Prognostic utility of global longitudinal strain in myocardial infarction

Cardiovascular magnetic resonance(CMR) represents the reference standard for cardiac morphology and function assessment. Since introduction in 2009, CMR feature tracking(CMR-FT) has become a frequently used tool in the assessment of myocardial deformation and wall motion on the basis of routinely acquired b-SSFP cine images. Extensive validation has led to excellent intra-and inter-observer as well as inter-study reproducibility. CMR-FT derived myocardial deformation indices such as left ventricular(LV) strain have been shown to be impaired in cardiac diseases such as cardiomyopathies as well as myocardial infarction. Although LV ejection fraction(LVEF) is the routinely and frequently utilized parameter for systolic myocardial function assessment and major adverse clinical event(MACE) prediction, it fails to assess regional differences. Recently, LV strain has emerged as a superior measure for risk assessment and MACE prediction as compared to the established markers e.g., LVEF. This editorial aims to elucidate current discussions in the field of strain assessment in myocardial infarction in the light of recent data from a large prospective multicentre CMR study.

Left atrial physiology and pathophysiology:Role of deformation imaging

The left atrium(LA) acts as a modulator of left ventricular(LV) filling. Although there is considerable evidence to support the use of LA maximum and minimum volumes for disease prediction,theoretical considerations and a growing body of literature suggest to focus on the quantification of the three basic LA functions:(1) Reservoir function:collection of pulmonary venous return during LV systole;(2) Conduit function:passage of blood to the left ventricle during early LV diastole; and(3) Contractile booster pump function(augmentation of ventricular filling during late LV diastole. Tremendous advances in our ability to non-invasively characterize all three elements of atrial function include speckle tracking echocardiography(STE),and more recently cardiovascular magnetic resonance myocardial feature tracking(CMR-FT). Corresponding imaging biomarkers are increasingly recognized to have incremental roles in determining prognosis and risk stratification in cardiac dysfunction of different origins. The current editorial introduces the role of STE and CMR-FT for the functional assessment of LA deformation as determined by strain and strain rate imaging and provides an outlook of how this exciting field may develop in the future.

Role of cardiac magnetic resonance imaging in troponinemia syndromes

Cardiac magnetic resonance imaging(MRI)is an evolving technology,proving to be a highly accurate tool for quantitative assessment.Most recently,it has been increasingly used in the diagnostic and prognostic evaluation of conditions involving an elevation in troponin or troponinemia.Although an elevation in troponin is a nonspecific marker of myocardial tissue damage,it is a frequently ordered investigation leaving many patients without a specific diagnosis.Fortunately,the advent of newer cardiac MRI protocols can provide additional information.In this review,we discuss several conditions associated with an elevation in troponin such as myocardial infarction,myocarditis,Takotsubo cardiomyopathy,coronavirus disease 2019 related cardiac dysfunction and athlete’s heart syndrome.