Number of segments with motion abnormalities is better correlated with infarct size in acute myocardial infarction

Abstract

Background The relationship between the number of segments with motion abnormalities (SMA) on the bull’s-eye plots of speckle-tracking echocardiography (STE) and myocardial infarct size (MIS) on late gadolinium-enhanced cardiac MRI (LGE-cMRI) has not been well characterized. This study aimed to determine MIS using the number of SMA in patients with acute myocardial infarction (MI). Methods Left ventricular two-dimensional STE and LGE-cMRI were performed in 380 patients with ST-segment elevation MI within 48 h and 5–6 days after primary percutaneous intervention, respectively. Results Patients with impaired global and regional myocardial strain, work and greater number of SMA had significantly larger infarcts (P < 0.05). Multivariate logistic regression analysis that included myocardial strain, work, and number of SMA showed that total number of SMA [odds ratio (OR) = 1.976; 95% confidence interval (CI): 1.539–2.538, P < 0.0001], the number of segments with paradoxalic systolic movements (SPSM, OR = 3.703; 95% CI: 2.112–6.493, P < 0.0001) were independent risk factors of large MIS (>19%). The area under receiver operating characteristic curve (AUC) of 0.904 (0.866~0.942) for total number of SMA was superior to that for global longitudinal strain (GLS, AUC = 0.813, 0.761~0.865), global work efficiency (GWE, AUC = 0.794, 0.730~0.857) and number of SPSM (AUC = 0.851, 0.804–0.899) to predict a large MIS (P < 0.05). The optimal cutoff value of total number of SMA was 7, with a sensitivity of 85.31%, a specificity of 81.48%, and an accuracy of 83.27%. Conclusion Total number of SMA is better associated with infarct size, which provided an incremental prognostic value above established prognostic parameters such as GLS and GWE.

Clinical study of two‐dimensional speckle tracking to evaluate abnormal myocardial motion due to coronary lesions

“…Local myocardial function can be rapidly assessed by displaying strain on a polar plot generated from 3 standard apical views 26 . The bull's‐eye view allows easy and rapid assessment of the regional distribution of myocardial necrosis by direct observation of local LS and allows inference of the site of the lesion based on the physiological distribution of the coronary arteries 27 . Local LS can be used for the differential diagnosis of ACS and other myocardial lesions, for example, fragmentation syndrome in which the bull's‐eye view shows a lesion involving only the apical region, and in acute myocarditis in which the damaged area of the bull's‐eye view does not correspond to the typical coronary distribution localization 28 .…”

Myocardial work is independent risk factor for coronary artery lesions in children with Kawasaki disease

“…As previously described [16,19], the measurement of myocardial work was executed offline on the commercially available GE software (EchoPAC version 203) with the AFI function. Myocardial work and related indices were calculated from a combination of 2D LV GLS data acquired by 2D STE and a noninvasively estimated LV pressure curve.…”