Prediction of infarct size by speckle tracking echocardiography in patients with anterior myocardial infarction

Grabka, Marek; Wita, Krystian; Tabor, Z.; Paraniak-Gieszczyk, Barbara; Chmurawa, Jarosław; Elżbieciak, Marek; Bochenek, Tomasz; Doruchowska-Raczek, Anika; Trusz‐Gluza, Maria

doi:10.1097/mca.0b013e32835b6798

Cited by 15 publications

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“…Our study confirmed GLS’s value as a marker of infarct size in AMI patients, as evaluated by CMR at 3 months. We studied strain parameters in the three main axes (radial, longitudinal, and circumferential), whereas most other published studies were chiefly focused on longitudinal strain alone [36]. Reproducibility and feasibility of GLS have been well-established in the AMI setting [5], [6], [34], [35], [39], which underlines the parameter’s value as a prognostic tool.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Strain Is a Marker of Microvascular Obstruction and Infarct Size in Patients with Acute ST-Segment Elevation Myocardial Infarction

et al. 2014

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ObjectivesWe assessed the value of speckle tracking imaging performed early after a first ST-segment elevation myocardial infarction (STEMI) in order to predict infarct size and functional recovery at 3-month follow-up.Methods44 patients with STEMI who underwent revascularization within 12 h of symptom onset were prospectively enrolled. Echocardiography was performed 3.9±1.2 days after myocardial reperfusion, assessing circumferential (CGS), radial (RGS), and longitudinal global (GLS) strains. Late gadolinium-enhanced cardiac magnetic imaging (CMR), for assessing cardiac function, infarct size, and microvascular obstruction (MVO), was conducted 5.6±2.5 days and 99.4±4.6 days after myocardial reperfusion.ResultsGLS was evaluable in 97% of the patients, while CGS and RGS could be assessed in 85%. Infarct size significantly correlated with GLS (R = 0.601, p<0.001), RGS (R = −0.405, p = 0.010), CGS (R = 0.526, p = 0.001), ejection fraction (R = −0.699, p<0.001), wall motion score index (WMSI) (R = 0.539, p = 0.001), and left atrial volume (R = 0.510, p<0.001). Baseline ejection fraction and GLS were independent predictors of 3-month infarct size. MVO mass significantly correlated with GLS (R = 0.376, p = 0.010), WMSI (R = 0.387, p = 0.011), and ejection fraction (R = −0.389, p = 0.011). In multivariate analysis, GLS was the only independent predictor of MVO mass (p = 0.015). Longitudinal strain >−6.0% within the infarcted area exhibited 96% specificity and 61% sensitivity for predicting the persistence of akinesia (≥3 segments) at 3-month follow-up.ConclusionsSpeckle-tracking strain imaging performed early after a STEMI is easy-to-use as a marker for persistent akinetic territories at 3 months. In addition, GLS correlated significantly with MVO and final infarct size, both parameters being relevant post-MI prognostic factors, usually obtained via CMR.

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Section: Discussionmentioning

confidence: 99%

Longitudinal Strain Is a Marker of Microvascular Obstruction and Infarct Size in Patients with Acute ST-Segment Elevation Myocardial Infarction

et al. 2014

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“…Our observed associations between strain and MI size build upon prior studies conducted in smaller cohorts. Among 39 patients with anterior MI, Grabka et al reported GLS to correlate with CMR‐evidenced MI size ( r = .68, P = .001). That study, however, compared echo (performed 6 days post‐MI) to CMR performed 3 months afterward, prohibiting direct comparisons of imaging tests performed at near identical post‐MI time points.…”

Section: Discussionmentioning

confidence: 82%

“…[9][10][11] Strain has also been shown to yield improved agreement with volumetric chamber quantification as provided by well-validated techniques such as CMR. 12,13 Pilot studies have shown global strain to moderately correlate with MI size, 14,15 although these studies have been limited by small sample size and wide variations in interval between echo and CMR. Moreover, regional strain impairment has yet to be tested against CMR-quantified regional MI size and functional indices.…”

Section: Introductionmentioning

confidence: 99%

Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus

et al. 2017

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Background Myocardial strain provides a novel means of quantifying subtle alterations in contractile function; incremental utility post‐MI is unknown. Objectives To test longitudinal—quantified by postprocessing routine echo—for assessment of MI size measured by cardiac magnetic resonance (CMR) and conventional methods, and assess regional and global strain (GLS) as markers of LV thrombus. Methods The population comprised of patients with anterior ST‐segment MI who underwent echo and CMR prospectively. Preexisting echoes were retrieved, re‐analyzed for strain, and compared to conventional MI markers as well as CMR‐evidenced MI, function, and thrombus. Results Seventy‐four patients underwent echo and CMR 4 ± 1 weeks post‐MI; 72% had abnormal GLS. CMR‐quantified MI size was 2.5‐fold larger and EF lower among patients with abnormal GLS, paralleling 2.6–3.1 fold differences in Q‐wave size and CPK (all P ≤ .002). GLS correlated with CMR‐quantified MI (r = .66), CPK (r = .52) and Q‐wave area (r = .44; all P ≤ .001): Regional strain was lower in the base, mid, and apical LV among patients with CMR‐defined transmural MI in each territory (P < .05) and correlated with cine‐CMR regional EF (r = .53–.71; P < .001) and echo wall motion (r = .45–.71; P < .001). GLS and apical strain were ~2‐fold lower among patients with LV thrombus (P ≤ .002): Apical strain yielded higher diagnostic performance for thrombus (AUC: 0.83 [0.72–0.93], P = .001) than wall motion (0.73 [0.58–0.88], P = .02), as did global strain (0.78 [0.65–0.90], P = .005) compared to LVEF (0.58 [0.45–0.72], P = .41). Conclusions Echo‐quantified longitudinal strain provides a marker of MI size and improves stratification for post‐MI LV thrombus beyond conventional indices.

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“…GLS, GCS or GRS was not different between patients with or without LV remodeling. The association between GLS and infarct size has been studied recently [23–27]. Sjoli et al investigated GLS after revascularization in 39 patients with STEMI and treated with thrombolysis [26].…”

Section: Discussionmentioning

confidence: 99%

Two-Dimensional Speckle Tracking Echocardiography Predict Left Ventricular Remodeling after Acute Myocardial Infarction in Patients with Preserved Ejection Fraction

et al. 2016

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ObjectivesLeft ventricular remodeling after acute myocardial infarction increases cardiovascular events and mortality. But few study was done in patients with preserved ejection fraction (EF > 40%). We investigate whether the strain and strain rate by 2D speckle tracking echocardiography could predict left ventricular remodeling after acute myocardial infarction in this cohort.MethodsThe 83 patients (average age 60.7 ± 12.3 y, 75 [90.4%] male) with new-onset acute myocardial infarction receiving echocardiography immediately, and 6 months after admission were grouped by the presence or absence of left ventricular remodeling. Strain and strain rate including longitudinal, circumferential, and radial direction were calculated. The average of strain and strain rate of which segmental longitudinal strains > – 15% were defined as the injury longitudinal strain (InjLS).ResultsLeft ventricular remodeling occurred in 24 of 83 patients (28.9%). In univariate logistic regression analyses, gender, peak CK-MB, log BNP, use of statin before discharge, wall motion score index, and InjLS were significantly associated with left ventricular remodeling (p < 0.05). In multivariate analysis using the forward stepwise method, gender, CK-MB, and InjLS were independent predictors. The hazard ratio for InjLS was 1.48 (p = 0.04). Receiver operating characteristic curve (ROC) analyses showed the area under the curve (AUC) of InjLS was largest (AUC = 0.75, cut-off value = –11.7%, sensitivity = 81%, specificity = 71%, p < 0.01). In ST-segment elevation myocardial infarction subgroup, InjLS was the only predictor according to ROC analysis (AUC = 0.79, p < 0.01, cut-off value = –11.4%, sensitivity = 88%, specificity = 77%) and multivariate logistic regression analysis (hazard ratio = 1.88, 95% CI: 1.22–2.88, p < 0.01).ConclusionsInjLS was an excellent predictor for left ventricular remodeling after acute myocardial infarction in patient with preserved ejection fraction.

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Prediction of infarct size by speckle tracking echocardiography in patients with anterior myocardial infarction

Abstract: STE seems to be a very promising tool in the prediction of infarct size in patients with anterior STEMI.

Cited by 15 publications

References 0 publications

Longitudinal Strain Is a Marker of Microvascular Obstruction and Infarct Size in Patients with Acute ST-Segment Elevation Myocardial Infarction

Longitudinal Strain Is a Marker of Microvascular Obstruction and Infarct Size in Patients with Acute ST-Segment Elevation Myocardial Infarction

Echocardiography‐quantified myocardial strain—a marker of global and regional infarct size that stratifies likelihood of left ventricular thrombus

Two-Dimensional Speckle Tracking Echocardiography Predict Left Ventricular Remodeling after Acute Myocardial Infarction in Patients with Preserved Ejection Fraction

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