Can strain rate imaging predict recovery of contraction after acute myocardial infarction?
To assess whether strain rate imaging (SRI) can serve to evaluate myocardial viability in patients with acute coronary syndrome (ACS). In 23 patients with ACS, we measured longitudinal tissue Doppler strain and strain rate values from left ventricular basal, mid, and apical segments (n = 414). These...
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Published in | European journal of echocardiography Vol. 12; no. 5; pp. 364 - 371 |
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Format | Journal Article |
Language | English |
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01.05.2011
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Abstract | To assess whether strain rate imaging (SRI) can serve to evaluate myocardial viability in patients with acute coronary syndrome (ACS).
In 23 patients with ACS, we measured longitudinal tissue Doppler strain and strain rate values from left ventricular basal, mid, and apical segments (n = 414). These segments were grouped according to their acute end-systolic strain values (S(ES)) into those with normocontraction (S(ES)≤-13%), hypocontraction (S(ES) between -13 and -7%), and severe contraction abnormality (S(ES)>-7%). At 8 months, we evaluated the recovery of contraction: Segments with acutely severe contraction abnormality that improved their strain values to ≤-7% were defined as viable, and those that failed to do so as non-viable. In the acute phase, S(ES), post-systolic strain, as well as systolic, early, and late diastolic strain rate values were significantly better in the viable than in the non-viable segments. Post-systolic strain had the best AUC 0.78, and a cut-off value of -3.8% predicted recovery from severe contraction abnormality with a sensitivity of 85% and specificity of 62%. The transmurality of the infarction, assessed by magnetic resonance imaging with delayed enhancement, was significantly larger in the non-viable than in the viable segments (P = 0.006). Acute global S(ES) and systolic strain rate showed the best correlations with final global S(ES) and global infarction percentage after recovery.
SRI can serve to evaluate myocardial viability in patients with ACS, and to assess the recovery of segmental as well as global left ventricular function. |
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AbstractList | AIMSTo assess whether strain rate imaging (SRI) can serve to evaluate myocardial viability in patients with acute coronary syndrome (ACS).METHODS AND RESULTSIn 23 patients with ACS, we measured longitudinal tissue Doppler strain and strain rate values from left ventricular basal, mid, and apical segments (n = 414). These segments were grouped according to their acute end-systolic strain values (S(ES)) into those with normocontraction (S(ES)≤-13%), hypocontraction (S(ES) between -13 and -7%), and severe contraction abnormality (S(ES)>-7%). At 8 months, we evaluated the recovery of contraction: Segments with acutely severe contraction abnormality that improved their strain values to ≤-7% were defined as viable, and those that failed to do so as non-viable. In the acute phase, S(ES), post-systolic strain, as well as systolic, early, and late diastolic strain rate values were significantly better in the viable than in the non-viable segments. Post-systolic strain had the best AUC 0.78, and a cut-off value of -3.8% predicted recovery from severe contraction abnormality with a sensitivity of 85% and specificity of 62%. The transmurality of the infarction, assessed by magnetic resonance imaging with delayed enhancement, was significantly larger in the non-viable than in the viable segments (P = 0.006). Acute global S(ES) and systolic strain rate showed the best correlations with final global S(ES) and global infarction percentage after recovery.CONCLUSIONSRI can serve to evaluate myocardial viability in patients with ACS, and to assess the recovery of segmental as well as global left ventricular function. To assess whether strain rate imaging (SRI) can serve to evaluate myocardial viability in patients with acute coronary syndrome (ACS). In 23 patients with ACS, we measured longitudinal tissue Doppler strain and strain rate values from left ventricular basal, mid, and apical segments (n = 414). These segments were grouped according to their acute end-systolic strain values (S(ES)) into those with normocontraction (S(ES)≤-13%), hypocontraction (S(ES) between -13 and -7%), and severe contraction abnormality (S(ES)>-7%). At 8 months, we evaluated the recovery of contraction: Segments with acutely severe contraction abnormality that improved their strain values to ≤-7% were defined as viable, and those that failed to do so as non-viable. In the acute phase, S(ES), post-systolic strain, as well as systolic, early, and late diastolic strain rate values were significantly better in the viable than in the non-viable segments. Post-systolic strain had the best AUC 0.78, and a cut-off value of -3.8% predicted recovery from severe contraction abnormality with a sensitivity of 85% and specificity of 62%. The transmurality of the infarction, assessed by magnetic resonance imaging with delayed enhancement, was significantly larger in the non-viable than in the viable segments (P = 0.006). Acute global S(ES) and systolic strain rate showed the best correlations with final global S(ES) and global infarction percentage after recovery. SRI can serve to evaluate myocardial viability in patients with ACS, and to assess the recovery of segmental as well as global left ventricular function. |
Author | Kivistö, Sari M Lauerma, Kirsi Antila, Margareta Laine, Mika K Kylmälä, Minna M Toivonen, Lauri |
Author_xml | – sequence: 1 givenname: Minna M surname: Kylmälä fullname: Kylmälä, Minna M email: minna.kylmala@hus.fi organization: Division of Cardiology, Helsinki University Central Hospital, Haartmaninkatu 4, P.O.Box 340, 00029 HUS, Helsinki, Finland. minna.kylmala@hus.fi – sequence: 2 givenname: Margareta surname: Antila fullname: Antila, Margareta – sequence: 3 givenname: Sari M surname: Kivistö fullname: Kivistö, Sari M – sequence: 4 givenname: Kirsi surname: Lauerma fullname: Lauerma, Kirsi – sequence: 5 givenname: Lauri surname: Toivonen fullname: Toivonen, Lauri – sequence: 6 givenname: Mika K surname: Laine fullname: Laine, Mika K |
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CitedBy_id | crossref_primary_10_1007_s12574_020_00476_8 crossref_primary_10_1007_s00467_020_04862_3 crossref_primary_10_1016_j_ijcard_2020_02_039 crossref_primary_10_1111_echo_12476 crossref_primary_10_1007_s00467_012_2144_6 crossref_primary_10_1093_ckj_sfx056 crossref_primary_10_1016_j_echo_2013_11_014 crossref_primary_10_1002_jcu_22349 |
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Snippet | To assess whether strain rate imaging (SRI) can serve to evaluate myocardial viability in patients with acute coronary syndrome (ACS).
In 23 patients with ACS,... AIMSTo assess whether strain rate imaging (SRI) can serve to evaluate myocardial viability in patients with acute coronary syndrome (ACS).METHODS AND RESULTSIn... |
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SubjectTerms | Acute Coronary Syndrome - diagnostic imaging Acute Coronary Syndrome - pathology Aged Analysis of Variance Chest Pain Echocardiography, Doppler Female Heart Ventricles - diagnostic imaging Heart Ventricles - pathology Humans Male Middle Aged Myocardial Contraction Myocardial Infarction - diagnostic imaging Myocardial Infarction - pathology Myocardium - pathology ROC Curve Systole Time Factors |
Title | Can strain rate imaging predict recovery of contraction after acute myocardial infarction? |
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