Assessment of Myocardial Contractile Function Using Global and Segmental Circumferential Strain following Intracoronary Stem Cell Infusion after Myocardial Infarction: MRI Feature Tracking Feasibility Study
Background. Magnetic resonance imaging (MRI) strain analysis is a sensitive method to assess myocardial function. Our objective was to define the feasibility of MRI circumferential strain ( ) analysis in assessing subtle changes in myocardial function following stem cell therapy. Methods and Results. Patients in the Amorcyte Phase I trial were randomly assigned to treatment with either autologous bone-marrow-derived stem cells infused into the infarct-related artery 5 to 11 days following primary PCI or control. MRI studies were obtained at baseline, 3, and 6 months. was measured in the short axis views at the base, mid and apical slices of the left ventricle (LV) for each patient (13 treatments and 10 controls). Mid-anterior LV improved between baseline ？ and 3 months ？ , . There were no significant changes in at 3 months and 6 months compared to baseline for other segments. There was excellent intraobserver and interobserver agreement for basal and mid circumferential strain. Conclusion. MRI segmental strain analysis is feasible in assessment of regional myocardial function following cell therapy with excellent intra- and inter-observer variability's. Using this method, a modest interval change in segmental was detected in treatment group. 1. Introduction Circumferential strain ( ) analysis is an established method to assess myocardial function. has been demonstrated to detect changes in myocardial contractility across a variety of cardiac conditions including hypertensive [1] or hypertrophic cardiomyopathy [2] and Duchenne muscular dystrophy [3] before changes in left ventricular ejection fraction (LVEF) are observed. Cell therapy offers a promising approach for regeneration of damaged vascular and cardiac tissue after acute myocardial infarction (MI) [4–8]. The Amorcyte trial evaluated effect of autologous bone marrow derived CD34+ cell therapy on LVEF and myocardial perfusion [9]. Significant improvement in myocardial perfusion and a trend towards improvement in LV ejection fraction were reported. Because the changes seen in systolic function are modest and by design regional, the more sensitive myocardial strain techniques offer an attractive option for analyzing these results. Accordingly, we evaluated the feasibility of MRI-derived segmental analysis in patients treated with cell therapy following primary intervention for ST-segment elevation myocardial infarction (STEMI), using the feature tracking (FT) technique. The FT technique was previously validated for assessment against harmonic phase imaging (HARP) [10] and subsequently utilized for
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