeling.
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