1. New Echocardiographic Parameters of Global and Regional Left Ventricular Function in
Patients with ST- segment Elevation Acute Myocardial Infarction
K. Hristova 1, Tz. Katova 1, J. D’ Hooge 2
1 Department of Noninvasive Functional Diagnostic and Imaging National Heart Hospital, Sofia, Bulgaria Cardiac Medical Imaging Research Center, Catholic University , Leuven, Belgium
Results:
At 36h, LVS, LVSR ,LVT and LVUR were significantly reduced in both AMI groups when compared to normals( Tabl.1)
At 4mFU, both AMI groups showed recovery in EF and reduction in IS (7.24±10.07 vs ±13.9, p< for inferior AMI and13.13 ± 10.3 vs ± 15, p <0.0001, for anterior AMI).
LVS, LVSR, LVT and LVUR increased significantly, but remained below normal levels. LVS and LVSR are significant reduced in infarcted zones, but in zones out from ischemia are closely to the normals.
LVSLL is the main parameter for myocardial dysfunction, which changed significantly in infracted zone (p <0,001).
Background:
Left ventricular (LV) functional recovery and morphological remodeling after acute myocardial infarction (AMI) followed by reperfusion remains incompletely understood. The aim of the study was to describe the recovery of LV strain (LVS), strain rate (LVSR), twist (LVT) and untwist rate (LVUR) upon revascularization after AMI using 2-dimensional tissue tracking.
Methods:
Were evaluated 88 subjects:
22 normal volunteers (mean age 31 y± 5),
66 patients with AMI (mean age 65 y± 12 ), 40 pts- anterior AMI.
Echocardiography Apical and basal short axis images were acquired (frame rate 82± 5 frames/s) in addition to apical four, three and two chamber views, within 36 h (baseline) after revascularization (PCI) and after 4 months All images were analyzed offline in order to extract the segmental strain (rate) values and the LV torsion (rate) curve.
The infarct size (IS) was estimated based on MRI delayed enhancement and expressed as a percentage of the total LV volume.
Normals
AMI-ant
AMI-inf
LVT_bl
12.3±3.2
3.43±2.4*
5.03±1.2*
LVT_FU
9.8±3.2
10.0±2.3
LVUR-bl
88.2±24
34.0±5.1*
41.7±11.6*
LVUR_FU
56.1±5.3
66.8±2.15
text
Global
Strain i
Normals
(1)
AMI-anterior
(2)
AMI- inferior
(3)
Srr_bl
51.6±4.9
37.2±7.5*
39.9±4.8*
Srr_FU
47.0±13*
45.3±10*
Scc_bl
20.9±0.7
11.2±2.0*
13.9±4.2*
Scc_FU
16.4±3.0*
18.9±2.7
Sll_bl
19.7±1.8
7.25±3.5*
9.81±1.9*
Sll_FU
13.5±2.7*
15.4±1.7*
Tabl.1Results of Global Strain at baseline and 4mFU
* Significances b/n normal and AMI group
Correlation of LVT and LVUR with IS was significantly, but week ( r=0.34 and r=0.34 respectively). In addition, a fair correlation of LVT with EF (r=0.64) and LVS and LVSR ( r=0.56 ) with IS and a weak correlation of LVUR with EDV (r=-0.34) was found.
Conclusion:
LVT and LVUR might be good parameters to monitor the recovery of global LV function after treatment. Ultrasound Strain Rate/ Strain imaging can be used for analysis of regional longitudinal and radial deformation in patients with AMI and are good performance for regional LV function.
 EUROECHO 2010