JCMR 2020; 22:44. Left ventricular functional recovery of infarcted and remote myocardium after ST-segment elevation myocardial infarction (METOCARD-CNIC randomized clinical trial substudy) (CME)

Purpose/ Objective

The evolution of LV strain after STEMI within infarcted and remote myocardium has not yet been investigated with feature-tracking CMR. Accordingly, the present sub-analysis of the METOCARD-CNIC trial evaluated the changes in regional LV peak circumferential strain with feature tracking CMR at 1 week and at 6 months after STEMI. Specifically, the effects of the early intravenous metoprolol treatment, microvascular obstruction, intramyocardial hemorrhage and adverse LV remodeling on the evolution of infarct and remote zone strain were investigated.

This activity covers recently developed sequences based on the concepts of black-blood PSIR. It also covers novel image reconstruction strategies that allow scan acceleration and respiratory motion compensation. By combining these acquisition and reconstruction techniques it is possible to obtain high-resolution 3D whole-heart images for simultaneous visualization of cardiac anatomy, coronary arteries and myocardial infarction.

Readers of this article will improve their knowledge by gaining several important insights into the role of feature-tracking CMR to investigate the evolution of the infarct zone and the remote zone circumferential strain in STEMI patients.


Learning Objectives

Readers of this article will get new insights into the evolution of regional LV systolic function (in terms of circumferential LV strain) after STEMI:

  1. Early intravenous metoprolol has a long-lasting cardioprotective effect on the infarct zone circumferential strain and no significant effect on the remote zone circumferential strain.
  2. The infarct zone circumferential strain is significantly impaired in patients with MVO and IMH, but it improves between 1 week and 6 months after STEMI regardless of the presence of MVO or IMH.
  3. In patients with adverse LV remodeling, defined as ≥20% increase in LV end-diastolic volume, the infarct zone circumferential strain improves but the remote zone circumferential strain worsens between 1 week and 6 months after STEMI.


Accreditation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


Credit Designation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Instructions for Claiming CME

  • Read and fully comprehend the article
  • Complete the post-activity evaluation
  • A certificate of completion will be available once the evaluation is submitted


Financial Disclosures


Disclosure of Commercial Support
The planners and faculty for this activity did not have any relationships to disclose.


Please see the bibliography at the end of the journal article.

Course Information
Course Date:
December 10, 2020
Article 22:44.
Individual topic purchase: Selected
Accreditation Council For Continuing Medical Education
Total General Hours: 1.00
SCMR Member Price:$0.00
Non-Member Price:$10.00