Document Detail


Myocardial Deformation Imaging by Two-Dimensional Speckle-Tracking Echocardiography for Prediction of Global and Segmental Functional Changes after Acute Myocardial Infarction: A Comparison with Late Gadolinium Enhancement Cardiac Magnetic Resonance.
MedLine Citation:
PMID:  24368027     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Myocardial deformation analysis by speckle-tracking echocardiography (STE) has been shown to accurately predict viability in patients with chronic ischemic left ventricular (LV) dysfunction. The aim of this study was to evaluate two-dimensional STE for the prediction of global and segmental LV functional changes after acute myocardial infarction (AMI) in comparison with late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR).
METHODS: In 93 patients (mean age, 60 ± 11 years) with first AMIs (55 with ST-segment elevation myocardial infarctions and 38 with non-ST-segment elevation myocardial infarctions) treated with acute percutaneous coronary intervention, global peak longitudinal strain was determined to describe global function by STE, and peak systolic circumferential and longitudinal strain was determined for segmental function analysis. LGE CMR was performed to define the amounts of global and segmental myocardial scar. STE and LGE CMR were performed within 48 hours of AMI. At 6-month follow-up, transthoracic echocardiography was repeated to determine global und segmental LV recovery and adverse LV remodeling (increase in end-systolic volume > 15%).
RESULTS: Accuracy to predict global functional improvement as well as LV remodeling at 6-month follow-up after AMI was similar for STE and LGE CMR (areas under the curve, 0.715 vs 0.729 [P = .8830] and 0.806 vs 0.824 [P = .7141], respectively). Peak systolic circumferential strain < -14.2% had sensitivity of 71.6% and specificity of 58.1% to predict segmental functional improvement. Compared with LGE CMR, the predictive accuracy of transmural STE for segmental functional improvement at 6-month follow-up was lower (area under the curve, 0.788 vs 0.668; P = .0001). Predictive accuracy for segmental functional improvement could be improved by analysis of endocardial circumferential strain (area under the curve, 0.700 vs 0.668 for transmural speckle-tracking echocardiographic analysis; P = .0023).
CONCLUSIONS: Two-dimensional STE allows the prediction of global functional recovery as well as LV remodeling after AMI with accuracy comparable with that of LGE CMR. Accuracy to predict segmental functional recovery using transmural deformation analysis by two-dimensional STE is inferior compared with LGE CMR but can be improved by a layer-specific analysis of endocardial deformation.
Authors:
Ertunc Altiok; Sonja Tiemann; Michael Becker; Ralf Koos; Christian Zwicker; Jörg Schroeder; Nils Kraemer; Felix Schoth; Dan Adam; Zvi Friedman; Nikolaus Marx; Rainer Hoffmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-12-21
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  -     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
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