| Predictive Value of Left Ventricular Remodeling by Area Strain Based on Three-Dimensional Wall-Motion Tracking after PCI in Patients with Recent NSTEMI. | |
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MedLine Citation:
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PMID: 22766116 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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We aimed to explore whether a novel left ventricular performance index, area strain (AS), based on three-dimensional wall-motion tracking (3-D-WMT) done before and after percutaneous coronary intervention (PCI) could predict left ventricular (LV) remodeling in patients with recent non-ST elevation myocardial infarction (NSTEMI). Sixty-one patients (53.6 ± 8.8 years) with recent NSTEMI were enrolled. Coronary angiography and PCI were undertaken for reperfusion. Parameters of myocardial deformation (including LV end-diastolic volume, LV end-systolic volume, LV ejection fraction, LV global and regional peak area strain) were measured by 3-D-WMT before and 1 week after reperfusion therapy. Six months after reperfusion, LV negative remodeling was defined as lack of improvement in LV function, with increase in LV end-diastolic volume ≥15%. Patients were subdivided into remodeled group (n = 25) and non-remodeled group (n = 36) at follow-up. Patients with negative LV remodeling had significantly higher cardiac troponin I (cTnI) levels at baseline (21.21 ± 12.22 vs. 15.56 ± 8.91 ng/mL; p = 0.0357), higher B-type natriuretic peptide (BNP) level (247.56 ± 177.39 vs. 170.53 ± 97.89 pg/mL; p = 0.0336) and reduced global AS (-27.9 ± 4.6% vs. -31.9 ± 4.3%; p = 0.001) than those without remodeling. Global AS at baseline had a significantly close correlation with cTnI level 36 h after MI (r = 0.71, p < 0.001). Moreover, a weak relationship was found between LV global AS at baseline and BNP level 24 h after myocardial infarction (r = 0.423, p < 0.001). By multivariate logistic regression analysis, lack of improvement of global AS 1 week after PCI was found to be a powerful independent predictor of negative LV remodeling at follow-up (OR = 1.41, 95% CI 1.28-3.27, p = 0.003). In particular, a global AS ≤32% (absolute value) showed a sensitivity and a specificity of 86.1% and 68.0% in predicting negative LV remodeling. These data suggest that AS could be used to assess myocardial global and regional LV function with good feasibility and repeatability. Global AS 1 week after PCI is a good independent predictor of negative LV remodeling after 6-month follow-up. |
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Authors:
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Xiu-Chang Li; Feng-Lin Jin; Cai Jing; Qiang Xiao; Yan Liu; Zhang-Shen Ran; Jia-Jun Zhang |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-3 |
Journal Detail:
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Title: Ultrasound in medicine & biology Volume: - ISSN: 1879-291X ISO Abbreviation: - Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0410553 Medline TA: Ultrasound Med Biol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, Affiliated Hospital of Taishan Medical University, Taian, P.R. China. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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