{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:43:34Z","timestamp":1790275414366,"version":"4.1.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T00:00:00Z","timestamp":1620000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005971","name":"Deutsche Herzstiftung","doi-asserted-by":"publisher","award":["K\/31\/19"],"award-info":[{"award-number":["K\/31\/19"]}],"id":[{"id":"10.13039\/501100005971","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nCardiovascular magnetic resonance (CMR) is the current reference standard for the quantitative assessment of ventricular function. Fast Strain-ENCoded (fSENC)-CMR imaging allows for the assessment of myocardial deformation within a single heartbeat. The aim of this pilot study was to identify obstructive coronary artery disease (oCAD) with fSENC-CMR in patients presenting with new onset of chest pain.<\/jats:p>\n<\/jats:sec>\n\nMethods and results<\/jats:title>\nIn 108 patients presenting with acute chest pain, we performed fSENC-CMR after initial clinical assessment in the emergency department. The final clinical diagnosis, for which cardiology-trained physicians used clinical information, serial high-sensitive Troponin T (hscTnT) values and\u2014if necessary\u2014further diagnostic tests, served as the standard of truth. oCAD was defined as flow-limiting CAD as confirmed by coronary angiography with typical angina or hscTnT dynamics. Diagnoses were divided into three groups: 0: non-cardiac, 1: oCAD, 2: cardiac, non-oCAD. The visual analysis of fSENC bull\u00b4s eye maps (blinded to final diagnosis) resulted in a sensitivity of 82% and specificity of 87%, as well as a negative predictive value of 96% for identification of oCAD. Both, global circumferential strain (GCS) and global longitudinal strain (GLS) accurately identified oCAD (area under the curve\/AUC: GCS 0.867; GLS 0.874; p<0.0001 for both), outperforming ECG, hscTnT dynamics and EF. Furthermore, the fSENC analysis on a segmental basis revealed that the number of segments with impaired strain was significantly associated with the patient\u00b4s final diagnosis (p<0.05 for all comparisons).<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nIn patients with acute chest pain, myocardial strain imaging with fSENC-CMR may serve as a fast and accurate diagnostic tool for ruling out obstructive coronary artery disease.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0251040","type":"journal-article","created":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T17:32:03Z","timestamp":1620063123000},"page":"e0251040","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5430-8930","authenticated-orcid":true,"given":"Johannes H.","family":"Riffel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Siry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janek","family":"Salatzki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Andre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ochs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas D.","family":"Weberling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Giannitsis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo A.","family":"Katus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias G.","family":"Friedrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,5,3]]},"reference":[{"issue":"2","key":"pone.0251040.ref001","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1136\/hrt.2003.027599","article-title":"The health care burden of acute chest pain","volume":"91","author":"S Goodacre","year":"2005","journal-title":"Heart"},{"issue":"2","key":"pone.0251040.ref002","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"B Ibanez","year":"2018","journal-title":"European heart journal"},{"issue":"3","key":"pone.0251040.ref003","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/eurheartj\/ehv320","article-title":"2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC)","volume":"37","author":"M Roffi","year":"2016","journal-title":"Eur Heart J"},{"issue":"7","key":"pone.0251040.ref004","doi-asserted-by":"crossref","first-page":"23C","DOI":"10.1016\/0002-9149(87)90192-5","article-title":"The ischemic cascade: temporal sequence of hemodynamic, electrocardiographic and symptomatic expressions of ischemia","volume":"59","author":"RW Nesto","year":"1987","journal-title":"The American journal of cardiology"},{"issue":"1","key":"pone.0251040.ref005","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1177\/2048872618819421","article-title":"Serial high-sensitivity cardiac troponin T measurements to rule out acute myocardial infarction and a single high baseline measurement for swift rule-in: A systematic review and meta-analysis","volume":"9","author":"M Arslan","year":"2020","journal-title":"European heart journal Acute cardiovascular care"},{"issue":"10","key":"pone.0251040.ref006","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1080\/14779072.2019.1675514","article-title":"High-sensitivity troponin assays: development and utility in a modern health-care system","volume":"17","author":"G Fitzgerald","year":"2019","journal-title":"Expert review of cardiovascular therapy"},{"issue":"11","key":"pone.0251040.ref007","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/j.amjcard.2005.07.057","article-title":"Efficacy of myocardial contrast echocardiography in the diagnosis and risk stratification of acute coronary syndrome","volume":"96","author":"DH Kang","year":"2005","journal-title":"The American journal of cardiology"},{"issue":"5","key":"pone.0251040.ref008","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.echo.2014.01.019","article-title":"Early assessment of strain echocardiography can accurately exclude significant coronary artery stenosis in suspected non-ST-segment elevation acute coronary syndrome","volume":"27","author":"T Dahlslett","year":"2014","journal-title":"Journal of the American Society of Echocardiography: official publication of the American Society of Echocardiography"},{"issue":"3","key":"pone.0251040.ref009","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1007\/s00392-015-0916-2","article-title":"Myocardial deformation by strain echocardiography identifies patients with acute coronary syndrome and non-diagnostic ECG presenting in a chest pain unit: a prospective study of diagnostic accuracy","volume":"105","author":"J Schroeder","year":"2016","journal-title":"Clinical research in cardiology: official journal of the German Cardiac Society"},{"issue":"4","key":"pone.0251040.ref010","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1007\/s000590050031","article-title":"Quantification of right and left ventricular function by cardiovascular magnetic resonance","volume":"25","author":"NG Bellenger","year":"2000","journal-title":"Herz"},{"issue":"5","key":"pone.0251040.ref011","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1161\/CIRCULATIONAHA.108.811547","article-title":"Cardiovascular magnetic resonance","volume":"121","author":"DJ Pennell","year":"2010","journal-title":"Circulation"},{"issue":"2","key":"pone.0251040.ref012","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1002\/mrm.1195","article-title":"Imaging longitudinal cardiac strain on short-axis images using strain-encoded MRI","volume":"46","author":"NF Osman","year":"2001","journal-title":"Magnetic resonance in medicine"},{"key":"pone.0251040.ref013","article-title":"A multi-vendor, multi-center study on reproducibility and comparability of fast strain-encoded cardiovascular magnetic resonance imaging","author":"J Erley","year":"2020","journal-title":"The international journal of cardiovascular imaging"},{"issue":"2","key":"pone.0251040.ref014","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1373\/clinchem.2009.132654","article-title":"Analytical validation of a high-sensitivity cardiac troponin T assay","volume":"56","author":"E Giannitsis","year":"2010","journal-title":"Clinical chemistry"},{"issue":"3","key":"pone.0251040.ref015","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1016\/j.ijcard.2013.01.255","article-title":"A prospective validation of the HEART score for chest pain patients at the emergency department","volume":"168","author":"BE Backus","year":"2013","journal-title":"Int J Cardiol"},{"key":"pone.0251040.ref016","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1532-429X-16-2","article-title":"T1-mapping in the heart: accuracy and precision","volume":"16","author":"P Kellman","year":"2014","journal-title":"J Cardiovasc Magn Reson"},{"issue":"4","key":"pone.0251040.ref017","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1161\/hc0402.102975","article-title":"Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association","volume":"105","author":"MD Cerqueira","year":"2002","journal-title":"Circulation"},{"issue":"2","key":"pone.0251040.ref018","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1161\/CIRCIMAGING.108.789032","article-title":"Strain-encoded MRI for evaluation of left ventricular function and transmurality in acute myocardial infarction","volume":"2","author":"M Neizel","year":"2009","journal-title":"Circ Cardiovasc Imaging"},{"issue":"1","key":"pone.0251040.ref019","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1148\/radiology.143.1.7063747","article-title":"The meaning and use of the area under a receiver operating characteristic (ROC) curve","volume":"143","author":"JA Hanley","year":"1982","journal-title":"Radiology"},{"issue":"7","key":"pone.0251040.ref020","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1093\/eurheartj\/ehq481","article-title":"Assessment of cardiac ischaemia and viability: role of cardiovascular magnetic resonance","volume":"32","author":"J Schwitter","year":"2011","journal-title":"European heart journal"},{"issue":"4","key":"pone.0251040.ref021","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1161\/01.CIR.0000047527.11221.29","article-title":"Detecting acute coronary syndrome in the emergency department with cardiac magnetic resonance imaging","volume":"107","author":"RY Kwong","year":"2003","journal-title":"Circulation"},{"issue":"10","key":"pone.0251040.ref022","doi-asserted-by":"crossref","first-page":"101801","DOI":"10.1103\/PhysRevLett.116.101801","article-title":"Measurement of the ZZ Production Cross Section in pp Collisions at sqrt[s] = 13 TeV with the ATLAS Detector","volume":"116","author":"G Aad","year":"2016","journal-title":"Phys Rev Lett"},{"issue":"2","key":"pone.0251040.ref023","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1002\/mrm.20770","article-title":"Real-time imaging of regional myocardial function using fast-SENC","volume":"55","author":"L Pan","year":"2006","journal-title":"Magnetic resonance in medicine"},{"issue":"4","key":"pone.0251040.ref024","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1159\/000381856","article-title":"Acute One-Stop Cardiovascular Magnetic Resonance Imaging for Differential Diagnosis in Patients with Acute Coronary Syndrome and Unobstructed Coronary Arteries","volume":"24","author":"G Chu","year":"2015","journal-title":"Medical principles and practice: international journal of the Kuwait University, Health Science Centre"},{"key":"pone.0251040.ref025","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12968-016-0225-6","article-title":"Role of cardiovascular magnetic resonance in the guidelines of the European Society of Cardiology","volume":"18","author":"F von Knobelsdorff-Brenkenhoff","year":"2016","journal-title":"J Cardiovasc Magn Reson"},{"issue":"11","key":"pone.0251040.ref026","doi-asserted-by":"crossref","first-page":"210","DOI":"10.4330\/wjc.v10.i11.210","article-title":"Clinical applications of feature-tracking cardiac magnetic resonance imaging","volume":"10","author":"D Muser","year":"2018","journal-title":"World J Cardiol"},{"issue":"4","key":"pone.0251040.ref027","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jcct.2016.06.002","article-title":"Triple rule-out computed tomography for risk stratification of patients with acute chest pain","volume":"10","author":"MK Chae","year":"2016","journal-title":"Journal of cardiovascular computed tomography"},{"key":"pone.0251040.ref028","article-title":"2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation","author":"JP Collet","year":"2020","journal-title":"Eur Heart J"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0251040","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,3]],"date-time":"2021-05-03T17:32:46Z","timestamp":1620063166000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0251040"}},"subtitle":[],"editor":[{"given":"Otavio R.","family":"Coelho-Filho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,5,3]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,3]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0251040","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,3]]}}}